CT Nursing Home Demanding More Money, State Uncommitted

“We look forward to continued discussions to improve the lives of Connecticut’s nursing home residents,” said Andrea Burton-Reeves, commissioner of the State Department of Social Services.

But lawmakers and supporters have argued that the state has already provided millions of dollars in additional funding to the industry during COVID-19, and before approving such a request, nursing home said they want to be more transparent about their spending.

Matthew Barrett, President and CEO of the Connecticut Association of Health Care Institutions and Mag Morelli, Head of Leading Age Connecticut, Connecticut, represent 186 of Connecticut’s 205 nursing homes, In a November 30 letter to the state, he said, “We have an emergency. We need additional funding.

“To provide additional financial relief to the state’s skilled nursing facilities that are striving to provide quality care in the current prolonged and constant environment of double-digit inflation and rising labor costs. I am writing to you again to make a request,” they wrote.

Between February 2020 and December 2022, the nursing home industry will lose 210,000 jobs nationwide, with staffing plummeting to levels not seen since 1994, according to the American Health Care Association. Officials at the National Center for Assisted Living said.

The facility has added an average of 3,700 jobs per month over the past nine months. At the current pace, staffing will not return to pre-pandemic levels until 2027, he notes, AHCA.

In Connecticut, staffing shortages are causing widespread problems at some facilities. Athena, one of the state’s largest long-term care providers, has been placed under surveillance by authorities in three New England states after receiving consistent complaints about nursing home conditions, CT Miller reported.

Athena faces numerous lawsuits alleging it owes a staffing agency that provided workers to understaffed facilities. The company has also been accused of failing to pay nearly $6 million in employee health insurance and is facing consent orders at its facilities in Connecticut, Massachusetts and Rhode Island.

Some Athena home residents complained of being stuck in bed for long periods of time, lacking food and medicine, and being unable to participate in daily activities. I described my loved ones as slovenly. Residents regularly report missing showers and haircuts.

Some residents have even seen 1 out of every 20 nursing assistants assigned to them in some homes. According to the state care ombudsman, a common ratio to ensure adequate care is one worker for every eight or ten.

The State Department of Public Health recently placed one of Athena’s facilities, the Newtown Rehabilitation and Health Care Center, in imminent danger. An imminent danger arises when a breach would cause or could cause serious harm or death. Athena she fixed the problem in less than 2 days and the order was released.

But nursing home officials and state investigators say Athena’s problem is not an isolated one, with staffing shortages and rising costs affecting care at many facilities.

Barbara Cass, director of DPH’s health care quality and safety division, said the division issued four imminent danger orders across Connecticut nursing homes in the last quarter, from Mystic to Windsor. said.

“It’s really about staffing,” Morelli said of the funding request. “And all labor costs are rising, not just direct care staff. [enough] in terms of earnings. ”

Legislators, Advocates Call for More Transparency

Legislators and advocates acknowledge that conditions in care homes are dire and must be addressed. But while some advocate sending additional funds, many say more transparency is needed to show exactly how managers are spending their money.

Mairead Painter, Long Term Care Ombudsman for Connecticut, said: “[The state has] Gave them lots of dollars since COVID — lots of money. where did this money go? Because what we can see is not for staff or residents. ”

In the first year of the pandemic, the state announced it would donate more than $90 million to nursing homes to help address plummeting occupancy rates, labor costs, protective equipment and other costs.

States still reeling from the worst of COVID have extended a temporary 10% Medicaid rate hike for nursing homes in 2021, spending an additional 86 million between July 2021 and March 2022. I sent the dollar to the facility. We will go on strike in the spring of 2021 and significantly increase wages and benefits. The state increased Medicaid rates and remitted an additional $125 million to $130 million annually to cover labor costs.

Facility operators are required to submit an annual cost report with income, expense and balance sheet information. But the painters want a deeper explanation of the spending.

As part of this year’s legislative agenda, Painter has asked lawmakers to require nursing home managers to submit spending summaries, along with descriptions of many individual costs. She also recommended that the Director of Social Services make the report easily identifiable on the state’s website and include a comparison of each household’s spending.

Additionally, Painter called on legislators to pass legislation to stop entry into nursing homes if they do not meet the minimum staffing requirement of three hours of direct care per resident per day.

AARP officials in Connecticut support transparency measures.

“Historically, it’s been too easy for the industry to say, ‘We need more money,'” he said. … The hard part to ascertain from the available cost reports and data is who ultimately benefits the most: residents, workers, facility owners?

“My concern as an advocate is that there are many clues that point to someone other than the residents who are the ultimate beneficiaries here.”

As the legislative session begins, lawmakers have indicated their intention to draft legislation to increase accountability.

West Hartford Democrat Gillian Gilcrest, co-chair of the Human Services Commission, said: “We need funding transparency from providers before we take any policy action.”

“I know it’s hard enough to attract people to these difficult jobs, and a lot of the time they’re underpaid,” she said. If we raise interest rates in 2020, we need to make sure it gets paid to our staff.”

considerable surplus

Given that the state is projecting a budget surplus of $3.2 billion, Barrett said nursing home leaders are keeping lines of communication open with DSS officials.

“The dynamics are different in years with a significant surplus,” he said.

The problem with nursing homes, since 2019, is Medicaid rates that have not been adjusted to compensate for inflation. Congress and social services officials have launched a three-year process in 2021 to fix the issue.

But that became even more difficult when inflation hit a 40-year high. The consumer price index has been above 8% for most of last calendar year, and in June he reached 9%. By comparison, the CPI was just 5.4% when Congress adjourned in June 2021.

By November 30, when Morelli and Barrett requested funding, the required inflation adjustment was 16.2%. However, legislators gave her DSS discretion to limit rate growth based on available resources. This ‘stop-loss’ clause was effectively used to contain interest rate rises well below the recommended inflation adjustment.

Connecticut nursing homes receive an average of $282 per patient per day from Medicaid. On that basis, the 16.2% adjustment would require the state to increase average facility charges by $45 per patient. A stop-loss provision limited the inflation adjustment to $6.50 per patient per day.

“Nursing homes are in decline,” Barrett said in an interview. “In general, nursing homes will continue to be disadvantaged, compromising their ability to hire additional staff …and that means there will continue to be problems related to their ability to accommodate hospitalizations. To do.”

Crisis situation

Windsor Democrat Jane Garibay is getting a flood of emails, texts and phone calls from voters who have loved ones in nursing homes.

“What I hear is that we are in crisis,” said Garibay, co-chair of the Aging Commission. I’ve got pictures of bedsores, I’ve got videos of their loved ones in pain.

“We have to work on legislation to protect the elderly. It seems like a forgotten group. They are our future, but I feel we are not treating them with the dignity they deserve.”

Senate Minority Leader Kevin Kelly (D-Stratford) has proposed to Congress to increase Medicaid reimbursement in the next state budget to strengthen the staff.

Facility leaders aren’t opposed to increased accountability, Barrett said.

“This sector is open to more transparency,” he said. “He believes the Connecticut system is one of the most transparent in the country, and he is open to ideas that can make it more transparent.”

Recently, the Connecticut Association of Medical Facilities donated $25,000 to Lamont’s inaugural ball. It’s a glamorous event that kicks off his second term as governor, headlined by Kevin’s Bacon band, The Bacon Brothers.

Barrett said it wasn’t the first time the organization had donated to an inaugural ball. I didn’t say I donated more than the ticket price).

“Thanks to our significant presence across the state, we were able to reach the $25,000 figure,” he said. , not an insignificant amount, but very markedly different. [however] Inflation-adjusted … over $100 million.”

CT Mirror Reporter Keith M. Phaneuf contributed to this article.