HARTFORD — In response to the deaths of roughly 2,500 nursing home residents during the COVID-19 pandemic, the Connecticut state legislature’s bipartisan Women’s Caucus is calling for change in the industry, at the state Department of Public Health and from the Office of the Governor in an effort to prevent a second wave from devastating this population again.
Although Governor Ned Lamont released a request for proposals for an independent contractor to complete a review of procedures to address the COVID-19 pandemic inside nursing homes and assisted living facilities last week, the caucus is requesting that the review encompass much more.
“We request that the independent review not only look at the preparedness and response of the nursing home industry to a pandemic, but at the preparedness and response of the state agencies to a pandemic,” said Rep. Dorinda Borer of West Haven, co-chair of the Women’s Caucus. “We think that allows for a complete, honest assessment.”
Among other things, the caucus is asking that the review examine when and how nursing homes were inspected, the isolation procedures for residents admitted with COVID-19, use and supply of personal protective equipment, how the additional COVID funds from the state and federal government were used and at the penalties for deficiencies and violations cited during COVID-19.
“We can come together and work together to get things done. This is an issue that does transcend party lines. We have members on both sides of the aisle who have come forward with issues that need to be addressed,” said Rep. Rosa Rebimbas of Naugatuck, co-chair of the Women’s Caucus. “We need to know what happened, what worked and what didn’t work. What was the chain of command and how can we improve on it? We need to ask, what was known, what was done and what needs to be done for future pandemics. This is not over, we need to gather the knowledge and support that’s absolutely necessary for these special workers. We need to make sure our loved ones and constituents are safe.”
Lamont, who attended the caucus’ Tuesday press conference on the north steps of the Capitol, assured those gathered that the review would consider both the governmental and industry responses.
“We are a state where you are much more likely to be in a nursing home –the sixth most likely state for someone to be in a nursing home — and that’s why we have investigated these nursing homes, physically investigated them several times,” Lamont said. “That’s why we are doing this study, so that if there is a second wave we get this right.”
Lamont said that the review will consider what qualities define the 20 percent of nursing homes that have had no cases and what qualities are shared by facilities, like Apple Rehab Saybrook, where a majority of residents have contracted the disease.
A failure of reporting
One thing that is certain before the study even begins — as Rep. Michelle Cook of Torrington and a member of the Women’s Caucus explained through a personal story — part of the problem has been a lack of communication and reporting from the nursing homes to the families of residents and to the state.
“In the nursing home my father-in-law was in, they had 160 beds, and 127 cases. They had 41 deaths, not including my father-in-law, and not including Patty, a devoted staffer that lost her life due to COVID,” Cook said.
As present, there is no requirement that nursing homes ever notify families that there is an infectious disease spreading in a facility.
Cook’s father-in-law, William Cook, died on April 2.
As late as April 21, Litchfield Woods Health Care Center, where Cook’s father-in-law was resident, would not confirm a single case of COVID at the facility, according to constituents who spoke with Cook.
“This is why I asked for a statewide investigation of all nursing homes in the state. This why, a group of incredible women legislators started working on this issue,” Cook said. “We also recognize that this investigation is not the end to addressing the crisis in the nursing homes, but just the beginning.”
In emailed statement to CT Examiner, Athena Health Care Systems Spokesperson Tim Brown, replied to Cook’s allegation, writing that “Litchfield Wood’s first confirmed case of COVID-19 was announced on April 2, 2020. The center did not have any cases prior, per the center and the local health district, as has been erroneously reported in the past. As soon as we were notified, we contacted our families and notified our staff and put our COVID-19 protocols in place.”
Beyond the pandemic
According to the gathered legislators, their concerns stretch far beyond the pandemic to how violations and deficiencies at nursing homes are cited and the lack of penalties when they are.
“Every time we say why aren’t [the nursing home operators in violation] getting a financial hit, [the department of public health] say it’s not part of what the protocol is for this particular issue,” said Rep. Catherine Abercrombie of Meriden. “If 10 people come down with the flu — let’s not even talk the pandemic — that should be a financial hit.”
According to Matt Barrett, the President and CEO of the Connecticut Association of Health Care Facilities, nursing homes have been receiving impactful, financial penalties before and during COVID-19.
“The notion that there is not significant fines is a misunderstanding that I don’t understand.” The nursing homes have received fines and will be receiving more, Barrett said. “I think the review is going to demonstrate that Connecticut nursing facilities have been subject to the most significant surveillance in the nation.”
Barrett said the nursing homes he represents all welcome the Governor’s review and think it will help to tell a complete story that includes how hard the nursing homes have been working to keep residents and staff safe.
“Many nursing facilities did everything right, but have bad outcomes,” Barrett said. “The real bad character here is the virus.”
Most inspections in the past were self-reported, not surprise inspections as are now taking place, said Rep. Toni Walker of New Haven.
“That’s got to stop, we’ve got to always have eyes on the ground,” Walker said. “The whole system is over $1.2 billion in the budget, we have 213 nursing homes, this is a major part of our society that has not been regulated very well. We need to change that and address the issue to protect our families that live there or work there. It’s multiple sides and we have neglected it and we can no longer neglect it.”
At this point, Abercrombie said, the goal is to make more of the citations result in fines.
The view, Walker said, needs to be to the longer term, beyond the pandemic. When the current regime of surprise inspections being carried out by the National Guard end with the state of emergency, Walker said that others need to take over that role.
“We have to look at the way we’ve staffed this, this is a major part of our budget and we need to complete the investment,” Walker said. “We can’t do a surface investment.”
As the state closes the five COVID-19 only recovery centers, the importance of making nursing homes safer becomes even more important, said Abercrombie.
“We need to think about if there should be a special set of laws and statutes for a pandemic, like ones that suspend the right to return to a nursing home if you are positive with the disease,” Abercrombie said.
This story has been updated to include comments by Matt Barrett, the President and CEO of the Connecticut Association of Health Care Facilities and Athena Health Care Systems Spokesperson Tim Brown.