Link Between Oversight and Patient Safety Lacking in Yale Report, as Lamont Negotiates to Avoid Strike

The ten nursing homes in Connecticut reporting the highest number of deaths from COVID-19 received no fines or citations from the Department of Public Health, according to a report issued today by Yale Law School’s Worker and Immigrant Rights Advocacy Clinic and the SEIU District 1199 NE union. 

The report found that the 34 fines the department did issue for COVID-19 violations between March 2020 and February 2021 bore no relation to the number of deaths in any particular nursing home. 

The authors of the report also found no evidence that any citations or fines were levied against an additional 170 nursing homes where a total of 3,398 residents and staff died from the virus.

Jesse Martin, vice president of the Nursing Home Division for the District 1199 SEIU, said that these findings show both a lack of resources in the department and a problem with the department’s evaluation system.

“DPH needs to staff up,” said Martin. 

The report also calls into question the dollar value of the fines. Under Connecticut law, the department is allowed to issue a fine of up to $10,000 for violations that “present a potential for death or serious harm in the reasonably foreseeable future to any patient in the nursing home facility.” According to the report, the average fine for a COVID-19 violation was $2,885, while the average fine for a non-COVID violation was $6,032. 

According to Martin, the department shut down in-person surveys for the two months when COVID-19 was at its peak in the nursing homes, relying instead on video conferencing with administrators.

According to State Sen. Saud Anwar, D-East Hartford, who echoed Martin’s comments, workers told him that even when the department did speak with nursing home staff, it was in the presence of an administrator. 

“This clearly failed,” said Anwar.  

Martin said the department failed to provide nursing homes with clear guidance for implementing policies like cohorting. According to Martin, there were instances where the homes cohorted the residents, but the same staff worked with both the COVID-positive and non-COVID residents. 

“There are plenty of data sets that the Department of Public Health has access to, but has not used to track trends between employers, between regions, between common workplace issues or infection control procedures,” said Martin.

The Department of Public Health said in a statement that the agency had “conducted extensive inspections, and mandated special infection control monitoring” including over 3,000 focused infection control surveys.

“We’re so tired” 

The Yale researchers found that facilities reporting staffing shortages had more than four times the number of cases and deaths from COVID-19 compared to facilities that did not report shortages. The majority of the cases and deaths occurred between December 2020 and January 2021. 

Tanya Beckford, a certified nurse assistant and member of the SEIU District 1199 NE union, works in the Alzheimer’s unit at Newington Rapid Recovery Rehab Center. She said she’s responsible for 15 to 17 residents every day. 

“We’re just so tired right now,” she said. “By the time we get home to our families, we serve no purpose.”  

Beckford contracted COVID at the start of the pandemic. She said that she had been out of work for seven months, and is still receiving treatments for her lungs. She said that the disease almost killed her. 

The report issued today includes a recommendation that the staffing ratio for nursing homes should be increased to the federally-recommended 4.1 hours of direct care per resident, an increase from the current level of 1.9 hours per resident in Connecticut.

Beckford said the low wages and benefits are a deterrent to potential workers who could take other jobs that pay the same but are less stressful, such as working in a fast-food restaurant. 

According to statistics from the Department of Labor, the entry level wage for certified nursing assistants in Connecticut is $13.71. The median hourly wage for certified nursing assistants is $16.19. 

The Lamont administration approved a temporary five percent Medicaid reimbursement increase between April and June of 2021, but Martin said a long-term solution was needed.

“You don’t lift someone out of poverty by giving them a one-time bonus,” said Martin. “Temporary Medicaid increases are band-aids.” 

“A tragedy waiting to get worse” 

Last week, the union released an announcement that 3,400 workers at 33 nursing homes are preparing to strike on May 14 for better wages and working conditions. Today, Martin said that workers at an additional six nursing homes were preparing to strike on May 28. 

Beckford said union members were also calling on Lamont to renew the reimbursement rate increases, which the governor removed from his budget proposal. A budget proposal by the legislature would reinstate those increases, which would amount to $11.1 million in 2022 and $24.3 million in 2023, and require that 75 percent of those funds be directed toward wage increases. 

“We do not want to do a strike right now, because we know that we are leaving residents behind,” Beckford said. 

The union supports a number of changes recommended in the report, including staffing increases, infectious disease testing during an outbreak, a three-month stockpile of Personal Protective Equipment, employing a full-time infection preventionist at each facility, and a council at each nursing home to improve communication between staff and family and friends of residents. 

The report also recommends a minimum wage of $20 an hour for certified nursing assistants and $30 an hour for licensed practicing nurses, in addition to health insurance and retirement benefits. The increased wages and staffing requirements would cost an additional $400 million each year, but about half of the cost to taxpayers would be reimbursed through Medicaid. 

In a press conference on Friday, Lamont said that the state was currently negotiating with the union and with the nursing homes. He said the state had made an “aggressive proposal,” including an increase in Medicaid rates, a 10 percent increase in funding for the nursing homes, increased pay and “combat pay” for nurses, discounted daycare and a pension. 

“We’re trying to do anything we can to avoid a strike,” said Lamont. 

Martin said the union planned to strike “as long as it is necessary for the governor and the nursing home employers to understand that these workers need to be lifted out of poverty, they need to be treated with dignity, and the nursing home residents need to have the staff to care for them in the proper way.” 

But he added that without additional funding earmarked for the nursing homes, negotiations were going to be “difficult to say the least and impossible to say the most.”

“This is a tragedy waiting to get worse,” he said. 

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