The construction of the Connecticut State Capitol in Hartford, Connecticut, on Monday, June 3, 2013.
State officials showed little commitment this month in responding to a voluminous investment request from the nursing home industry, which is suffering because of its amenities and keeps up with skyrocketing inflation.
Nursing homes, plagued by chronic staffing disorders and wage pressures, had asked for an additional $193 million to help care facilities for suffering seniors. The state’s social facilities budget provides another $28 million. the sector.
“We look forward to more discussions as we analyze the lives of Connecticut nursing home residents,” wrote Andrea Barton Reeves, commissioner of the state Department of Human Services.
But lawmakers and advocates say they need to see greater transparency in nursing home spending before signing such a request, arguing that the state has already provided the industry with millions of dollars in additional COVID investments.
Matthew Barrett, president and CEO of the Connecticut Association of Health Care Centers, and Mag Morelli, leader of LeadingAge Connecticut, which together make up 186 of Connecticut’s 205 nursing homes, wrote in a Nov. 30 letter to the state that there is an “urgent need” for additional funding.
“We are writing to you once again to ask you to provide more monetary assistance to skilled nursing services in our state as they attempt to provide quality care in this now widespread and unforgiving environment of double-digit inflation and emerging costs to the workforce. “They wrote.
From February 2020 to December 2022, the nursing home industry lost 210,000 jobs nationally and fell to levels not noticed since 1994, officials from the American Health Care Association and the National Center for Assisted Living said.
Services have added an average of 3,700 jobs per month for the past nine months. At the current rate, enrollment would return to pre-pandemic levels through 2027, according to the AHCA edition.
In Connecticut, staffing has led to widespread disorder at some facilities. The CT Mirror reported that Athena, one of the state’s largest long-term care providers, has come under scrutiny from officials in 3 New England states after receiving consistent court cases about situations in her nursing home.
Athena faces lawsuits alleging she owes cash to transitional employment agencies that have staffed understaffed services. The company is also accused of failing to pay about $6 million in fitness benefits for staff and has faced consent orders on services in Connecticut, Massachusetts and Rhode Island.
Residents of some Athena homes complained of being stuck in bed for long periods of time, without food or medicine, and unable to participate in daily activities. Family members described their loved ones being overlooked during visits. Residents reported not showering or cutting their hair. .
In some households, citizens report seeing a single caregiver assigned to 20 people. A typical ratio to make sure smart care is one employee for every 8 or 10 people, the state’s long-term care ombudsman said.
The state Department of Public Health recently placed one of Athena’s facilities, the Newtown Medical Care and Rehabilitation Center, in immediate danger due to troubling situations discovered when inspectors visited the building. There is immediate danger when violations cause or are very likely to cause serious injury or death. Athena resolved the problems in less than two days and the order was lifted.
But nursing home officials and state investigators say Athena’s disorders aren’t isolated, and that shortages and increases in charges are affecting care at many facilities.
Barbara Cass, chief of DPH’s health care quality and protection branch, said the branch issued 4 immediate danger orders in Connecticut nursing homes in the last quarter, from Mystic to Windsor.
“It’s staffing,” Morelli said of the investment request. “And it’s not just the direct care staff, all the staff prices have gone up. There has been a very genuine tension on the charges side and not [enough] on the earnings aspect. “
Lawmakers and advocates recognize that the situation in nursing homes is dire and needs to be addressed. But while some are in favor of sending additional money, many say greater transparency is needed to accurately show how managers spend money.
“There’s no duty where that cash goes,” said Mairead Painter, Connecticut’s long-term care ombudsman. “[The state] has given them a lot of dollars since COVID, a lot of cash. Where did that cash go? Because it doesn’t happen to the staff and citizens we can see. “
In the first year of the pandemic, the state announced more than $90 million for nursing homes to cope with falling occupancy, staffing and equipment prices, among other expenses.
Still recovering from the worst of COVID, the state in 2021 extended nursing homes with a 10% transient increase in Medicaid rates that sent another $86 million to services between July 2021 and March 2022. And nursing homes and Gov. Ned Lamont’s management have moved away from a lead caregiver strike in the spring of 2021 with a significant package of pay and benefits improvements.
Facility operators are required to file annual charge reports containing revenue, expenses, and balance sheet. But Painter and others are asking for more detailed explanations of the expenses.
As part of his legislative calendar this year, Painter asked lawmakers to require nursing home managers to provide narrative summaries of spending, with explanations of many individual costs. Also that the Commissioner of Social Services make the reports easily identifiable on the state’s online page. And they come with comparisons between family expenses.
In addition, Painter called on lawmakers to pass a law requiring nursing homes to halt admissions if they don’t meet the minimum staffing requirement of 3 hours of direct care per resident per day.
AARP officials on Connecticut transparency measures.
“It’s been too simple for the industry to say, ‘We want more money,'” said Anna Doroghazi, deputy state director of advocacy and outreach. . . . . What is more difficult to see in the reports in charge and to know about is ultimately who benefits the most?
“The fear we have as advocates is that there are many clues that seem to imply that the ultimate beneficiaries here are other than citizens. “
At the beginning of the legislative consultation, lawmakers have announced that they will expand spending to accountability.
“A key question for us is, ‘Where does the money go if it doesn’t go to pay for more staff?'” Before we can take political action, there needs to be some transparency in supplier investment. “
“It’s hard enough to attract other people to do this hard work, and we know that in many cases they’re not getting paid enough,” he said. the staff. “
With the state projecting a budget surplus of $3. 2 billion, Barrett said, nursing home leaders are keeping communication open with DSS officials.
“The dynamic is different in a year where there is an abundant surplus,” he said.
Current rates for nursing homes are Medicaid rates that have not been adjusted to offset inflation since 2019. The legislature and social officials introduced a three-year procedure in 2021 to begin solving this problem.
But it became much more complicated when inflation rates hit a 40-year high. The customer value index exceeded a maximum of 8% in the last calendar year and reached 9% in June. By comparison, the CPI only reached 5. 4% when the legislature was postponed in June 2021.
As of Nov. 30, when Morelli and Barrett implemented the financing, the mandatory inflation correction was 16. 2%. The capitalization rate increases considerably under inflationary adjustment.
Connecticut nursing homes get an average of $282 per patient based on Medicaid day. On this basis, a 16. 2 percent adjustment would require the state to increase the average facility payment to $45 depending on the patient. It capped the inflationary adjustment at $6. 50 a day, one-seventh of what the industry says it wants to sit back financially.
“Nursing homes are losing ground,” Barrett said in an interview. “Overall, nursing homes will continue to be deprived and undermined in their ability to hire more staff. . . And that will mean there will continue to be problems with nursing. the ability of households to settle for hospital admissions.
Jane Garibay, D-Windsor, has won a flood of emails, text messages and calls from voters with loved ones in nursing homes.
“What I hear is that we are in crisis,” said Garibay, co-chair of the Committee on Aging. their enjoyed suffering.
“We want to paint our seniors on the law. It seems to me that this is a forgotten group. We properly invest a ton of cash in our children, they are our future. But I feel like we’re not treating our seniors with the dignity they deserve.
Senate Minority Leader Kevin Kelly, D-Stratford, advised the General Assembly to increase Medicaid reimbursement in the next state budget to help strengthen staff.
Facilities leaders are reluctant to become more accountable, Barrett said.
“The industry is open to even greater transparency,” he said. “We believe the Connecticut formula is one of the most transparent in the country, and we are open to concepts where there can be greater transparency. “
Recently, the Connecticut Association of Health Care Facilities donated $25,000 to Lamont’s inaugural ball, a lavish occasion that kicked off the governor’s term, hosted by Kevin’s band, The Brothers.
Barrett said this is the first time the organization has donated to an inaugural ball. When divided into the 151 nursing homes it represents, he said no facility contributed more than $200 consistent with the room, the value of a ticket.
“We were able to succeed in the $25,000 figure because of our significant presence in the state,” he said. ] of inflationary adjustment. . . more than $100 million. “
CT Mirror journalist Keith M. Phaneuf contributed to this story.