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May 9, 2024

CT Senate gives final approval to nursing home oversight bill

SHAHRZAD RASEKH / CT MIRROR Susan Griffin has been a resident at Montowese Health & Rehabilitation Center for 18 months. "The nurses are great, there just aren't enough," she says.

A measure that would reduce the number of people who can reside in a nursing home room, add consumer protections at assisted living centers and beef up oversight of nursing home management companies, among other reforms, cleared the Senate with unanimous support Wednesday.

The bill now heads to Gov. Ned Lamont’s desk for his signature.

“This bill aims to provide the aging citizens of Connecticut with high-quality nursing homes, provides consumers and family caregivers with greater transparency in selecting the appropriate level of care, promotes industry-leading practices and holds poor-performing homes accountable,” said Sen. Jan Hochadel, D-Meriden, co-chair of the Aging Committee.

The proposal, introduced by Lamont, phases out three- and four-bed nursing home rooms beginning July 1, 2026, by halting new admissions in rooms that already have two people. Those currently living in a room with three or four beds will not be forced to move. Lawmakers said 17 of the state’s roughly 200 nursing homes still feature three- and four-bed rooms.

Nursing homes can report capital costs, such as room modifications or renovations, on their annual cost reports, and the social services department will factor expenses into the Medicaid reimbursement rates, officials said. A provision in the bill gives the state’s social services commissioner the authority to recalculate Medicaid rates to adjust for conversions if needed.

The measure also allows for more oversight of nursing home management companies. Under the proposal, the state’s public health department would be able to deny or decline to renew a nursing home management certificate based on past or current discipline, enforce plans of correction against management companies, put management companies under similar scrutiny as the department has for change of ownerships, and impose penalties, such as revocation of certificates or civil penalties.

It also requires management companies to get approval from the health department before taking on new facilities beyond those identified at licensure or renewal.

The bill also mandates that assisted living services agencies disclose fee increases to residents or their representatives at least 60 days before they take effect and, upon request, provide them with a history of fee increases over the past three years.

Additionally, the measure would:

  • Allow the health department to bring disciplinary actions against long-term care facilities that fail to comply with the terms of an accepted plan of correction (currently, the department lacks enforcement mechanisms).
  • Extend the health department’s authority to enforce violations of state law, not just federal law.
  • Require nursing home or residential care home applications for receivership, an involuntary process initiated by creditors or the state, to be granted if the facility sustains any type of serious financial loss or failure.
  • Update the criteria for who may be appointed as a receiver by removing the requirement that they be licensed a nursing home administrator.
  • Establish a working group to make recommendations that assist nursing homes in phasing out three- and four-bed rooms.

The Connecticut Mirror has reported extensively on gaps in the state’s elder care system — both in nursing homes and home care — and highlighted worsening conditions in many nursing facilities. Serious violations known as immediate jeopardy orders were on the rise in 2023, a major nursing home chain faced a number of lawsuits, and the chief executive officer of that company acknowledged he was six months behind in paying health claims for employees.

“This bill was crafted in a bipartisan fashion,” said Sen. Lisa Seminara, R-Avon. “We all worked together to end up with a bill I feel truly attempted to make all the parties involved comfortable. And we did this by never losing sight of improving the lives of our ever-growing population of seniors.”

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