The mission is personal for members of new Connecticut nursing home group
Liz Stern of Stonington considers herself a student of nursing homes and assisted living facilities, having had parents in both places before and during the COVID-19 pandemic.
Her mother died on Election Day in an area nursing home where she'd lived for four and a half years. Her death was not COVID-related. Stern's father lives in the Masonicare independent living facility in Mystic, where she said he receives excellent care.
"It's exposed things to me that were just grueling," she said of her experiences. "It put me on a path to advocacy which I'll be on for a long time."
That's why, Stern said by phone, she is excited Gov. Ned Lamont appointed her to serve on a newly formed Nursing Home and Assisted Living Oversight Working Group. The group is scrambling to come up with proposed legislation to improve the lives of about 20,000 of the state's most vulnerable residents and the people who care for them. Stern, meanwhile, has been studying industry trends in Connecticut, nationwide and internationally.
Sixty-three percent of Connecticut's 4,656 COVID-related deaths to date have occurred in longterm care facilities, and Lamont retained Mathematica Policy Research, a Princeton, N.J.-based company, to conduct an independent review of the response to the coronavirus in the nursing homes and assisted living facilities.
The newly formed working group of legislators, executive branch officials and agency heads and nursing home industry, staff and resident representatives has now formed four committees that will propose legislation for the 2021 session.
The group has established subcommittees on infection control protocols and COVID recovery facilities, staffing levels, socialization, visitation and caregiver engagement, and infrastructure/capital improvement funding.
Most of the 2,948 deaths of long-term care residents occurred during the first six months of the pandemic. The number of COVID cases receded over the summer, but some persist, and the state wants to strengthen its response as the number of community cases rises. It also want to prepare for future pandemics.
The latest figures from the state indicate that during the week of Oct. 28 to Nov. 3, there were 113 confirmed cases of COVID-19 and 22 deaths in nursing homes and 117 confirmed cases in assisted living facilities. The only reported active cases in southeastern Connecticut for the week were in Groton, at Fairview Rehabilitation and Skilled Nursing Care and Groton Regency.
Fairview had one confirmed case and two COVID-related deaths between Oct. 28 and Nov. 3, bringing the total number of cases at Fairview since July 22 to 62 and the total deaths to seven, according to federal health data. Groton Regency had two residents with COVID-19 during the Oct. 28 to Nov. 3 period, bringing its total cases to eight since July.
Members of southeastern Connecticut's delegation in the working group include state Sen. Cathy Osten, D-Sprague, state Sen. Paul Formica, R-East Lyme, state Sen. Heather Somers, R-Groton, and state Rep. Kathleen McCarty, R-Waterford.
Osten said by phone Thursday that she would be on the subcommittee on visitation and socialization and is interested in the other topics, such as how Medicaid dollars are spent by private, for-profit facilities.
"I'm going to make sure we're putting in recommendations and policy to protect the residents who live there and the staff that work there," Osten said. "We also want to incorporate group homes and the whole continuum of care. Many of our most vulnerable residents live in group homes."
Weekly testing of staff, which is currently funded by the state through the end of the year, has to continue throughout the pandemic, along with contact tracing, Osten said. Facilities are required to test residents if there are positive cases in their buildings.
One of the biggest concerns she's heard about from constituents is the inability for family to visit residents when faciilties close down to prevent the spread of the virus. Osten said her mother lived in a nursing home for the last six months of her life.
"My mother had Alzheimer's, and without the family visiting her, she would have quickly lost her memory of us," Osten said. "I think it's important. Plus, I think that people who are visiting loved ones keep an eye on what's going on and know when a family member is not feeling right."
She added that when her uncle was in a Rocky Hill facility years ago with early onset Alzheimer's disease, the only person who could get him to eat was her aunt.
Somers, a ranking member of the legislature's Public Health committee and its former chairwoman, said the Mathematica report lays out areas for improvement, but it's important to talk with providers in the industry, and for people to understand that public health audits of facilities are an opportunity to help them improve, rather than just to place blame.
"We were all learning about this in real time," she said. "Yes, I'm sure some skilled nursing facilities were not as good as they could have been, but it's important to use this time to look at where we can improve."
Somers said she's thought from the beginning of the pandemic that nursing homes should have a full-time nurse dedicated to infection control — many just have a part-time staff member — though she's mindful that Medicaid reimbursment rates have not increased for many years. Somers said that even with the extra money skilled nursing facilities are receiving for COVID patients, many are losing money due to the skyrocketing expenses for personal protective equipment and staffing needs.
Maireed Painter, the state's longterm care ombudsman, will be serving on the working group's visitation and socialization committee.
"I do feel strongly they need to hear directly from residents," she said by phone. "I will be advocating for them and for their families."
Much of her office's work, lately, has been on the topic of visitation, Painter said. As of now, facilities can only pause indoor vistitation if a staff or resident has the virus. Compassionate care visits, for those who are failing to thrive or dying, and end of life visits can't be stopped.
Painter is trying to find creative ways to continue outdoor visits, which are considered safer and are allowed unless there is a virus positivity rate above 10%. She said each building will receive about $3,000 to purchase outdoor visiting equipment, such as tents, from a civil monetary penalty fund of money collected from those who commit Medicare and Medicaid fraud.
She said the holidays would be difficult, and her program has purchased 80 small pocket projecters to loan to nursing homes so that families can contact residents via Facetime and the images can be projected onto the wall so that residents feel like part of the celebration.
Like many of the working group members, the mission is both personal and professional for Melissa McCaw, secretary of the state Office of Policy and Management.
"I come from a policy perspective," she told other members during the group's Oct. 29 introductory meeting. "But I must share with you on a personal note that I was raised by a parent who spent most of her career in a nursing home. I spent half my life in a nursing home after school."