State lawmakers from both parties expressed interest in adopting more ambitious mandatory minimum staffing requirements at Connecticut nursing homes during a Tuesday hearing on new regulations from the Department of Public Health.
The agency heard testimony on its proposed regulations during a morning hearing in Hartford. The regulations were required under a 2021 law, which tasked DPH with raising the minimum number of direct care hours in state nursing homes from 1.9 hours per resident each day to at least three hours per day.
Among those to testify were Reps. Jane Garibay, D-Windsor, and Mitch Bolinsky, R-Newtown. Both serve in leadership positions on the legislature’s Aging Committee and voiced support for more rigorous staffing requirements.
Bolinsky stated the committee planned to pass a 4.1-hour requirement during next year’s session.
“We are planning to legislate it to 4.1 hours in the 2024 session,” he said. “Personal care for our residents is not a luxury, it’s a necessity and the neglect that we see and the stories that we hear about people that are dying tragically, it’s completely real.”
Tuesday’s hearing included some of those stories. Monroe resident Nancy Sorge grew emotional as she recounted the recent death of her mother at a facility, which she said lacked adequate staff to administer proper care to her mother.
“The reality of the whole thing is my mom should have died with dignity, the way she was supposed to die, not the way she did die and I will continue to advocate,” Sorge said. “Things need to change. They need to get more people in.”
State lawmakers considered but ultimately declined to pursue a 4.1-hour requirement during this year’s session. On Tuesday, Garibay, a co-chair of the Aging Committee, recalled representatives of the long term care industry reporting that many nursing homes already staff above the current 3.0-hour requirement.
“Why is it such a hard push to get to 3.0? We should be higher,” Garibay said. “We have to take care of our elderly. We can not forget them.”
During the hearing, industry representatives largely did not object to the three-hour requirement but they did object to how the DPH regulations plan to calculate the requirement. The new regulations define which types of employees count toward the minimum hours to include only licensed nurses and certified nurse aides who are engaged in direct health care services.
“The proposed regulations creating separate minimum staffing ratios are not authorized by statute,” Mag Morelli, president of LeadingAge Connecticut, said. “In fact, the legislature considered but rejected these categories and modeled the fiscal impact of the minimum staffing legislation on a 3.0 minimum staffing ratio without these breakout categories.”
Others told the agency that Connecticut did not have enough qualified nurses to allow nursing homes to meet the requirements of the new standard as they were drafted by DPH.
“If the staff are not currently or readily available in the workforce, there’s no way providers can meet that mandate,” Curtis Rodowicz, administrator at Colonial Health & Rehab, said. “Is the state securing a pool from outside of Connecticut that providers can utilize to fill vacancies? Is the military being called in to backfill the vacancies?”
Meanwhile, state Long Term Care Ombudsman Mairead Painter applauded the department for separating nursing staff in the calculation of the minimum hours, saying that the industry had previously counted certain non-nursing positions toward the requirement.
“As a result, many residents are still not receiving the care they need, leading to adverse health outcomes and decreases in quality of care,” Painter said. “This is not dietary, physical therapy and does not include recreation and social work. These individuals help support residents in their daily life and other goals but do not provide for direct care.”
Susan Bilansky, a long term care resident at the Hebrew Home in West Hartford, said staffing shortages hindered the ability of nursing home residents to socialize, attend activities and feel like part of a community. The shortages hit individuals who require more intensive care even harder, she said.
“When there are not enough staff in the building, these individuals are less likely to get help getting out of bed, getting showered or getting assistance in the bathroom,” Bilansky said. “These are not uncommon things to hear and there is so much more than that.”
Anna Doroghazi, associate director of advocacy and outreach at the Connecticut AARP, applauded the 3.0-hour requirement as a step in the right direction.
“We know that the challenges associated with staffing are real but despite these challenges it is important to require staffing levels that appropriately support the health and safety and dignity of residents as well as the residents who care for them,” Doroghazi said.