The Department of Public Health (DPH) held a public hearing on August 1 on proposed regulations that increase minimum staffing level requirements for nursing homes.
The proposed regulations would require that nursing homes and rest homes maintain staffing levels that allow licensed nursing personnel and nurse’s aide personnel to provide a minimum of three hours of direct care per resident per day. They also revise minimum staffing requirements for therapeutic recreation directors at nursing or rest homes with nursing supervision and for social work and recreational staff to ensure there is one full-time social worker per 60 residents.
The proposed regulations are the result of a 2022 law that revised various public health statutes and directed DPH to establish minimum staffing level requirements.
Comments made during the hearing were largely in support of the regulation.
Mairead Painter, the state’s long-term care ombudsman, said that support for the changes “has never been stronger or more necessary.”
“This increase was established to support the quality of care for residents and to ensure that skilled nursing facilities provide the level of care that residents need and deserve.” Painter added.
Painter also stated that the required three hours of care per resident is just a “starting point” and needs to be increased to 4.1 hours per resident.
Anna Doroghazi, an outreach and advocacy director at AARP Connecticut, also spoke in support of the regulation.
“Low staffing levels mean that residents cannot get out of bed, use the bathroom, or eat in a timely manner. Staff risk physical injury and cannot give residents the time and attention they deserve. Visits with loved ones may be limited or canceled and it is more difficult for facilities to contain the spread of infectious diseases.” said Doroghazi, who added low staff levels are associated with high turnover rates.
Doroghazi also pointed out what she said AARP believes was a bill drafting error in the public act that mandated the changes, which she said led DPH to draft updates that lower staffing requirements for therapeutic recreation staff below current requirements. Doroghazi said the group believes this is counter to the legislature’s intent.
Several legislators also spoke in favor of the bill, including Rep. Jane Garibay, D-Windsor, and Rep. Mitch Bolinsky, R-Newtown, who shared the story of how his mother passed away as a result of an infection stemming from dehydration at an understaffed nursing facility.
Other commenters were residents of nursing homes or had family members who were nursing home residents and experienced challenges resulting from a lack of staff.
Mag Mirelli, of LeadingAge Connecticut, supports the new statutory minimum requirement but objects to the proposed breakdown of care into two separate categories, one on licensed nursing staff and the other on nursing aide personnel. Mirelli said the categories were not authorized by the legislature.
John Anantharaj, who works for Ryders Health Management, raised the issue of nursing staffing agencies. He said that they are having difficulty getting staff because nursing agencies can offer higher salaries and there are “no regulations to keep people accountable.”
Curtis Rodowicz, of Colonial Health and Rehab Center, objected to DPH’s estimation that the proposed regulations will not have any fiscal impact on small businesses.
According to Rodowicz, according to attain proposed regulatory changes, the changes will increase the need for certified nursing assistant (CNA) labor, which cannot be covered by current wages.
Martin Sbriglio, CEO of Ryders Health Management, also stated that while his company supports the staffing ratios, the challenge is there are not enough resources in the nursing staffing field and that this could lead to nursing homes having to turn patients away if they cannot maintain those ratios.
The proposed regulations were posted on July 14, and went into effect as operational policy on the same day.
The comment period for the proposed regulations ends at midnight on August 15.
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