For months, state Sen. Edith Prague rallied support for nursing-home reforms from Democratic leaders and advocates for the elderly, telling anyone who would listen that "this is the year" for improvements to minimum-staffing requirements and stronger oversight of the industry.
This wasn't the year.
"We got nothing. Nothing, nothing, nothing," said Prague, D-Columbia, who has tried for a decade to increase the state's outdated minimum-staffing requirement for nursing homes, which is among the lowest in the country. "This was the closest we've ever come, and it turned out to be a big zero. … They left everything for the last day, and nothing got done."
Attorney General Richard Blumenthal said he was "deeply disappointed" that lawmakers had not acted on a package of reforms that would have strengthened oversight of nursing homes and allowed the state broader discretion to seek court-appointed receiverships of financially troubled homes. The reforms were prompted by revelations of serious patient care and financial problems at Haven Healthcare, a large chain that declared bankruptcy late last year after a series in The Courant detailed its troubled regulatory record.
"The absence of action is absolutely astonishing, given the experience of the past year and our clear and dramatic experience with the abuses that can result from inadequate oversight," Blumenthal said. "I'm deeply disappointed because the state has essentially been deprived of tools and weapons that are desperately needed to protect both financial assets and patient care."
Democratic legislative leaders blamed the state's tight finances for the lack of action, citing Republican Gov. M. Jodi Rell's warning that she would veto any legislation that carried a significant price tag. Democratic leaders and Rell's office had reached an agreement last week that they would make no changes to the $18.7 billion budget already approved for next year, which provides no increases to nursing homes and nonprofit agencies, and offers lower-than-expected aid for cities and towns.
The "do-nothing" budget deal made no exception for improvements to nursing-home oversight or staffing, even though both Rell and Democratic leaders had touted nursing-home care as a priority.
Among the proposals not acted upon was a bill that would have raised the state's minimum-staffing standard to 3.6 hours of care per resident per day — up from the 1.9-hour requirement now in place.
Federal studies have recommended a minimum of 4.1 hours of care a day.
Because a Democratic proposal to phase in a 3.6-hour minimum would have cost the state $10 million in Medicaid reimbursement in the next fiscal year, Democratic lawmakers late Wednesday pushed the start date ahead to October 2009 to avoid any fiscal impact next year.
But even that proposal died in late-night House debate.
Proposals to make nursing home owners more accountable financially — hashed out in meetings this week — did not get an airing on Wednesday, even though some of them would have had a limited fiscal impact.
Among them was the creation of a state oversight panel that would have had the authority to audit the financial records of nursing homes and related entities, supplementing the role of the state Department of Social Services.
Another would have required the Department of Public Health to publish "report cards" on nursing homes for consumers.
"This is a very sad day for our residents, their families and their caregivers, and an abject failure by the Rell administration and the legislature, who have wasted a rare opportunity to address the crisis of care," said Carmen Boudier, president of the New England Health Care Employees Union, District 1199, which represents nursing-home workers.
She said the death of the staffing bill, "combined with an utter lack of accountability for nursing-home operators and zero funding in this second year of the budget, is a recipe for more nursing home scandals and closures."
Prague said she was discouraged that state House leaders waited until the final hours of the session to raise the staffing bill, then watched it die.
"They all come to the press conferences and say it's a priority, and then they go and leave it until the last day," she said. She said she may ask for nursing-home reforms to be included in the coming special session of the legislature.