Nursing Home Changes Sought
Nursing homes would have 10 months to comply with new staffing standards that would more than double the minimum hours of nursing care per resident now required by state law, under a plan presented Wednesday by Democratic legislative leaders.

The proposal would allocate $9.5 million to nursing homes in the next fiscal year to phase in an increase in the state's minimum staffing rules, which now require 1.9 hours of daily nursing care per resident — one of the lowest state minimums in the country. Nursing homes would have to provide at least 4.2 hours of daily care per resident as of May 2009 — a requirement that would put Connecticut well above the national average, and in line with a federal recommendation calling for a minimum of 4.1 hours of care.

"No one initiative will solve all of our [nursing home] problems, but we must start somewhere," said Joyce Fontana, an assistant professor of nursing at St. Joseph College in West Hartford who spoke in favor of the proposal at a press conference Wednesday. Increasing the staffing minimum is "a moral response we can be proud of. It is something we as a state can build on," she said.

The state's minimum staffing rule has not been updated in more than 25 years, despite repeated efforts by state Sen. Edith Prague, D-Columbia, and other elderly services advocates to increase the required hours of care.

The new effort was prompted by revelations of serious patient care and financial problems at one of the state's largest nursing home chains, Haven Healthcare, which declared bankruptcy late last year, after a series in The Courant detailed its troubled regulatory record.

Prague said the public outrage over Haven's situation had led lawmakers to propose the increased staffing rule, as well as other measures aimed at improving oversight and financial accountability of the state's 240 licensed nursing homes.

House Speaker James Amann, D- Milford, Senate President Pro Tem Donald E. Williams Jr., D-Brooklyn, Senate Majority Leader Martin Looney, D- New Haven, and other Democratic leaders said the staffing bill would be a first step toward restoring public confidence in nursing home care.

Under the proposal, homes would be required to provide each resident with at least 3.5 hours of direct care a day starting in October; 3.9 hours of care starting in January 2009; and 4.2 hours of care as of May 2009.

The $9.5 million would be targeted to homes that need to hire staff to meet the minimums.

Most of the state's nursing homes already staff well above the existing 1.9-hour minimum.

The most recent federal data show that Connecticut's homes provide an average of about 3.7 hours of care a day per resident — about the same as the national average.

But advocates for the elderly say the outdated staffing rule allows homes too much discretion to operate with reduced nursing staff, without fear of being penalized by the state.

About 80 nursing homes currently fall below 3.9 hours of care, while 114 fall below the 4.2-hour minimum, said Rep. Peggy Sayers, D- Windsor Locks.

Although the cost of bringing homes up to the new minimums will be blunted next year because of the phase-in, sustaining the higher staffing levels could cost taxpayers more than $30 million in the following year, Williams said.

Once fully in place, the new minimum would mean a staffing ratio of one nurses' aide for every five residents during daytime hours.

Typically, the ratio of nursing staff to residents is now about one for every eight or one for every nine, said Deborah Chernoff, spokeswoman for the New England Health Care Employees Union, District 1199.

Toni Fatone, executive vice president of the Connecticut Association of Health Care Facilities, said that while the nursing home industry supports higher staffing levels, the proposal doesn't provide nearly enough funding — or time — for homes to meet the new minimums.

The $9.5 million "doesn't even come close to enough money," Fatone said. "If they were really committed to staffing, there would be over $100 million in funding to do it and realistic time frames to get it done."

She questioned where new workers would come from, given a shortage of nurses and nurses' aides.