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Press Releases

10/01/2020

Governor Lamont, DPH Commissioner Respond to Final Report from Firm Conducting Review of Covid-19 Response in CT Nursing Homes

Many Recommendations Already Being Implemented, Thousands of Inspections Completed, Comprehensive COVID-19 Testing for Nursing Home Residents and Staff

Governor Lamont and Acting Connecticut Department of Public Health Commissioner Deidre S. Gifford, MD MPH today are reacting to the final report from Mathematica Policy Research reviewing the response to COVID-19 in Connecticut nursing homes and assisted living facilities.  The report evaluates the COVD-19 preparedness and response of both the State and the long term care industry and makes specific recommendations for handling future outbreaks.  Governor Lamont ordered the independent, third-party review on June 8, 2020.  An interim report was released to the public on August 15, 2020.  Key Mathematica findings include that nursing homes in communities with high levels of COVID-19 were more likely to have severe COVID outbreaks and that the impact on Connecticut’s nursing homes was similar to the experience of neighboring states. The report also notes the adverse impact of visitation restrictions on health and well-being of nursing home residents. 

 

Over the last few months, the state has worked hard to help reduce the spread of COVID-19 in Connecticut’s nursing homes by, among other initiatives, supporting universal, state-funding testing of both staff and residents in nursing homes, revising nursing home visitation requirements, conducting targeted infection control surveys, and providing regular guidance with the latest updates on testing and infection control.  Many of these initiatives are reflected in Mathematica’s recommendations.  Indeed, the state has already implemented or begun to implement 14 out of the 15 of the report’s short-term recommendations directed at the state. 

 

Governor Lamont issued the following statement:

 

“This report is important for our state, especially for both nursing home residents and their families, as it is a transparent look at how our state responded to COVID-19 within our long term care facilities. The novel coronavirus spread quickly and aggressively in Connecticut during the early stages of the pandemic, and we took the steps we believed were necessary at the time to control the spread and save lives. I am pleased by this independent validation of our decisions and actions, and that nearly all of the short term recommendations provided to the state have already been implemented.  I look forward to future discussions with the legislature, the industry, staff and families on the additional longer term recommendations brought forward.”

 

Acting DPH Commissioner Gifford issued the following statement:

 

“I want to thank Mathematica for their very thorough, fair and honest review of how COVID-19 impacted our long-term care facilities and most especially the residents and staff of nursing homes.  This report provides us the reassurance that our intensive strategies to contain the COVID pandemic in long term care are on the right path, and that our preparations for a second wave are comprehensive and in line with national best practices.

 

The report acknowledges that since June of this year, Connecticut has mandated and funded a testing strategy for nursing homes under which 72,196 COVID-19 tests have been conducted for nursing home residents, and 196,444 tests have been conducted for staff.  Since beginning this program, our infection rates have plummeted, and remain low.  I want to commend the efforts of the long term care industry, and in particular the staff caring for residents in our long term care facilities, for partnering with us in this achievement.

 

I also want to commend the dedication and round-the-clock work of the staff of the Department of Public Health, both in monitoring and assisting the industry during this unprecedented event.  DPH staff have conducted 2,406 focused infection control surveys, found more than 390 deficiencies and issued 21 citations with fines ranging between $720 and $10,000, provided countless hours of COVID-related training for facilities, and produced a library of guidance to help navigate a rapidly evolving and complex pandemic. DPH continues to plan actively for the future as well.  Last week, for example, DPH issued an order requiring that nursing homes maintain a 30 day stockpile of personal protective equipment (PPE) as part of an effort to position the state’s nursing homes to meet a potential surge of COVID-19, and the state continues to stockpile its own reserve should facilities have trouble in the future sourcing their own PPE.  These efforts are part of our on-going assessment and re-assessment of our COVID response, and the Mathematica report is an important resource informing our work.

 

DPH appreciates that there are recommendations in this report that we have not yet implemented, and we will be working with the Office of Policy and Management, the Department of Social Services and our partners in the legislature and industry to review and consider those as well.”

 

Some of the final Mathematica report’s key findings include:

 

  • Nursing homes with a greater incidence of COVID-19 in the surrounding community and those with more residents that received dialysis or cancer treatments – which tend to be delivered offsite – had more cases and deaths per licensed bed.

     

  • The prevalence of symptoms of depression increased by 15 percent and rates of unplanned weight loss nearly doubled right after the peak of the COVID-19 outbreak, suggesting that measuring COVID-19 cases and deaths alone does not capture the full impact of the pandemic on residents’ well-being.

     

  • After adjusting for facility characteristics such as size and proximity to Connecticut, Connecticut cases and deaths per licensed bed did not vary significantly across nearby states.

 

Based on study findings, Mathematica made 23 short-term recommendations and 22 long-term recommendations – some directed at the nursing home industry and some directed to the state -- to mitigate a potential second wave of COVID-19 and to prevent future infectious disease outbreaks.

 

Key recommendations include:

 

  • Developing a framework to guide policies on the reopening of LTC facilities to visitors based on a set of criteria at the facility and community levels, rather than a one-size-fits-all state-wide visitation policy.

     

  • Considering legislation or regulations to (1) mandate a full-time infection preventionist in nursing homes and (2) increase the minimum required staffing levels in nursing homes.

     

  • Ensuring that all LTC facility staff have access to guaranteed paid sick leave under the state’s existing regulations.

 

Mathematica Policy Research conducted its review by looking at data and interviews/consultation with the Departments of Public Health and Social Services; members of the legislative and executive branch; industry, residents and families, long-term care facility experts, and long-term care facility staff.  The report synthesizes findings that emerged throughout the project and offers policy and programmatic recommendations for the governor and legislative leaders.  Mathematica was compensated approximately $450,000 for the review, analysis, and report.