Report Assesses Long-Term Care Facility Response

CONNECTICUT — The full impact of the coronavirus on nursing homes and assisted living facilities far transcended infection tallies and death tolls, according to a new report.

The final report from Mathematica Policy Research, released Wednesday, evaluates the COVID-19 preparedness and response of both the state and the long-term care industry and makes specific recommendations for handling future outbreaks. Gov. Ned Lamont ordered the independent, third-party review on June 8. An interim report was released to the public on August 15.

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.

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,” the Department of Public Health said in a news release published Thursday. DPH eased visitation restrictions for nursing homes on Monday.

“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,” Lamont said. “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.”

Mathematica was compensated approximately $450,000 for the review, analysis, and report, according to a DPH news release.

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 long term care facilities to visitors based on a set of criteria at the facility and community levels, rather than a one-size-fits-all statewide visitation policy.

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

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

“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,” said Acting DPH Commissioner Gifford.

This article originally appeared on the Across Connecticut Patch

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