Conn. Department of Public Health gets funds to help address complaint backlog

Department of Public Health Commissioner Manisha Juthani addresses the press as Governor Ned Lamont watches. (Shahrzad Rasekh/CT Mirror)

The Connecticut Department of Public Health will receive $700,000 in American Rescue Plan Act funds to help clear a backlog of unaddressed complaints from nursing home residents and their families.

Lawmakers set aside the funding in a budget stabilizer bill passed during the final week of the legislative session. The Connecticut Mirror reported in April that the health department had a backlog of 2,400 complaints from nursing home residents and their loved ones, and another 1,300 complaints related to incidents at hospitals, some of which date back five years.

The funding was designated for nursing home survey teams.

And even as the department is trying to catch up on complaint inspections, Dr. Manisha Juthani, the state’s public health commissioner, said DPH is getting about 75 new grievances from nursing homes each month.

Chris Boyle, a spokesman for the department, said this week that officials are weighing how to use the ARPA funds. “DPH is currently reviewing the proposal to assess whether and how we might use it to increase weekly work hours for surveyors,” he said.

The health department currently has 46 nursing home surveyors, including trainees, all of whom work 35 hours a week, Boyle said.

One option would be to allow those employees to work 40 hours a week voluntarily.

“We believe some surveyors will be interested in moving from 35 to 40 hours per week,” Boyle said. “Moving employees from 35 to 40 hours per week is subject to a collective bargaining agreement covering these employees and requires such moves to be made on a voluntary basis.”

“Over the last two years, DPH has [also] brought on board temporary worker retirees to help with survey work,” he added.

The pandemic and a wave of retirements in the agency’s Facility Licensing and Investigations Section contributed to the complaint pileup. At one point, FLIS was more than 40% understaffed, but through “aggressively” recruiting, its leaders said, the vacancy rate is down to 14%.

The unaddressed complaints date back as far as 2019, Boyle has said.

At the height of the pandemic, survey and complaint inspections were put on hold while health officials carried out infection control visits. The Centers for Medicare and Medicaid Services “halted our investigations for all complaints other than the most serious in early 2020, meaning that we had some complaints from 2019 on the books when the pandemic hit,” Boyle said.

As the department deals with the backlog, surveyors are handling “immediate jeopardy” and “high-priority events” quickly, while complaints that are considered “medium” or “low” priority can take longer to resolve. Immediate jeopardy cases — findings that indicate violations in a nursing home caused or were likely to cause harm or death to residents — are responded to within three business days. For high-priority events, the state must initiate an on-site survey within 18 business days, and for medium-priority incidents, within 45 calendar days. Low-priority events are typically dealt with during the facility’s next routine inspection.

A high-priority event could be a door falling off its hinges and hitting a resident, injuring them, or a staff member humiliating or speaking rudely to a resident. A medium-priority incident could be a resident receiving cold coffee, a resident missing a recreational activity, or that soiled clothes were left on the bathroom floor. Low-priority events could be an issue with coding in someone’s medical record that did not impact care.

“Every single complaint that comes to the agency is important to us, because it’s impacting someone’s life,” Barbara Cass, the health commissioner’s senior advisor for long-term care, told the CT Mirror .

Medium- and low-priority grievances are “important to us, but they are not suggesting an imminent threat to life or safety or an immediate negative outcome,” she said.

Legislators said that although high-priority events are being addressed, quality of life issues that could generate lower-priority grievances are also crucial.

“The atrocities we’ve been seeing in nursing homes, we need to be able to answer those complaints,” said Rep. Jane Garibay, D-Windsor, co-chair of the Aging Committee. “We hear from the public all the time, and we shouldn’t [only respond] because someone choked to death.

“If someone’s being mistreated … five years later, that person could be dead. Some of the people who complained in 2019 aren’t even alive now. So it’s very important to reach out to them. We’re hoping that with this support, they’re going to be able to pull this together.”

“There’s no such thing as a minor complaint. If somebody’s complaining, it’s quality of life stuff,” added Rep. Mitch Bolinsky, of Newtown, a ranking Republican on the Aging Committee. “The goal is to get every complaint taken care of. We have to clear the backlog. The intent of the funding is to get those teams up to 40 hours [a week] and give them the opportunity to sort through their workload.”

Sen. Cathy Osten, D-Sprague, co-chair of the Appropriations Committee, said the health department should also consider mandatory overtime for workers to help clear the complaint backlog.

“They should have overtime until these cases are caught up,” she said. “What is termed a ‘low’ or ‘medium’ complaint is still something important to the family member or person who’s inside a nursing home. If they’re stuck in bed for too long or the food they’re given doesn’t taste well or it’s not warm enough — those are big deals.

“I won’t eat a meal that’s not cooked enough. I don’t expect anyone to lay in a bed all day long. These are things we shouldn’t accept.”

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