Connecticut Nursing Home Closure Practices

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Connecticut Nursing Home
Closure Practices
Receivership closure in 1999
High proportion of Medicaid recipients
High proportion of significant acuity-physical and mental health
Large number of residents transferring quickly
Questions of appropriate discharge planning
Questions of residents pressured to move quickly
Grant St Workgroup convened by the State Ombudsman-DSS,
DMHAS, CLS, BRS, LMHA’s
Model became foundation for future CT closure interventions
Foundation of CT Closure Interventions
Grant Street Rehabilitation Center
Relocation Study
CT Nursing Home Financial Advisory Council
Distressed Nursing Home Conferences
CT General Statute 17b-352, Certificate of Need
CT General Statute 19a-533, Waiting Lists
Current CT Interventions
CT Nursing Home Financial Advisory Council
 
Committee responsibilities include (1) evaluating any information and data available, including,
but not limited to , (A) quality of care, (B) acuity, (C) census, and (D) staffing levels of nursing
homes operating in the state to assess the overall infrastructure and projected needs of such
homes, and (2) recommend appropriate action consistent with the goals, strategies, and long-
term care needs set forth in the strategic plan developed pursuant to subsection (c) of  section
17b-369 to the Commissioner of Social Services and the Commissioner of Public Health.
Issues of financial solvency as it relates to quality of
care
Getting ahead of the curve
“Bad” nursing home closures vs “good” nursing
home closures-right sizing in the right way
CT Nursing Home Financial Advisory Council
 
    
Regularly scheduled conference call with AAG, DSS,
DPH, LTCOP to review:
Current financial nursing home bankruptcies,
receiverships, closures
Nursing homes with signs of financial
problems/potential for interventions
Distressed Nursing Homes
Conferences
19a-532 outlines process for filing for a CoN
 Letter of Intent (LoI) filed with DSS
Certificate of Need application
Public Hearing
 DSS determines whether to grant closure
Certificate of Need
Waiting Lists
2011 “BURS” receivership-4 nursing homes close
Issues of bed availability prompted Ombudsman to
propose legislation to provide opportunity for
resident to relocate to first choice facility from
another facility
Closures take on a life of their own!
Business/State Interests vs Residents Interests
Collaboration and vigilance
LTCOP and MFP collaboration=good resident transitions
Ombudsman Program Lessons Learned
All stakeholders agree that the best closure process is
one that:
Knows and Respects Residents’ Rights
Bias is best left to oneself
Provides information and ample opportunity to
explore all living options
Resident transitions always based on informed choice
After the closure and move the resident feels it is a
successful transition
Wish
 
List
Nancy Shaffer, State Ombudsman
www.ct.gov/ltcop
860-424-5239 or 866-388-1888
55 Farmington Avenue, Hartford, CT 06105
Connecticut Long-Term Care
Ombudsman Program
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Foundation of CT Closure Interventions: Grant Street Rehabilitation Center experienced closure in 1999 with a high proportion of Medicaid recipients and residents with significant physical and mental health needs. Current CT interventions involve the Nursing Home Financial Advisory Council and Distressed Nursing Home Conferences, addressing issues of financial solvency and quality care in nursing homes. The CT Nursing Home Financial Advisory Council, established under Public Act 14-55, directs a committee to assess nursing home infrastructure, needs, and quality of care. This council focuses on ensuring financial solvency aligns with maintaining high-quality care in nursing homes.

  • Nursing Home Closure
  • Connecticut Interventions
  • Financial Advisory Council
  • Quality Care
  • Public Act

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  1. Connecticut Nursing Home Closure Practices

  2. Foundation of CT Closure Interventions Grant Street Rehabilitation Center Relocation Study Receivership closure in 1999 High proportion of Medicaid recipients High proportion of significant acuity-physical and mental health Large number of residents transferring quickly Questions of appropriate discharge planning Questions of residents pressured to move quickly Grant St Workgroup convened by the State Ombudsman-DSS, DMHAS, CLS, BRS, LMHA s Model became foundation for future CT closure interventions

  3. Current CT Interventions CT Nursing Home Financial Advisory Council Distressed Nursing Home Conferences CT General Statute 17b-352, Certificate of Need CT General Statute 19a-533, Waiting Lists

  4. CT Nursing Home Financial Advisory Council PUBLIC ACT 14-55, SECTION 2: SUMMARY Public Act 14-55, section 2[1]and section 17-339 of the Connecticut General Statutes[2]directs a Nursing Home Financial Advisory Committee that examines financial solvency of and quality care provided by nursing homes. The committee members shall include the following: the Commissioner of Social Services or designee, the Commissioner of the Department of Public Health or designee, the Secretary of the Office of Policy and Management or designee, the Executive Director of the Connecticut Health and Education Facilities Authority, Long Term Care Ombudsman, and two members appointed by the Governor, one of whom shall be a representative of not-for-profit nursing homes and one of whom shall be a representative of for-profit nursing homes. Additionally, the Labor Commissioner may appoint a nonvoting member to the committee. directs the Commissioner of Social Services and the Commissioner of Public Health or their designee s to co-chair the committee and meet quarterly. Committee responsibilities include (1) evaluating any information and data available, including, but not limited to , (A) quality of care, (B) acuity, (C) census, and (D) staffing levels of nursing homes operating in the state to assess the overall infrastructure and projected needs of such homes, and (2) recommend appropriate action consistent with the goals, strategies, and long- term care needs set forth in the strategic plan developed pursuant to subsection (c) of section 17b-369 to the Commissioner of Social Services and the Commissioner of Public Health. The legislation

  5. CT Nursing Home Financial Advisory Council Issues of financial solvency as it relates to quality of care Getting ahead of the curve Bad nursing home closures vs good nursing home closures-right sizing in the right way

  6. Distressed Nursing Homes Conferences Regularly scheduled conference call with AAG, DSS, DPH, LTCOP to review: Current financial nursing home bankruptcies, receiverships, closures Nursing homes with signs of financial problems/potential for interventions

  7. Certificate of Need 19a-532 outlines process for filing for a CoN Letter of Intent (LoI) filed with DSS Certificate of Need application Public Hearing DSS determines whether to grant closure

  8. Waiting Lists 2011 BURS receivership-4 nursing homes close Issues of bed availability prompted Ombudsman to propose legislation to provide opportunity for resident to relocate to first choice facility from another facility

  9. Ombudsman Program Lessons Learned Closures take on a life of their own! Business/State Interests vs Residents Interests Collaboration and vigilance LTCOP and MFP collaboration=good resident transitions

  10. WishList All stakeholders agree that the best closure process is one that: Knows and Respects Residents Rights Bias is best left to oneself Provides information and ample opportunity to explore all living options Resident transitions always based on informed choice After the closure and move the resident feels it is a successful transition

  11. Connecticut Long-Term Care Ombudsman Program Nancy Shaffer, State Ombudsman www.ct.gov/ltcop 860-424-5239 or 866-388-1888 55 Farmington Avenue, Hartford, CT 06105

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