WILTON, Conn. For-profit nursing homes in Connecticut had significantly more cases and deaths from COVID-19 than non-profit ones, according to an independent inquiry released on Tuesday that shed new light on the shortfalls of the state’s pandemic response.
Connecticut in June commissioned Mathematica Policy Research to investigate why COVID-19 had taken such a drastic toll on the state’s nursing homes and assisted living facilities, accounting for nearly three quarters of its coronavirus-related deaths.
Among other findings, the Princeton, New Jersey-based research firm found that for-profit nursing homes had about 60 percent more cases and deaths per licensed bed than nonprofit ones, and that larger facilities were harder hit than smaller ones.
It did not assess any reason for those discrepancies in its 93-page interim report, which included short-term proposals that Mathematica said it hopes “the state and industry can take to mitigate a potential second wave of COVID-19."
Connecticut and other northeastern U.S. states such as New York appear to have gained control over the virus, with infection rates among the lowest in the country.
But these states - the hardest hit early in the pandemic - are still coming to terms with their failure to prevent the virus from infiltrating nursing homes and other assisted living facilities in February, March and April, and are looking to create a playbook for a potential second wave in the fall months.
The inquiry could also offer lessons for U.S. Sun Belt states that have recorded a surge in nursing home cases in recent weeks.
Unique in some ways, Connecticut’s experience could prove especially instructive. It adopted a novel approach to keeping discharged COVID-19 hospital patients from re-entering nursing homes and ousted its health commissioner in May, exposing bureaucratic infighting that may have hindered its response.
“By no means do we get the ‘A’ grade," Sten Vermund, dean of the Yale School of Public Health, said in an interview before the report’s release. “I think most of us wished that we had been more aggressive and more savvy in predicting the inevitability of the wave through our state."
More than 3,200 residents of Connecticut nursing homes and assisted living facilities have died from COVID-19. Connecticut’s death toll per licensed bed did not differ significantly from nearby states, Mathematica found.
Connecticut’s coronavirus deaths have in recent weeks slowed to a trickle, helped by expanded inspections, testing and a move in April to set up facilities to take in discharged COVID-19 patients to prevent re-introducing the virus in nursing homes.
Mathematica also highlighted some potential flaws in the state’s response. It said Connecticut had not issued any citations to nursing homes for infection-control related problems from March to June, citing a survey of reports to the federal Centers for Medicare and Medicaid Services.
It also found that Connecticut tended to follow federal guidance rather than “proactively respond" to regional developments, citing the state’s universal mask order for healthcare facilities on April 4, which came well after New York issued a similar order on March 13.
Connecticut is the second state to disclosed an independent review of its nursing homes. New Jersey has enacted 19 proposals from its inquiry - made public in June - including a requirement that nursing homes report on staff taking sick leave or quarantined to identify future outbreaks.
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