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States getting creative to cut into nursing home survey backlogs

Amid nationwide concern about nursing home survey backlogs, one state is tapping into its COVID-19 funding to help jumpstart a recovery.

Connecticut lawmakers last week agreed to commit $700,000 in American Rescue Plan Act funds to address lingering complaints from nursing home residents and their families. The decision was included in a May 30 budget bill toward the end of a legislative session that also increased oversight of the aging services sector.

The Connecticut Mirror first reported the new funding for the state Department of Health and its nursing home survey teams. The digital news site previously reported that the state had 2,400 complaints from nursing home residents and others that had yet to be addressed. Surveyors also need to tackle about 1,300 hospital-related complaints, with some going without investigation for five years.

Connecticut is not alone.

A series of federal investigations has found significant nursing home survey delays in nearly every state, a long-running problem that was exacerbated by pandemic-era nursing home survey pauses, a focus on infection control inspections and a workforce crisis that has hit may state survey offices.

States have had mixed results rebuilding their rolls of investigators and cutting through the stacks of complaints. Delaware, for instance, announced in February that it had cut its nursing home survey backlog by 91%, partly by using contracted surveyors. But next door in Maryland, consumer advocates are so frustrated with the state’s slow progress that they have filed a lawsuit along with several nursing home residents with disabilities, seeking to compel faster survey responses.

Connecticut has faced mixed results with its efforts, according to the Mirror. The pandemic and retirements cost the health department’s investigations division critical employees, leaving it 40% understaffed at one point. One official told the Mirror the vacancy rate was down to 14%, but the state’s public health commissioner said about 75 new nursing home complaints are filed each month.

The additional Rescue Plan Act funds could help the state entice more surveyors to work full-time, said Chris Boyle, a spokesman for the health department. He said the department’s 46 nursing home surveyors work 35 hours a week. They could opt to work 40 hours a week but must volunteer to do so under the rules of a collective bargaining agreement.

It’s unclear whether other states could still tap American Rescue Plan Act funding to support survey efforts.

ARPA provided $350 billion in emergency funding for state and local governments to respond to the COVID-19 emergency and restore jobs. Though the money must be rationed out by the end of September, the Economic Policy Institute found in early 2024 that about half of that funding had yet to be earmarked.

The survey news came as Connecticut Gov. Ned Lamont (D) on Tuesday signed two significant aging services bills. One requires presumptive eligibility for would-be Medicaid patients starting Oct. 1, a move intended to get them into care, including home care, more quickly. Another limits the number of residents nursing homes can assign to a shared room.

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