CT House approves sweeping changes for nursing homes

The House on Monday passed a second broad bill addressing reforms in Connecticut’s elder care sector, including reducing the number of people who can reside in a nursing home room, adding consumer protections at assisted living centers and beefing up oversight of nursing home management companies.

The measure, introduced by Gov. Ned Lamont, moved forward with a vote of 143 to 7. Republican Reps. Anne Dauphinais, Craig Fishbein, Carol Hall, Gale Mastrofrancesco, Cara Pavalock-D’Amato, John Piscopo and Karen Reddington-Hughes voted against the proposal.

A few key sections of the governor’s original bill, such as the creation of a nursing home dashboard to compare quality ratings and a program that would designate high performing facilities as “centers of excellence” were moved to another proposal that passed the House last week.

(RELATED: House passes broad bill overhauling aspects of elder care sector)

The bill advanced Monday would phase out three- and four-bed nursing home rooms beginning on July 1, 2026 by halting new admissions in rooms that already have two people. Those currently living in a room with three or four beds will not be forced to move. Lawmakers said 17 of the state’s roughly 200 nursing homes still feature three- and four-bed rooms.

An earlier version of the proposal would have ceased new admissions to these rooms in 2025. Authors of the bill said the deadline was pushed back a year to give nursing homes more time to adjust.

Some legislators raised concerns about reducing the number of people per room.

“If we create conditions by lowering and limiting the number of beds available without adequate compensation, and we, by our actions here, force a nursing home operator potentially to not be able to afford to stay in business — now we’ve taken, say, 100 beds with the intent of going down to 80. And it could be zero if they’re not able to stay operational,” said Rep. Steve Weir, R-Hebron.

Nursing homes can report capital costs, such as room modifications or renovations, on their annual cost reports and the social services department will factor expenses into the Medicaid reimbursement rates, officials said. A provision in the bill gives the state’s social services commissioner the authority to recalculate Medicaid rates to adjust for conversions if needed.

The bill allows for better oversight of nursing home management companies. Under the measure, the state’s public health department would be able to deny or decline to renew a nursing home management certificate based on past or current discipline, enforce plans of correction against management companies, put management companies under similar scrutiny as the department has for change of ownerships, and impose penalties, such as revocation of certificates or civil penalties.

It also requires management companies to get approval from the health department before taking on new facilities beyond those identified at licensure or renewal.

The proposal also mandates that assisted living services agencies disclose fee increases to residents or their representatives at least 60 days before they take effect and, upon request, provide them with a history of fee increases over the past three years.

Additionally, the bill would:

Allow the health department to bring disciplinary actions against long-term care facilities that fail to comply with the terms of an accepted plan of correction (currently, the department lacks enforcement mechanisms).
Extend the health department’s authority to enforce violations of state law, not just federal law.
Require nursing home or residential care home receiver applications to be granted if the facility sustains any type of serious financial loss or failure.
Update the criteria for who may be appointed as a receiver to remove the requirement that they be licensed nursing home administrators.
Establish a working group to make recommendations that assist nursing homes in phasing out three- and four-bed rooms.

The Connecticut Mirror has reported extensively on gaps in the state’s elder care system — both in nursing homes and home care — and highlighted worsening conditions in many nursing facilities. Serious violations known as immediate jeopardy orders were on the rise in 2023, a major nursing home chain faced a number of lawsuits, and the chief executive officer of that company acknowledged he was six months behind in paying health claims for employees.

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