Gov. Ted Lamont

A third-party research team has released an interim report on its preliminary assessment of the coronavirus outbreak in Connecticut’s assisted living communities and nursing homes, along with short-term recommendations to help the state prepare for a second wave.

In June, Connecticut Gov. Ned Lamont hired Mathematica Policy Research for a reported $450,000 to conduct an independent review of the state’s response to COVID-19 in its long-term care facilities. Connecticut had more than 3,000 long-term care deaths — 74% of all COVID-19 deaths in the state — claiming the highest death rate per population among area states.

Although many of the state’s assisted living communities saw COVID-19 outbreaks, they generally were less severe than those in nursing homes. Only 3% of assisted living communities had more than 50% of residents contract the virus, 3% had more than 20% of residents die from the virus, and 37% reported no cases or deaths.

“Our preliminary assessment of the state’s response found that state officials made policy decisions and issued guidance based on the available knowledge at the time from national and state epidemiologist and public health experts, but that knowledge was undermined by gaps in the scientific understanding of the virus,” said Patricia Rowan, researcher at Mathematica and the project’s director. “Connecticut took an important step in supporting this independent research, and we believe our recommendations will help ensure that the state and long-term care industry are better positioned to respond to a potential second wave of COVID-19.”

Mathematica’s findings and recommendations fell into eight categories: surveillance and outbreak response, screening and testing, infection control, staffing and workforce availability, communications, emergency response, reimbursement mechanisms and person-centered care. 

Takeaways for assisted living communities:

  • Strict measures to limit viral spread should be balanced with person-centered supports for residents’ physical, emotional and psychosocial needs. 
  • Safe visits between loved ones and residents should be a priority, and policies restricting the movement of residents within their community should be assessed continually to prevent loneliness and depression.
  • Families should receive timely updates on individual residents during lockdowns.
  • Widespread availability of on-site, rapid testing and regular testing of residents and staff members is necessary for operating through a second wave and beyond.
  • Communities should continue partnering with the state for personal protective equipment needs and technical assistance on infection control guidelines.
  • Communities should consider creative staffing solutions to limit potential exposure of both staff members and residents, including 12-hour shifts to limit entry and exit of staff, the limitation of staff working in multiple facilities, and the cohorting of residents and staff.
  • Long-term care representatives should be part of early planning and response efforts for a second wave of the virus. Communities should have the option to transfer COVID-19-positive residents directly to COVID-19 recovery facilities without a hospital transfer. 

Mathematica compared publicly reported data from the state’s long-term care facilities with data from other states in the region, reviewed policy and guidance, and interviewed a wide range of stakeholders, including state agency staff members, facility administrators, trade association representatives, labor representatives, legislators and family members.

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