Connecticut nursing home responsiveness requirements

A complaint of patient abuse, or any abusive act toward a patient by any person, is a Class B reportable event requiring immediate notice to DPH confirmed by written report within 72 hours, and the facility must launch its own investigation within 24 hours of an allegation of abuse or an injury of suspicious or unknown origin.

Classes A, B and C: immediate notice by telephone to the Department, to be confirmed by written report as provided herein within seventy-two (72) hours of said event ... An investigation shall be initiated by the facility within twenty-four (24) hours of the discovery of a patient(s) with an injury of suspicious or unknown origin or receipt of an allegation of abuse.

Nursing home administrators, nurses, nurse's aides, and any staff person of a nursing home facility are mandatory reporters who must report suspected abuse, neglect, exploitation, or abandonment of a person 60 or older to the Commissioner of Social Services within 24 hours of the suspicion arising.

shall, not later than twenty-four hours after such suspicion or belief arose, report such information or cause a report to be made in any reasonable manner to the Commissioner of Social Services or to the person or persons designated by the commissioner to receive such reports.

The long-term-care-facility-specific mandatory reporting statute, which still carries a 72-hour clock to the Commissioner of Social Services for suspected abuse, neglect, exploitation, or abandonment of a resident in a long-term care facility.

shall, not later than seventy-two hours after such suspicion or belief arose, report such information or cause a report to be made in any reasonable manner to the Commissioner of Social Services pursuant to chapter 319dd.

Nursing homes must report reportable events to DPH through the department's electronic notification system rather than by voice call.

Nursing homes and behavioral health facilities shall report reportable events to the department using the electronic reporting system developed pursuant to subsection (b) of this section.

The nurse supervisor must notify the resident's personal physician on any significant change in condition or need for immediate medical care, and must escalate to the medical director if that physician does not respond promptly.

Notification of a patient's personal physician if there is a significant change in the condition of the patient or if the patient requires immediate medical care, or notification of the medical director if the patient's personal physician does not respond promptly.

The medical director must ensure every resident has an assigned personal physician and must personally provide or arrange the necessary medical care whenever that personal physician is unable or unwilling to do so.

Provide or arrange for the provision of necessary medical care to the patient if the individual's personal physician is unable or unwilling to do so;

At least one registered nurse must be on duty 24/7; a chronic and convalescent nursing home must also keep a licensed nurse on every resident-occupied floor at all times, a rest home with nursing supervision must keep an aide on each floor with intercom access to a licensed nurse, and total direct-care staffing may not fall below 2.17 hours per resident (7 a.m.–9 p.m.) and 0.83 hours per resident (9 p.m.–7 a.m.).

There shall be at least one registered nurse on duty twenty-four hours per day, seven days per week. (A) In a chronic and convalescent nursing home, there shall be at least one licensed nurse on duty on each resident-occupied floor at all times. (B) In a rest home with nursing supervision, there shall be at least one nurse's aide on duty on each resident-occupied floor at all times and intercom communication shall be available with a licensed nurse.

Statute directing DPH to set nursing home minimum staffing at three hours of hands-on direct care per resident per day (implemented in the Public Health Code at § 19-13-D8t(m)(6), whose 2.17 + 0.83 hour tiers sum to exactly three hours).

the Department of Public Health shall (1) establish minimum staffing level requirements for nursing homes of three hours of direct care per resident per day

The director of nurses must build a duty schedule assuring 24-hour nursing coverage and must report significant clinical developments to the resident's personal physician and to the medical director.

reporting significant clinical developments to the patient's personal physician and to the medical director;

Under Connecticut's statutory patients' bill of rights, a nursing home resident may send and receive personal mail unopened and make and receive telephone calls privately, unless a physician, PA, or APRN documents in the record that this is medically contraindicated.

may send and receive the patient's personal mail unopened and make and receive telephone calls privately, unless medically contraindicated, as documented by the patient's physician, physician assistant or advanced practice registered nurse in the patient's medical record

Residents have a right of access to representatives of the Department of Public Health and of the Office of the Long-Term Care Ombudsman, and to present grievances without restraint, interference, coercion, discrimination, or reprisal.

(C) access to representatives of the Department of Public Health or the Office of the Long-Term Care Ombudsman;

Connecticut-specific right, added in 2021, for a nursing home resident to use audio/video technology of the resident's own choice in their room for virtual visitation and virtual monitoring, at the resident's expense and subject to notice and privacy conditions.

A resident shall have the right to use technology of the resident's choice that facilitates virtual monitoring or virtual visitation

Every facility must maintain a written emergency preparedness plan, reviewed by the fire marshal, that specifies identification and notification of appropriate persons plus alarm systems, staff assignments, evacuation and relocation, transfer of records and casualties, with a copy on each nursing unit, key sections conspicuously posted, drills on every shift four times a year, and documented staff training.

The plan shall specify the following procedures: (A) Identification and notification of appropriate persons; (B) Instructions as to locations and use of emergency equipment and alarm systems;

Each nursing home's administrative head must furnish the home's emergency plan of operations to the municipality in which it is located, for incorporation into the municipality's own emergency plan.

the administrative head of each nursing home and each dementia special care unit shall provide its emergency plan of operations to the political subdivision of this state in which it is located

A nurses' calling station is required at every patient bed, toilet, bathing fixture and patient lounge, with visible and audible registration at the nurses' station and a corridor dome light, emergency-only cancellation at the source for toilet and bathing stations, and two-way voice communication with an indicating light at each station.

A nurses' calling station shall be installed at each patient bed, toilet, bathing fixture and patient lounges: (i) All calls shall register a visible and audible sound at the station, and shall activate a visible signal in the corridor at the patient's door ... (iv) Stations at toilet and bathing fixtures shall be emergency stations. The emergency signal shall be cancelled only at the source of the call. (v) Nurses' call systems shall provide two-way voice communication and shall be equipped with an indicating light at each station.

Required-equipment rule mandating at least one telephone per nursing unit (a staff nursing-unit phone, not a resident telephone).

(D) one (1) telephone per nursing unit;

Closest Connecticut analog to QAPI: the administrator and director of nurses must review all reportable events monthly, identify every situation carrying a potential for risk, determine what preventive measures staff will implement, and document that determination to the medical staff, retaining it three years.

All reportable events, which have occurred in the facility, shall be reviewed on a monthly basis by the administrator and director of nurses. All situations which have a potential for risk shall be identified. A determination shall be made as to what preventative measures shall be implemented by the facility staff. Documentation of such determination shall be submitted to the active organized medical staff.

The active organized medical staff must meet at least every 90 days to hear reports on all deaths, accidents, complications and infections and to conduct medical quality-of-care evaluations, and its by-laws must set criteria for evaluating the quality of medical care in the facility.

(ii) medical quality of care evaluations; and ... (ii) criteria for evaluating the quality of medical care provided in the facility;

Each nursing home's infection prevention and control committee must meet at least monthly (daily during an outbreak) and must evaluate the implementation and outcome of its protocols at least annually and after every outbreak — a subject-matter-limited quality review committee.

Not less than annually and after every outbreak of an infectious disease in the nursing home, the prevention and control committee shall evaluate (A) the implementation and analyze the outcome of such protocols