Surveyors in Connecticut are failing to conduct routine inspections in about half of the state’s 203 nursing homes, with serious violations on the rise over the past year-and-a-half.

That’s according to a review by the CT Mirror of state data, which found 95 of Connecticut SNFs are overdue for recertification inspections. Facilities should receive recertification inspections every 16 months.

The state Department of Public Health (DPH) linked inspection backlogs to a lack of staff, a suspension of inspections during the first year of the pandemic, and the time it takes to hire and train new surveyors.

It appears a lack of surveyor staff is nothing new, with about 20% to 25% of such positions open currently. Compared to a year ago, about 40% of such positions were vacant.

In a joint statement, LeadingAge Connecticut President Mag Morelli and Connecticut Association of Health Care Facilities (CAHCF) President and CEO Matthew Barrett said their members are eager to get the annual survey inspections back on schedule.

A timely survey process is important for consistency in the regulatory process and ensures quality care for residents.

“That said, Connecticut providers have a deep understanding of the overwhelming impact that the workforce shortage is having on the state’s efforts to hire new surveyors,” Barrett and Morelli added. “In fact, Connecticut nursing homes are among the many health care providers competing with the Department of Public Health in recruiting for the same workforce as the majority of surveyors are nurses by profession.”

Immediate jeopardy orders in the state escalated as well, with 17 issued in 2018, and 24 in 2022. The state reported 12 just within the first half of last year, the CT Mirror reported. Such orders from the DPH indicate that a violation occurred and was likely to cause harm or death to residents.

Twenty people have died in connection with these immediate jeopardy violations, which appear to be more egregious since April 2019, with more than half occurring since October, the CT Mirror reported.

Overall, Barrett and Morelli said the industry could benefit from a longer time frame of review and more detailed information to better understand root causes behind immediate jeopardy findings. More analysis could determine if results are more of a reflection on surveyor experience, or directed survey behavior nationwide, they said.

It appears this is a national trend, with providers facing surveys conducted by less experienced individuals.

“There may be many different circumstances or situations surrounding those events and we would be very open to working with DPH on a strategy to provide sector-wide education and training in any area identified as needing particular focus,” noted Morelli and Barrett.

A rise in immediate jeopardy cases, and more concerning ones at that, are attributed to less oversight, high turnover and gaps in training, the CT Mirror reported. Facilities are seeing younger, newer administrators, directors of nursing and management teams overall, according to Mairead Painter, Connecticut’s long-term care ombudsman.

State officials met in May to examine inspection issues more closely, with the panel composed of public health and social services employees, providing updates to the state health commissioner.

Barbara Cass, the health commissioner’s senior advisor for long-term care, told the CT Mirror the state is “aggressively” hiring and training surveyors, but the entire process usually takes six months.

And, while 95 nursing homes are overdue for survey inspections, health officials have visited about 80% of facilities to respond to complaints or perform other types of surveys, Cass said, including infection control inspections.

“DPH has had a strong presence in the nursing homes over the last three years, just not in conducting the annual survey,” Barrett and Morelli said. “Nursing homes received multiple infection control surveys throughout the pandemic and worked very closely with DPH during the height of the Covid-19 crisis.”