Connecticut’s nursing home owners will be required to disclose ties to private equity companies or real estate investment trusts under new state rules. 

But lawmakers there did not take the same stringent tone when it came to a proposal that would have increased the daily direct nursing care requirement, or staffing minimum, by more than one-third.

Lawmakers in Connecticut approved new accountability and transparency measures aimed at shining a light on who is making decisions or who is profiting from nursing, according to local reporting. The information gleaned from these new reports that could show if “owners and operators are collecting large salaries or administrative fees” could be used to introduce more bills “requiring facilities to direct a certain portion of state funds toward direct care only,” according to an article in the Hartford Courant. 

“We have to know what’s going on,” Rep. Jane Garibay (D), a co-chair of the Aging Committee, told the paper. “We don’t really know how much they’re earning. And not just the bottom line of the nursing home — how much are the owners earning? That’s going to be an important piece.”

Nursing home operators who fail to disclose private equity or real estate investment trust stakes may be fined up to $10,000 for each reported violation, the paper reported. They will also have to submit narrative expenditure summaries to accompany annual cost reports filed with the state. 

Enhanced accountability and directing funding are among legislative trends seen in states and at the federal level. US Sen. Chuck Grassley (R-IA) has been pushing the Centers for Medicare & Medicaid Service to finalize rules the agency has let sit since May 2011 to clarify ownership definitions, set “strong” auditing and enforcement measures; and create an “easily searchable format” for required information. 

New York recently passed legislation that would lessen the penalties on nursing homes that fail to meet new requirements to spend 70% of their revenue on patient care with at least 40% of that mandated to pay for resident-facing staff. The legislation also drops the amount of money facilities that exceed a 5% profit cap will have to pay back to the state if they reduce their usage of agency staff. Gov. Kathy Hochul (D) has not yet signed those bills into law. 

As the clock ticks on the federal Centers for Medicare & Medicaid Services’ release of a federal rule on staffing minimum levels, lawmakers in Connecticut ultimately took a pass on creating a state law that would have raised from 3 hours to 4.1 hours the minimum time required for direct nursing care per patient day. 

That staffing minimum measure would have cost $26.6 million in the first year of implementation. The sector’s operators opposed the rule, pointing to the ongoing workforce crisis. 

Lawmakers also passed on a bill that would have cut funding for facilities where occupancy drops below 90%, opting instead to create a working group to examine licensed bed capacity and whether Medicaid payment policies are supporting “right sizing” the sector, the Hartford Courant reported.

“The notion of having a thoughtful study and review that really drills down on the excess bed capacity issues is well timed and a smart move in our view,” Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, said, according to the newspaper. “Right-sizing, rebalancing and questions of bed capacity are part of the culture or calculus of Medicaid decision making now. … And so with that, the policy of really drilling down on where the excess beds are is a smart move.”