Judge bangs his gavel

Connecticut’s highest court has offered a mixed ruling for a nursing home that sought dismissal of a wrongful death suit under a state provision limiting COVID-era liability.

The court backed the provider’s interpretation that operators were protected in cases where short staffing due to COVID-19 conditions affected the ability to care for any patients in a healthcare facility. Coverage applies even when the affected patient doesn’t have COVID.

But the Supreme Court also ruled last week that a lower court was correct in denying Regency House of Wallingford’s motion, explaining that the provider should have presented more evidence of the effect of COVID on its operations to benefit from protections granted under an executive order.

In a companion ruling last week, the state Supreme Court also decided in Mills v. Hartford HealthCare Corp. that the immunity granted by Gov. Ned Lamont’s (D) 2020 order broadly applies to services meant to prevent, diagnose or treat COVID, but not to those taken after the virus had been ruled out.

The ruling comes as state courts grapple with how to interpret various immunity provisions and a federal liability statute. Many of the protections expired with the end of the public health emergency,  but cases from when they were in place continue to wind their way through appeals.

In denying the motion to dismiss the case involving Regency and its management company, National Health Care Associates, a Connecticut trial court cited the Mills case. A lower court had earlier interpreted the executive order to apply only in ‘‘instances involving the treatment of COVID-19 patients.’’ National sought to appeal its case to the state Supreme Court to help determine whether that ruling was too limited.

The state Supreme Court published rulings on the companion cases simultaneously Aug. 8.

“We are pleased with the court’s interpretation of the governor’s executive order within the opinions, which acknowledges the importance of protecting providers in the early days of the pandemic,” the company said in a statement emailed to McKnight’s Long-Term Care News Thursday. “Otherwise, we cannot comment on litigation that remains pending.”

Lack of resources may include ‘staffing’

Much of the court’s unanimous decision in Manganelli vs. Regency House centered around language in Lamont’s order regarding the “lack of resources” as providers responded to the pandemic.

The court found that cases involving a lack of resources — including a staff shortage — attributable to the pandemic that led to sub-par care should be covered under the immunity clause. But it also said the language clearly requires defendants to show evidence that COVID conditions caused that lack of resources.

In the Regency case, executor Kimberly Manganelli is seeking damages following the December 2020 death of Darlene Matejek. Matejek had lived at the 4-star nursing home since 2014 but fell during a bed transfer on April 26, 2020. She fractured both legs but when she returned, Manganelli alleged, she did not receive adequate physical therapy and developed other complications.

Regency argued that Matejek’s fall occurred during the height of the facility’s first COVID outbreak. A former director of nursing outlined detailed administrative challenges including staff shortages due to virus exposure, shortages of personal protective equipment, increased phone call volume, the weakened condition of Regency House residents, and increased requests for nurse evaluations. 

Court: More needed from provider

But the court said that was not enough, and that the facility’s attorneys should have sought an evidentiary hearing to argue how those operational challenges affected Matajek’s care specifically.

“The defendants provided no evidence regarding how the lack of these resources led to the defendants’ failing to implement Matejek’s health program, leading to her fall,” Associate Justice Gregory T. D’Auria wrote. “They also supplied no evidence regarding how the lack of these resources related to the defendants’ failure to provide Matejek treatment for two days. Finally, the defendants advanced no evidence regarding how the lack of these resources connects to the defendants’ alleged failure to provide Matejek with proper treatment after she left the hospital and returned to Regency House.”

The court, however, affirmed repeatedly that such arguments could be valid in future cases given proper evidence.

“This interpretation of the ‘‘lack of resources’ clause is consistent with the language of the immunity provision as a whole,” D’Auria wrote. “Specifically, the clause at issue goes on to clarify that the alleged acts and/or omissions are caused by the lack of resources when the lack of resources ‘renders the healthcare professional or healthcare facility unable to provide the level or manner of care that otherwise would have been required in the absence of the COVID-19 pandemic . . . .’ This language eliminates any possibility that the governor intended the immunity afforded by Executive Order No. 7V to apply only to the diagnosis and treatment of COVID-19 patients.”