Family-owned nursing homes in Connecticut are closing. The companies are losing funding and residents, as the state shifts to accommodate an increasing number of people who want to age at home.
WSHU’s Ebong Udoma spoke with CT Mirror’s Dave Altimari to discuss his article, “After 50 years, a five-star nursing home closes — with a warning,” as part of the collaborative podcast Long Story Short.
WSHU: Hello Dave, can you tell us about the closure of Hughes Health & Rehabilitation in West Hartford? Why is it a significant warning for the future of nursing home care in Connecticut?
DA: Well, first of all, it is a well-respected nursing home, family-owned, and was purchased in 1961. It was a five-star facility before COVID. The concern is the state is spending less money on long-term care facilities and more money on home health care. And what advocates are worried about is, what's going to happen is, you're going to lose what they call the mom and pop nursing homes, the privately owned nursing homes that are important in a community, such as Hughes, and you're going to end up with just chains that own many nursing homes. And you don't get what they feel is that level of care that you get in a smaller facility that's family-owned.
WSHU: Now, the money has been shifting because a lot of elder care is funded by the state. And the state has been shifting funding to home-based health care. Why has it been doing that? And is this a fallout from the COVID situation?
DA: It started before COVID. But COVID certainly sped up the process. The idea is that overall, people want to stay home, they don't want to go into a nursing home. And so the state has been slowly shifting its Medicaid funding from nursing homes into more home health care things, whether it be a visiting nurse or a home health aide who comes to your house for a couple of hours.
The problem for nursing homes is that it's a double situation. For one, the funding levels have decreased. Also, costs have increased. Hughes was losing up to $30,000 a month post-COVID. That's a combination of not having as many residents in the facility (it's built for 170, at the time that they announced they were closing I believe they were like 85) but also costs that have gone up from everything from food to paying employees.
WSHU: Even the maintenance of the facility was very expensive.
DA: Yes, Hughes is a little specific because Sam, the 27-year-old guy that was left to take care of the facility for his family, acknowledges that they did not do a lot of work on the building after it was built. And the building is pretty much the same as it was then, it needs a significant amount of work — $10 to $12 million worth — to make it a COVID friendly building. And so that's an added cost that they're facing. But the reality is, many of the nursing homes in Connecticut are older than Hughes. Some of them were built in the early 1900s, many were built in the early 60s. And they're built similar to Hughes, all brick hospital-like looking buildings.
WSHU: So basically, the pendulum seems to be swinging away, and it may be swinging too far away. You quote the state's long-term ombudsman Mairead Painter, she said that small neighborhood nursing homes are what we want to see more of, not less of. Why do we want to see more of these smaller nursing homes, considering that there's this push to have people stay at home?
DA: Certainly people would like to see a smaller family-owned. What's happening in nursing homes now is many of them are being bought by hedge funds or private equity. And so it's not a local owner. In the case of Hughes, Mr. Hughes was a podiatrist in West Hartford when he purchased the nursing home. He expanded it and worked there until from the 1960s to the 1980s. Sam's dad was supposed to take over; he actually was a nurse at the facility. He died young, unexpectedly.
I think that, in a way, really hurt Hughes because he was supposed to be the family person that was going to run it from the inside, so to speak. But there have been a lot of smaller locally owned nursing homes that have sold in the last year or so. And many of them have been sold to private equity firms. And I think the state is getting a little concerned about that, because the level of care tends not to be as great.
WSHU: So is there anything in the works to shore up these locally-based nursing homes?
DA: At the moment, not really. The state has indicated that there needs to be a right sizing of nursing home beds. They believe right now that there's a couple thousand too many beds in Connecticut. And so frankly, they expect other nursing homes to close. This will not be the last one that we see close, there's been about a half a dozen that have closed since COVID. And I expect we will see more close or more be sold to the Wall Street companies that see the nursing homes as a way to turn a quick profit.
WSHU: I saw a story about one of the large private equity firms buying up nursing homes for real estate. And that was what they were more interested in than actually running a nursing home.
DA: No question. That's exactly what they're interested in. They're interested in the property. Quite frankly, some of the buildings, the property will get sold and somebody will probably tear it down and build apartments or something like that. That's what happens to a lot of these older buildings that no longer are going to be fit to be nursing homes.
WSHU: Okay, so basically, we've got to try and plan how we are going to age.
DA: That's a big issue in Connecticut in general, as we've talked about on this podcast a lot recently. There's a big shift in where the money's going and we are an older population, we are already old and getting older. And this is going to be a massive issue financially for the state, frankly, not just personally for people but for the state. It's going to be a financial issue, that at some point, there's going to be a reckoning that they need to deal with.
