Mold Remediation in Waterbury, CT

Staffing problems at a Prospect-owned hospital in Connecticut are affecting patients and practitioners, according to the hospital’s nursing and technicians union.

The concerns at Waterbury Hospital — one of three hospitals in Connecticut owned by the private equity firm Prospect Medical Holdings — continue after unannounced inspections last year found a staffing shortfall at the hospital’s emergency department.

Public records obtained by Connecticut Public stated the department was understaffed by between one and four registered nurses on 80% of the reviewed shifts in October and November.

Union officials say those staffing problems continue this year, even after a state law was passed in 2023 to try to fix the problem of staff-to-patient ratios at hospitals statewide.

In a statement, Waterbury Hospital said it continues to work to recruit nurses despite national shortages. It says “providing safe, quality patient care is our top priority” and that the hospital remains in compliance with state and federal care guidelines.

Private equity and persistent problems at Prospect

As Connecticut Public has reported, state investigations at two Prospect-owned hospitals in Connecticut, including Waterbury, unearthed a pattern of alleged patient abuse and a failure by hospital staff to conduct timely investigations in accordance with hospital policy.

A sale of the three Prospect-owned hospitals in Connecticut — Rockville General, Manchester Memorial and Waterbury Hospital — to Yale New Haven Health is also currently in jeopardy.

In May, Yale sued Prospect alleging mismanagement. Prospect countersued, saying Yale was breaching its contract on the $435 million deal.

The multimillion-dollar deal has caught the attention of lawmakers. In September, U.S. Sen. Chris Murphy told members of the Senate Health, Education, Labor, and Pensions Committee that private equity firms like Prospect are cutting staff and gutting services at hospitals to boost profits.

“Are you making money for the purpose of providing good health care or are you making money for the purpose of making the owners filthy rich?” Murphy said.

‘I was hopeful’

State law mandates hospitals formulate staffing committees to ensure each unit has a healthy ratio of patients to nurses or medical assistants. The staffing committee is evenly split between hospital administrators and nurses, but nurses get a "plus-one" vote. In a union hospital like Waterbury, the union selects the nurses on the committee.

In July, the administration and nurses at Waterbury Hospital met to hammer out a new agreement on staff-to-patient ratios and a plan was agreed upon.

Staff at the hospital were optimistic.

“It was a unanimous vote in favor of the plan, and I was hopeful that staffing would get better at that point,” said Edmund Gadomski, executive secretary at the Connecticut Health Care Associates District 1199.

But Gadomski says the hospital is “not complying with the staffing plan submitted and that is leaving the staff short staffed and working in a dangerous work environment on a daily basis.”

In a statement, the hospital said “any issues that are self-identified or noted by the Department of Public Health (DPH) are immediately addressed.”

“We continue to work with our unions and our regulators to meet all regulatory requirements,” the hospital said.

Medications not administered on time, not documented

Medication administration and documentation were also a problem at Waterbury Hospital, according to records obtained by Connecticut Public of unannounced state inspections of the hospital in 2023.

One nurse said she was unable to administer on Aug. 7 an intravenous antibiotic to a patient whose palm fell onto nails because “she was busy.”

That same patient, who was diabetic, also lacked documentation of proper blood-glucose monitoring, public records showed.

In a response to DPH investigators, the hospital on Aug. 8 said it provided education on dose timing to all nursing staff, and supplied a posted reference chart to each of the nursing units as a job aide.

One shift per day was also assigned to complete verification of the medication administration record to the physician’s orders. And the pharmacy and nursing unit would no longer accept medication orders if they were not complete or compliant with the guidance that was put in place, the hospital said.

‘The danger of a medical error occurring’

Gadomski, with the hospital’s nursing and technicians union, said when staff is stretched thin, problems can develop.

“If you’re working short staffed it certainly increases the danger of a medical error occurring and that’s what we’re trying to avoid,” Gadomski said.

He said the shortage — also comprising patient care assistants — persists across departments at Waterbury Hospital, including at a unit where patients need continuous cardiac monitoring.

A complaint by the union has been pending with the state Department of Public Health (DPH) since January and Gadomski said DPH officials have been on-site at the hospital on a regular basis.

Chris Boyle, a spokesperson for the DPH, said the agency “does not release any details regarding open investigations.”

‘These small hospitals can’t survive on their own’

Dr. David Hill, a pulmonary critical care physician on staff at Waterbury Hospital, who also serves as chair of the local leadership board for the hospital, attributed the hospital’s staffing challenges in part to cash flow problems, for which he said lawmakers bear responsibility.

“We have a high burden of Medicaid patients. The state has not increased reimbursement for Medicaid patients to hospitals in over fifteen years,” he said.

“The challenges we face, some of that may be put on Prospect, but a lot of this is on the state of Connecticut. We're a very wealthy state, and we're underfunding health care for the people who need it the most, and these small hospitals can't survive on their own.”

Waterbury’s median household income is $48,787, compared to $83,572 statewide, according to data from Data Haven.

Hospitals were reimbursed 62 cents for every dollar they spent on a patient insured by Medicaid in 2022, according to the Office of Health Strategy.

And then there’s the ongoing struggle of finding enough nurses.

It’s a crisis that has hit hospitals across America in the wake of the COVID-19 pandemic.

In a statement, Waterbury Hospital acknowledged the ongoing nursing shortages, but said, “despite this challenge, we continue to actively and successfully recruit nurses and staff, with new employees joining our team every month.”

Gadomski agreed. But said the problem is that they leave.

“Many of the nurses come in, unfortunately see what's going on and leave,” he said. “There's got to be a plan in place for retention, not just for drawing in nurses.”

Learn more

Pattern of alleged abuse emerges following state inspections at 2 Prospect-owned CT hospitals

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The developer of a proposed 650,000-square-foot Amazon distribution warehouse on 183 acres at the Waterbury/Naugatuck Industrial Park has been granted another extension by Waterbury officials to complete the sale and close on the property.

Waterbury Mayor Paul Pernerewski approved a nine-month extension of the deadline, giving the developer until next August to conduct due diligence in completing the deal. The extension comes after a small but vocal group of Naugatuck and Waterbury residents spoke out against the plans for the massive logistics Amazon facility to be built by the Bluewater Property Group, headquartered in New York City and suburban Philadelphia.

The intial presentation of the plans occurred in early September.

Thomas Hyde, chief executive officer of Naugatuck Valley Regional Development Corp. which is representing the two communities in the process, said Wednesday that the public shouldn't read anything into Bluewater's decision to seek another extension for the closing date.

"This is a big project and it takes time to work through everything," Hyde said. "At this point, the project needs approval from the wetlands commission in Naugatuck and the state Department of Transportation because of the amount of traffic this facility is expected to generate."

He said developers will sometimes purchase a property where a large facility is being planned, making the closing of the sale contingent on obtaining the necessary state and local land use approvals. In some cases, a developer will purchase the property first and then seek the necessary approvals, Hyde said.

"In some ways doing it this way is better for the communities involved," he said of the extension on the closing date. "In cases where the purchase of the property comes first, if the project falls through, then you worry about the property's owner just sitting on the property and doing nothing with it."

Pernerewski said Wednesday that city officials have remained in regular contact with Bluewater executives and "the conversations that have had with them have all been positive."

"When they sought the first extension last October, we were a little concerned because in a lot of other places they were building, they were scrapping their plans," Pernerewski said. "But they've made a lot of progress on this project since then and we're very confident this will continue to move forward. This is a very difficult site that they've chosen, especially in terms of the blasting they need to do."

Officials with Bluewater were not immediately available for comment on receiving another extension for closing on the property. A hearing on the project has been scheduled for Oct. 3 in Naugatuck.

Bluewater owns a number of logistics facilities in the Northeast, including one in Johnston, Rhode Island, and another under construction in Charlton, Massachusetts, not far from the Connecticut line and Interstate 84.

The developer's plans were first made public in January 2022.

Concerns raised by residents of the two communities at the informational meeting in early September included truck and employee vehicles snarling traffic at certain points during the day; damage to nearby structures from blasting rock to level the site during construction; any residual impact on nearby property values in having a busy industrial facility in close proximity; and the facility's overall environmental footprint.

Includes prior reporting by Liese Klein, Paul Schott and Alex Soule.

This story is part of CT Mirror Explains, an ongoing effort to distill our wide-ranging reporting into a "what you need to know" format and provide practical information to our readers.

Athena Health Care Systems has lost federal Medicare funding for nearly 200 residents living at the Abbott Terrace Health Center in Waterbury, causing the company to prepare for the closure of the nursing home.

The Centers for Medicare and Medicaid Services notified state officials and Athena that because of the “facility’s failure to meet Medicare’s basic health and safety requirements,” funding would be stopped as of Sept. 10 for any new patients and within 30 days for all patients.

The unprecedented step by federal officials in effect will close the 205-bed facility because most of its residents are Medicaid or Medicare recipients and not private payers. It comes amid growing financial problems and legislators’ concerns about patient care at Athena facilities.

Here’s what to know.

Department of Public Health officials made several visits to Abbott Terrace over the first six months of this year, during which concerns were raised about the facility itself and patient care.

The inspections showed staff shortages, particularly for nurses, large holes in the tile floors and at least one incident where an employee told a resident with incontinence problems “they could smell them in the hallway.”

[RELATED: Athena nursing home in Waterbury loses federal funding]

The federal Medicare website lists a 1-star rating for Abbott Terrace, with “much below average” health inspections and “below average” quality measures.

A spokeswoman for the company said the Department of Public Health had mandated updates to the building, particularly the flooring, and Athena invested $200,000 in renovating floors.

The company had also “earmarked additional dollars” for further upgrades, the spokeswoman, Savannah Ragali, said. She did not specify an amount.

“Our team did everything possible in the past several weeks to address the physical plant concerns identified by DPH,” Ragali said. “We have invested significant financial resources in returning our facility to compliance by upgrading floors, doors and other identified facility infrastructure. We believed that the identified issues had been successfully resolved.”

Following reports that CMS had granted a stay to Abbott Terrace, Ragali said the nursing home “has not been notified of any change to its status” and continues to prepare to close.

When asked if a stay had been granted, state officials referred The Connecticut Mirror to CMS.

A spokesperson from CMS declined to confirm or deny it, stating: “To protect the integrity of our survey process, we are unable to provide additional information at this time.”

Residents have begun receiving discharge notices ahead of the closure, said Mairead Painter, the state’s long-term care ombudsman.

Ragali said Abbott Terrace is looking for locations for its residents to move to and possible transfers to other Athena sites for its nearly 300 employees.

“Residents who have voluntarily decided to discharge from the center are being discharged under their rights,” Ragali said. “Based on the research from our staff at Abbott Terrace, there are 110-skilled nursing beds within a 15-mile radius of Abbott Terrace, with zero beds available on a secure dementia unit.”

Painter said her staff at the Office of the Long-Term Care Ombudsman is working with Abbott Terrace residents as well to ensure that their rights are being protected and preferences are taken into account.

Department of Public Health Commissioner Manisha Juthani and Department of Social Services Commissioner Andrea Barton Reeves said the announcement does not mean that Abbott’s residents have lost their coverage. Residents will still be covered when they move to a facility that participates in the Medicare and Medicaid programs.

Waterbury will be getting a new grocery store next spring.

Price Rite Marketplace will open a new store in the Waterbury Shopping Center at 881 Wolcott Street in May 2025, according to officials with Westport-basd Charter Realty, which brokered the deal to bring the low-cost grocery chain to a 34,000-square-foot store that was formerly occupied by Ollie's Bargain Outlet.

Ollie's, which sells closeout and salvage merchandise as well as excess inventory, opened in the Waterbury Shopping Center in November 2015 and closed in late February or early March 2023.

The Waterbury Shopping Center is owned by Monroe-based Tartaglia Commercial Properties.

Waterbury Mayor Paul Pernerewski called the announcement of Price Rite coming to the city "great news."

"We're filling a building that has been vacant for a while and we're going to be adding some jobs," Pernerewski said. "It also expands the choices that people have about where they do their shopping, which is always a good thing.This is a stretch of Wolcott Street that has been seeing a renaissance."

Since the beginning of the year, two major retailers have relocated to Wolcott Street and a third has relocated across the street from the Naugatuck Valley Shopping Center. The relocation involved Stop & Shop moving into the Mattatuck Commons on Wolcott Street in January, a move that was followed later in the year by PetSmart and T.J. Maxx opening in the same shopping center.

The space Price Rite is moving into in the Waterbury Shopping Center is adjacent to Porter and Chester Institute, a for-profit technical school.

Price Rite currently has nine Connecticut stores, according to the chain's web site. Price Rite is owned by New Jersey-based Wakefern Food Corp., which is the cooperative behind ShopRite Supermarkets.

Wakefern officials were not immediately available for comment on the new store, including how many people it might employ.

Wayne Pesce, president of the Connecticut Food Association, said Price Rite fills a need in the Connecticut market.

"There's a part of the populace out there that is looking for low prices," Pesce said.

Because Wakefern handles distribution for both ShopRite and Price Rite, "consumers benefit from a powerful supply chain," he said.

WATERBURY – Connecticut Health Care Associates District 1199 Waterbury Hospital held a no-confidence vote Friday with 133 nurses – or 96% – calling for the dismissal of the hospital’s Chief Nursing Officer Michelle Diaz due to staff shortages and what they referred to as ineffective leadership.

Two nurses described the situation in the hospital as dire, expressing deep concerns about patient care, large Emergency Department patient caseloads, and the lack of working equipment available for them to do their jobs.

Diaz could not be reached for comment.

Lauren LaRoche, a nurse at the hospital for two years, read from a statement she and several nurses wrote on the conditions at the hospital.

“We are more often than not short-staffed and we are left to figure it out and compromise patients safety,” she said. “We have been told countless times that Michelle Diaz would not approve doubles to allow for safer ratios and even at times not answer her phone to give us an answer.”

The term doubles means the hospital allows a registered nurse to stay on longer than their 12-hour shift, LaRoche said.

She said Diaz also disapproved of stabilizing and transferring patients out and instead, the patients stay at the hospital, increasing the volume.

LaRoche said Diaz has violated the state’s hospital staffing law countless times which has led to a mistrust among her staff. The new law requires specific nursing-to-patient ratios and assistive staffing-to-patient ratios.

Gov. Ned Lamont signed the bill into law in June 2023, and it went into effect on Jan. 1. It requires hospitals to submit nurse staffing plans that both nurses and hospital administrators have supported and to implement those nurse-to-patient ratios with the goal of quality care.

“We are being told to clock out for breaks which we are unable to take because it puts our patients at risk,” she said. “There is no one to cover and watch our residents. We all want to work in a safe environment and provide the very best safe patient care possible. We have pride in the community we serve.”

But LaRoche described the staffing situation as bleak.

“We have been stripped down to a skeleton crew,” she said. “So many have left because of how we have been treated as ICU nurses. We have the sickest of patients so overseeing three or four patients at a time instead of two puts us in an anxious state, an anxious overworked state. Being staffed like that allows for mistakes and important things that are being missed putting lives on the line and with all of this we are left without working equipment and short supplies.”

Lauresha Xhihani, director of communications and marketing for Waterbury Health, expressed confidence in Diaz in an email, describing her as “committed to providing exceptional care.”

“They are working on continuous process improvement aimed at providing the best patient experience,” she said. “It is unfortunate that CHCA’s leadership, at the local and regional level, continues to distract our team and our community with disruptive actions such as a vote of no confidence targeting one person. Our hospital thrives on collaboration and partnership.”

Xhihani said she invited the union to work collaboratively with the hospital’s leadership team.

The vote of no confidence also included results that showed that 131 or 95% of nurses taking part in the vote considered leaving Waterbury Hospital in the last six months.

Dawn Mott-Rositani, another nurse at Waterbury Hospital, also shared concerns about staffing and patient safety. The morale is low, she said.

Mott-Rositani said since May six nurses have left the Emergency Department and that the hospital has not replaced them and three more are preparing to leave. She said because they are short-staffed they are unable to move patients out of the ED and into patient rooms, with patient volume increasing and many waiting 12 to 13 hours.

And with a shortage of staff also comes concerns about patient safety.

“There are things missed. Giving medications. Every day things are delayed. Everything gets delayed. Taking patients to their rooms.” She said the equipment is not reliable.

“The computers hardly ever work,” she said. “They break down every day. Most of them are from 2006.” She added that vital sign machines do not work and that half of the thermometers do not work.

“We are using Dollar Tree thermometers and we should be able to use vital sign machines constantly,” she said. “The cuffs do not inflate right. You have to steal a cuff from another room.”

And with a shortage of workers who are tasked with stocking supplies there are times when nothing is stocked. “Every single day you have to go find things that should be stocked,” she said. “It makes everything take longer.”

Mott-Rositani added that the staff has kept her going during the difficulties in the hospital.

Waterbury Hospital’s fate remains in the balance. Yale New Haven Health’s offer to purchase the hospital from Prospect Medical Holdings collapsed and has stalled in legal wrangling.

Lamont said Thursday that Yale New Haven Health and Prospect Medical Group could be close to a breakthrough on the sale of Waterbury Hospital and two other Prospect-owned hospitals.

Lamont confirmed that he and representatives of Yale and Prospect met again last week in the governor’s office to discuss how the two health systems could resolve their differences over the proposed sale price and the state litigation between them.

Lamont stated that Yale and Prospect exchanged financial information that each side is taking back to their respective boards to review. While hopeful of a resolution, he also remained wary.

Yale and Prospect signed an agreement in October 2022 that set a $435 million sales price for Waterbury Hospital, Manchester Memorial Hospital Rockville General Hospital, and a medical group. Yale filed a state lawsuit in early May seeking a declaratory judgment that it is not obligated to close the sale because Prospect allegedly violated the purchase agreement.

Prospect brought a counterclaim against Yale for allegedly breaking the agreement by refusing to pay the negotiated $435 million sales price. The consolidated suits are currently scheduled to go to trial on Dec. 9 in Hartford Superior Court. Yale asked Prospect to lower the price to $150 million in a Jan. 31 proposal, and Prospect declined in a Feb. 15 response, according to court filings.

Ed Gadomski, the internal organizer for Connecticut Health Care Associates District 1199 Waterbury Hospital and Tech Unions, has said that most departments are understaffed, expressing concerns about medical errors occurring because he says the hospital is not compliant with the Hospital Staffing Committee Law.

At the end of August, nearly a month after Waterbury Hospital’s staffing committee agreed on a staffing plan that would increase staffing and provide adequate nursing-to-patient ratios, several nurses with the hospital’s two unions have filed almost daily complaints with the state Department of Public Health that the hospital is failing to meet the plan’s staffing requirements, saying it puts patient care at risk and violates state law.

The two hospital unions filed a complaint in July with the U.S. Inspector General’s Office alleging the hospital failed to meet the requirements of a new law that requires specific nursing-to-patient ratios and assistive staffing-to-patient ratios.

Gadomski also filed a complaint on the same grounds to the state Department of Public Health in January and said in July he received notice that DPH was investigating his complaint. He is still awaiting the outcome of that investigation.

– Paul Hughes contributed to this report.

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