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Why is group home information redacted, but STS information disclosed?

May 21, 2012

By David Kassel

We previously reported on this site  that Department of Developmental Services licensure reports for group homes in Connecticut appear to be routinely redacted or have missing pages relating to potentially serious deficiency citations.

That is not the case, however, with state Department of Public Health inspection reports done on the Southbury Training School, a state-run center that meets stringent federal regulations for care.  Not only do the DPH reports appear to be far more detailed than the DDS group home inspection reports, but the DPH reports we reviewed had no redactions or missing pages.  The only information that appeared to be withheld from those reports was the names of individual residents at STS.

STS is inspected by the DPH, under regulations established by the federal Centers for Medicare and Medicaid Services.  In response to a Freedom of Information Act request, the STS Home & School Association received copies of six inspection reports done of five separate residential cottages at STS. 

The DPH inspection reports contain both detailed findings of deficiencies in care and conditions at STS, along with written plans of Correction from DDS addressing each deficiency.  Residents are identified in the inspection reports by number.

For example, in a DPH inspection report dated August 15, 2011  of two cottages at STS, the surveyors noted that a bathroom on the first floor of one of the cottages had an unlocked and slightly open cabinet containing latex gloves, dressing wipes, and other items, and that five of the residents of the cottage had pica, a condition marked by a tendency to ingest inedible objects.  The residents were identified as Individuals #1, #2, #3, #5, and #6.

In a Plan of Correction, which was included in the inspection report, DDS stated that all of the residential staff would be retrained regarding the center’s guidelines for pica safety, and that new automatic locks would be installed on two of the bathroom cabinets.

The same inspection report states that DPH surveyors went as far as to follow a van containing three STS residents, identified as Individuals #4, #7, and #8, which was driven to a community park about 10 miles from the facility.  They noted that the van was parked at the state park for an hour and that no one got out.  Later, under questioning, an STS staff member stated that a “pica sweep” of the park had been done and that the park was determined to be unsafe for the residents, according to the inspection report.  The Plan of Correction stated that all trips would be reviewed for appropriateness and that all staff would be reminded about “the importance of completing trips as authorized and following the protocol…”

The same report also cited nursing staff for failing to provide adequate procedures to a resident identified as Individual #9, and failing to inform a doctor when the resident’s blood pressure rose above a certain level, among other issues.  The Plan of Correction stated that the facility would “ensure that nursing assessments are performed in accordance with the health care needs of clients…”

Some of the STS inspection reports listed multiple deficiencies, while others listed just a few deficiencies.  It should be noted that in many cases, the same incident — such as the trip to the park noted above — received more than one deficiency citation because the incident was found to violate more than one standard established by federal regulations.

All of this leads to the question why there is such a difference between what is disclosed in the group home reports and what is disclosed in the STS reports, particularly since DDS is pushing guardians at STS to move their loved ones from the state center to group homes.  The 2010 Messier v. STS court settlement stipulates that the guardians must make “informed decisions” about the community placements.

As previously noted, we question how STS guardians can make informed decisions about specific group homes if they can’t get complete information from DDS about care and conditions in those residences.

In a May 9 email, Joan Barnish, director of communications and constituent services at DDS, stated that the redactions of the group home licensure information “are made to comply with the (federal) Health Insurance Portability and Accountability Act (HIPAA) and state law regarding the confidentiality of DDS client records and information.”

The applicable state law appears to be Connecticut General Statutes Chapter 55, Section 4-190 et seq., which  prohibits the disclosure of personal data by state agencies.  The statute defines personal data as:

…any information about a person’s education, finances, medical or emotional condition or history, employment or business history, family or personal relationships, reputation or character which because of name, identifying number, mark or description can be readily associated with a particular person  (my emphasis).

The federal HIPAA Privacy Rule protects all “individually identifiable health information” held or transmitted by a “covered entity” or its business associate, in any form or media, whether electronic, paper, or oral. 

Both the state and federal laws appear to be concerned with information that can be either “readily associated” with a particular person or that can identify that person.  In our view — and apparently in the view of the DPH — eliminating the names of individuals from the inspection reports is sufficient to protect any individuals from being identified.  

In our previous post, we suggested that there are ways available to provide detailed information about deficiencies in residential facilities without identifying individual clients.  We think the DPH has certainly found a way to do that in its inspection reports on STS.  Why can’t DDS do this same thing with its own group home inspection reports?


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  1. Al Raymond permalink

    How can DDS expect to persuade us to move our loved ones from STS to group homes, when it denies us access to needed information on those group homes? How stupid and self-defeating!

  2. H. Phillips permalink

    It might be that DDS Commissioner Macy is unable to find ways to justify the obvious bias in reporting to a growing audience, and hopes his silence will make it all just go away. STS families and guardians will not allow that to happen.

  3. I worked at STS for 33 years where client care was monitored by the DPH and Speciasl Master guidelines. These brought the standards of living for the clients at STS to such levels that if you didn’t cross your “T” s and dot your “I” s you were cited for it. My staff were working to uphold very high standards first rather than reasonable expectations for many activities. Unfortunately due to the “politics” scrutinizing the abilaties of our staff to be 100% correct, (you were not allowed to make the slightest mistake without some type of dissapline), the job became “thankless” .I moved to the West Region in Chesire where I was in charge of the oversite of 3 group homes. Two on the Cheshire campus and one in Watertwon. The staff and the clients were wonderful but the homes were lacking because they were not under the DPH standards and were subject to basic health and safety guidlines for “Licensing”. Programatic standards were low and reporting proceedures outdated. Licensing reports were vague and didn’t take much to correct. I don’t know how many group homes are still run by the state but I suspect that the lack of information about the group homes is mainly due to the fact that the standards of care were not scrutinized half as much as STS and there was very little to report on. I do know that an internal audit of each clients care was being developed when I left several years ago and do not know how far this document has progressed. I fear that this document remains very redundent and confusing but with any luck it isn’t.

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