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Bipartisan Bill to Require Greater Oversight of Long-Term Care Facilities Clears Assembly Panel

With the goal to provide greater oversight of long-term care facilities, particularly those with ongoing compliance issues, repeated complaints and performance issues, bipartisan legislation aimed to hold non-compliant facilities accountable for deficiencies was approved Thursday by the Assembly Aging and Senior Services Committee.

“Over the last three inspection cycles, less than 100 of New Jersey’s nursing homes were fined for deficiencies, but about 41 percent of facilities – about 150 – in our state have very-below average and below-average health inspection ratings. These numbers just don’t add up,” said Valerie Vainieri Huttle (D-Bergen), chair of the Aging and Senior Services Committee. “Clearly, non-compliance issues are not being accurately reported or facilities are not being penalized enough to make improvements. The result is that many of our most vulnerable residents in nursing and veterans homes are receiving substandard care, potentially to the point of neglect. It’s time we hold these facilities accountable.”

The bill (A-4478), sponsored by Assemblywomen Vainieri Huttle, Shanique Speight, Holly Schepisi and BettyLou DeCroce, would require the New Jersey Department of Health (DOH) to develop a system of scaling actions and penalties for long-term care facilities which repeatedly violate state and federal regulations for administration and operations. These actions and penalties would include:

  • Conducting a licensure survey of a long-term care facility with three or more violations in a single year at least once every two years for the next four years, or at more frequent intervals for a longer time period if circumstances warrant greater oversight;
  • Assessing enhanced sanctions and other penalties for continued noncompliance with DOH regulations, particularly if the facility is cited multiple times for the same violation, or when the violations involve infection control. The penalties for repeated or multiple violations would include:
  • A series of escalating fines, as well as increased fines if it results in severe adverse health consequences for a resident or staff member;
  • A series of escalating licensure actions, particularly if a violation results in severe adverse health consequences, including suspending, terminating or revoking the facility’s license; restricting new admissions; requiring the transfer of residents to another facility; or, in the case of a nursing home, petition a court of competent jurisdiction for appointment of a receiver.

“The alarming impact of the COVID-19 pandemic in our long-term care facilities has forced us to ask ourselves some tough questions. Why are we allowing facilities that cannot meet basic health and safety standards to take in new residents? Why are they repeatedly violating these rules, and failing to make changes? What can we do to hold them accountable going forward?” said Speight (D-Essex), vice-chair of the Aging and Senior Services Committee. “There are no easy answers, but we must begin by enforcing stricter penalties and increasing our scrutiny of inadequate facilities. Every resident in long-term care – all 45,000 in New Jersey – deserve far better.”

Under the measure, DOH would be required to evaluate staffing levels and create a system to impose greater responsibility on each medical director at long-term care facilities. This would include establishing specific penalties against medical directors for repeated failure to improve outcomes at the facilities.

Additionally, DOH would be required to review reporting requirements for long-term care facilities, and take steps to standardize and consolidate reporting requirements. Long-term care facilities would be required to file monthly and quarterly unaudited financial information, quarterly unaudited financial statements, annual audited financial statements and other information. This data would be posted on the DOH website, along with performance reviews conducted by DOH.

“It was unconscionable that families were not receiving information about their loved ones in nursing homes,” said Assemblywoman Holly Schepisi (R-Bergen).  “Hopefully we will never see anything like it again with oversight that is more consistent and with better reporting in place.”

Long-term care facilities would also be required annually to report the number and severity of specific infections occurring among residents in the preceding year.

“Many families face the heart wrenching decision to entrust a loved one’s care,” said Assemblywoman BettyLou DeCroce (R-Morris). “That’s why this law is needed.”

Finally, the bill would establish the Long-Term Care Facility Advisory Council in DOH to advise the department on oversight of long-term care facilities, as well as foster communication with the public. The council would analyze the results of long-term care facility inspections, including penalties and adherence to federal guidance on state inspections, receive public comment on inspections, and consult with the New Jersey Long-Term Care Ombudsman.

The measure now goes to the Assembly Speaker for further consideration.