N.J. releases findings of rapid-response review of long-term care facilities

Manatt Health gave New Jersey a series of recommendations and actions the state can take to address systemic challenges in long-term care, as well as mitigate the impact of COVID-19 and reduce impacts of future outbreaks, the Governor’s Office announced Wednesday.

The state paid $500,000 for the rapid review, which was completed in four weeks.

In a release, the state said the recommendations outline how long-term care facilities can move forward both in the near- and long-term. It said the report gives guidance for new residents and visitors after the current COVID-19 outbreak and addresses mitigation, protection and resiliency against future outbreaks, both in the near- and long-term. It also said the recommendations present a roadmap for rebuilding a high-functioning long-term care system that emphasizes quality of care, patient safety, robust data infrastructure and strong staff supports.

A bullet-point outline of the report appears below.

Gov. Phil Murphy, in a statement and during his daily COVID-19 briefing, praised the report, which was overseen by Cindy Mann and Carol Raphael.

“The solutions recommended by the Manatt team provide a comprehensive and systemic approach to ensuring the safety of the residents and staff of New Jersey’s long-term care facilities,” Murphy said in a statement. “My administration looks forward to implementing Manatt’s recommendations to mitigate and protect one of our most vulnerable populations from future outbreaks.”

State Sens. Steven Oroho (R-Sparta), Declan O’Scanlon (R-Holmdel) and Kristin Corrado (R-Totowa), in a release,  said it was superficial report that does not absolve the Murphy administration for failures that led to the massive loss of life in New Jersey’s long-term care facilities due to COVID-19.

“The Murphy administration paid a consulting firm $500,000 to rush a report that attempts to shift blame for thousands of nursing home deaths to anyone but the governor,” Oroho said in the release. “What taxpayers received back is a glossy report that repackages the state’s data in colorful graphs and charts.”

The Manatt report outlines the following recommendations to improve New Jersey’s long-term care facilities, as presented by the Murphy administration in a release:

Strengthen Emergency Response Capacity by strengthening the ability to plan, coordinate and execute effective responses to the emergency protentional surges.

  • Consolidate and strengthen response through a central Long-Term Care Emergency Operations Center that would coordinate all activity and communications for nursing homes and long-term care facilities and obtain real-time input regarding staffing, supplies and operational issues;
  • Implement a “reopening” and forward-looking testing plan; and
  • Reinforce existing pathways for resident and family communications.

Stabilize Facilities and Bolster Workforce by increasing the responsibilities of and support for New Jersey’s nursing homes and their workers in the short and long term.

  • Recognize, stabilize, and resource the workforce by:
    • Ensuring staff have access to paid sick leave;
    • Instituting wage enhancements;
    • Implementing minimum staffing ratios for direct care;
    • Establishing a wage floor and wage pass-throughs for Medicaid rate increases; and
    • Strengthening training and career development opportunities;
  • Institute COVID-19 relief payments for facilities and review rates;
  • Create a Medical Loss Ratio to ensure payments to nursing homes, including any increases, are used for patient care.

Increase Transparency and Accountability by implementing stronger mechanisms to ensure a greater degree of accountability and increase transparency through data and reporting.

  • Institute new procedures to regulate and monitor facility ownership, with a focus on increasing transparency;
  • Improve oversight of and increase penalties for nursing homes; and
  • Centralize long-term care data collection and processing.

Build a More Resilient and Higher Quality System by establishing structures for stronger collaboration and advance payment and delivery reforms and increased reliance on home and community-based services.

  • Improve safety and quality infrastructure in nursing homes by requiring facilities to maintain Infection Control Preventionists and by supporting the state’s current surveillance efforts;
  • Strengthen state agency organization and alignment around long-term care operations; and
  • Create Governor’s Task Force on transforming New Jersey’s long-term care delivery system.

State Sen. Joseph Vitale (D-Woodbridge) and Assemblywoman Valerie Vainieri Huttle (D-Englewood) praised the findings in a joint statement.

“The COVID-19 pandemic ravaging New Jersey has shed light on the fragility of our state’s long-term care system. It is critically important that we increase transparency and provide necessary resources across all affected departments to enhance oversight in order to address the deficiencies that led to outbreaks within our long-term care facilities,” they said.

“It is equally important to build a resilient and stabilized health care system with strong workplace protections and adequate staffing in place to swiftly respond to future outbreaks. We look forward to working with Gov. Murphy, his administration, Senate President (Steve) Sweeney, Speaker (Craig) Coughlin and our colleagues to implement these much needed, overdue reforms outlined by Manatt to ensure the safety every resident and staff member within our long-term care system.”

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