NJ Nursing Homes Fined $12M During Pandemic: What We Know

NEW JERSEY — Nursing homes and assisted-living facilities have received more than $12 million in fines during the pandemic. With more than 8,000 COVID deaths of residents and staff in longterm-care facilities, public documents and testimony reveal the state's early-pandemic struggles and how officials hope to prevent future outbreaks.

The Assembly Budget Committee held a 2-1/2-hour hearing Monday with State Health Commissioner Judy Persichilli. The state's top health official outlined and defended the New Jersey Department of Health's pandemic response, especially when it came to nursing homes.

"We got hit hard and fast by a novel virus, never before seen in humans, and we were building the plane as we were flying it, as the governor has said," Persichilli said. "Decisions were made based on prior viruses that were far more predictable."

Nearly 30 percent of New Jersey's confirmed COVID deaths link to longterm-care facilities, with 8,559 residents and 149 employees dying from the virus. Here's what Persichilli's testimony and the Office of Legislative Service's budget analysis revealed about the health department's response:

1. $12.1 million in fines.

Noncompliant New Jersey nursing homes received a combined $12.1 million in fines from fiscal year 2020-22. The federal Center for Medicare & Medicaid Services imposed $11.9 million of those fines, while $250,000 came from the state. That's because the state doesn't impose a double fine after a nursing home gets federally fined.

Officials have not revealed which nursing homes were fined. But federal regulators fined a nursing home — Andover Subacute & Rehab Center Two in Sussex County — $220,235 in May 2020 after more than a dozen bodies were removed from a "makeshift morgue." Read more: 'Makeshift Morgue' Nursing Home In NJ Fined $220K

2. Most deaths came early in the pandemic.

Seventy-eight percent of nursing home deaths from the virus occurred in March and April 2020, according to Persichilli.

3. Keeping up with complaints.

The health department conducted 5,211 inspections of longterm-care facilities from March 2020-22, with more than 1,600 triggered by complaints. The remainder involved routine surveys and inspections focused on infection-control practices, according to officials.

Inspections have become more frequent, coming at a higher cost. In 2017, the health department conducted 2,305 inspections of health facilities, including 821 in longterm-care facilities, costing $11 million. Last year, the department conducted 3,696 inspections, including 1,293 in longterm-care centers, costing $16.6 million.

4. Outbreak response plans.

All but 34 facilities have provided the state with outbreak-response plans. The U.S. Department of Health and Human Services issued notices to noncomplying facilities to take back a percentage of each home's COVID-related 10 percent Medicaid-rate increase.

5. 'Mission Critical Teams'

Gov. Phil Murphy's budget proposed $500,000 to create Mission Critical Teams within the health department to intervene when longterm-care facilities show signs of distress, including declining quality of care.

The team would likely consist of four people with expertise in the matter who would get discharged to facilities "to assess, evaluate, and recalibrate before a crisis ensues," according to the budget analysis.

6. Vaccine numbers, mandates and lost jobs.

Longterm-care facilities are among the few workplaces with a COVID vaccine mandate for employees in New Jersey. Workers had until March 30 to submit proof that they at least completed their initial vaccination series. They must also receive a booster shot during a timeframe in which they become eligible.

As of April 11, 93.6 percent of employees were fully vaccinated, with 77.9 percent receiving a booster shot. The health department is "not aware" of the number of longterm-care facility employees who resigned or got fired for noncompliance with the vaccine regulation and does not track that number, according to the budget analysis.

The health department also "does not have any specific information on staffing shortages due to the vaccine mandate."

As far as longterm-care facility residents go, 91.6 percent completed their primary vaccination series, with 85.5 percent boosted.