Manatt Provides Recommendations to State of New Jersey Following Rapid Review of Nursing Homes

Barry LeePartner, Manatt, Phelps & Phillips, LLP

Editor’s Note: Manatt Health partner Cindy Mann testified today at a joint meeting of New Jersey’s Assembly Aging and Senior Services Committee and Assembly Military and Veterans’ Affairs Committee. Her testimony focused on Manatt Health’s recent report on strengthening the resilience of New Jersey’s nursing homes in the wake of COVID-19 and discussed the report’s key recommendations.

Based on an intensive three-week review commissioned by New Jersey, the report outlines a set of actionable proposals for the state to reduce the impact of future COVID-19 outbreaks in nursing homes and strengthen the state’s long-term care (LTC) system. On June 3, New Jersey Governor Phil Murphy shared the steps he will take based on Manatt’s recommendations, summarized below. Click here to read the full report.

Manatt Health’s report for New Jersey details recommendations on what it will take for the state and nursing homes to move forward with confidence in their ability to respond to COVID-19 as it continues to impact New Jersey and the nation. Notably, the report offers both near- and long-term recommendations for building a high-functioning LTC system that emphasizes quality of care, resident safety, strong supports for staff, a robust data infrastructure, and better communication and coordination between the state and a fragmented LTC system. Key recommendations include:

Strengthening Emergency Response Capacity to plan, coordinate and execute effective responses to future crises.

  • Consolidate and strengthen response through a central Long-Term Care Emergency Operations Center that would coordinate all activity and communications for nursing homes and other LTC facilities and obtain real-time input regarding staffing, supplies and operational issues.
  • Implement a “reopening” and forward-looking testing plan.
  • Ensure pathways for resident and family communications during the pandemic.

Stabilizing Facilities and Bolstering 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;
    • Longer term, establishing a wage floor and wage pass-throughs for Medicaid rate increases; and
    • Establishing minimum staffing ratios and training and career development opportunities.
  • Institute COVID-19 short-term relief payments for facilities, and undertake a comprehensive review of nursing home rates.

Increasing Transparency and Accountability by implementing stronger mechanisms to ensure a greater degree of accountability, and increasing transparency through data and reporting.

  • In light of the influx of for-profit facilities and frequent turnover in facility ownership, institute new procedures to regulate and monitor changes in ownership, with a focus on increasing transparency and ensuring that facility revenues are spent on direct care.
  • Improve oversight of and increase penalties for nursing homes with serious deficiencies.
  • Centralize LTC data collection and processing.

Building a More Resilient and Higher-Quality System by implementing structures for stronger state agency collaboration and advancing payment and delivery reforms, including increasing reliance on home- and community-based services.

  • Improve safety and quality infrastructure in nursing homes by requiring facilities to have infection control preventionists and by providing facilities with support to improve performance and create a “culture of quality.”
  • Strengthen state agency organization and alignment around LTC operations.
  • Create Governor’s Task Force on transforming New Jersey’s LTC delivery system to address issues around person-centered care, safety, quality improvement, workforce engagement and sustainability, including options for people to receive long-term services and supports at home.

Access Manatt’s complete report here, and read Governor Murphy’s announcement here.