N.J. audit finds no visits for 44% of incapacitated people under state care

By Susan K. Livio 

Employees from the New Jersey Office of the Public Guardian for the Elderly are expected to routinely visit people a judge has found to be unable to make their vital decisions and don’t have family to take on this responsibility.

But a new state audit of the Public Guardian’s records found no documented visits for 44% of these incapacitated people, meaning the employees either skipped the visits, didn’t bother to record them, or a combination of both, according to report released Thursday by the Office of the State Auditor.

The records showed that for 11 of 25 people chosen at random, their care managers were absent from five months to 2-1/2 years, according to the audit.

People 60 and older a judge finds legally are assigned supervision by the public guardian, which oversaw 1,423 active clients in August 2023. Care managers must visit every three months if people live in a nursing home, monthly if they are living in an assisted living or another form of supervised housing or weekly if they live at home.

“A client should be seen more frequently as issues arise, such as hospitalizations and increased behavioral issues,” according to the 19-page audit report.

The audit also found the guardian’s office failed to close the bank accounts for 2,452 people who had died. Collectively, there is $16.9 million that should have been paid to relatives or reimbursed to government entities. One account for a person who died in 2014 held $1.1 million.

The guardian’s office had oversight responsibilities for a couple and their daughter, who should have received $101,700 when her parents died about a decade ago. At the time of the audit, the daughter’s account contained just $143, the audit said.

The audit also found:

• Twenty care managers are given cars to visit people on their caseload, with the expectation they will drive a minimum of 1,250 miles a month. But 10 workers logged less, ranging from 435 miles to 1,206 miles a month. There was no record at all of how much five employees drove or who was using the vehicles.

“By not monitoring state vehicle usage, the Office of the Public Guardian risks being unable to determine if vehicles are needed or whether Care Managers are visiting clients in accordance with statutory requirements,” the audit report said.

• Care managers are permitted to make pre-authorized purchases for clients but receipts are required. Of the 232 purchases made during a period in 2023, 21% lacked a receipt and 43% lacked documentation showing the client received the purchased goods.

The Office of the Public Guardian for the Elderly, overseen by the Department of Human Services, agreed with many of the auditor’s findings. Some of the problems during the audited period — from July 1, 2021 to Sept. 4, 2024 — have been corrected, Helen C. Dodick, the Acting Public Guardian, said in a response to the report.

A new supervisor was hired to oversee the system documenting visits and reports are now generated on a monthly basis, Dodick wrote. Care managers were given laptops and WIFI hotspots so they can enter notes after visits “in real time,” she added.

“Temporary care management staff has been added in order to lower caseloads and increase time for documentation,” Dodick wrote. “Caseloads of senior care management staff are also being reduced where possible to permit them to monitor documentation by more junior care managers.”

Items bought with purchasing cards “are now subject to enhanced review,” Dodick’s statement said.

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N.J. audit finds no visits for 44% of incapacitated people under state care