Sunday, February 20, 2022

Report: New Jersey’s Lowest-Rated Nursing Homes Receive Over $100 Million in Annual Medicaid Funding

Article By Denise Mariani

A recent report from New Jersey’s Office of the State Comptroller (OSC) sheds light on the poor conditions at some of the state’s worst long-term care facilities—and the surprising amount of taxpayer funding that continues to support these organizations.

In this new report published on February 2, 2022, the OSC examined the fifteen lowest-rated nursing homes in the state and concluded that many of these facilities are unlikely to improve as long as they continue to receive state Medicaid funds.

Here’s a quick summary of the report and its key findings.

The CMS rating system for nursing homes

Every year, long-term care providers (LTCs) in New Jersey are inspected by state and federal inspectors who report their findings to the Centers for Medicare and Medicaid Services (CMS). Using this data, the OSC was able to conduct a comparison of New Jersey LTCs’ performance across multiple years.

The scores awarded to state nursing homes by the CMS are based on three elements:

  • A health inspection score based on a thorough evaluation of practices and policies including quality of life, medication management, nursing home administration, food services, resident rights, and more

  • A quality measure score based on both short- and long-term outcomes for residents

  • A staffing measure score based on available daily staff and Registered Nurse (RN) staffing hours

These three measurements are used to rate each facility on a scale of one to five stars. As part of their report, the OSC conducted an analysis of the long-term care facilities that had consistently received the lowest rankings between 2013 and 2021.

The lowest-rated nursing homes in New Jersey

Although LTC facilities across New Jersey scored an average of 3.6 stars, the OSC found that one in fourteen LTCs in the state had recently received the lowest possible rating (one star) and that many of those facilities had experienced low ratings for an extended period of time.

In fact, the OSC found that the following fifteen facilities had received a one-star rating for at least six of their last eight quarterly inspections:

  • Care One at Evesham in Burlington County

  • Cedar Grove Respiratory and Nursing Center in Gloucester County

  • Complete Care at Fair Lawn Edge in Passaic County

  • Cranford Park Rehabilitation & Healthcare Center in Union County

  • Forest Manor HCC in Warren County

  • Lakeview Rehabilitation and Care Center in Passaic County

  • New Grove Manor in Essex County

  • Oceana Rehabilitation and NC in Cape May County

  • Palace Rehabilitation and Care Center in Burlington County

  • Riverview Estates in Burlington County

  • Silver Healthcare Center in Camden County

  • South Jersey Extended Care in Cumberland County

  • Sterling Manor in Burlington County

  • Wardell Gardens at Tinton Falls in Monmouth County

  • Woodland Behavioral and Nursing Center in Sussex County

Of these fifteen lowest-rated care facilities, fourteen were found to be for-profit businesses, and all were found to have had periods of consistently low ratings across several years.

These consistently low ratings are especially concerning because LTCs scoring a one-star rating are significantly more likely to receive citations for “immediate jeopardy,” defined by the Department of Health as “a situation in which . . . the facility’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident receiving care in a facility.”

This problem is further compounded by the fact that many of these facilities continue to receive high rates of taxpayer funding through Medicaid, despite providing consistently poor treatment quality for residents. In fact, these fifteen lowest-rated facilities collect an average of $103 million dollars a year in Medicaid payments.

Fixing the system

As long as underperforming LTCs enjoy unrestricted access to Medicaid funding, it’s unlikely that many of these facilities will strive for a higher standard of care.

For this reason, the OSC advises that the New Jersey Division of Medical Assistance and Health Services (DMAHS) should deny Medicaid funds to LTCs that continually receive low CMS scores over an extended period of time.

Hopefully, these findings will encourage substantive change and lead to better standards of care at New Jersey’s long-term care facilities. In the meantime, however, the results of this report are both sobering and clear: Far too many NJ nursing homes still fail to provide adequate care for their residents.

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