Bills Addressing Staffing, Prevention of Isolation in Long-term Care Facilities Now Law in New Jersey

Gov. Phil Murphy recently signed two bills ordering reforms to the long-term care industry recommended by the Manatt Health Report. 

The first bill requires minimum direct care staff-to-resident ratios in New Jersey long-term care facilities, while the second law mandates long-term care facilities to institute policies to prevent social isolation of residents, addressing issues experienced by long-term care residents and their families as a result of prohibitions and limitations on visitation during the COVID-19 pandemic.

“These long-sought reforms will help bring accountability to the industry and protect residents, staff, and family members with a loved one living in a long-term care facility,” said Murphy in a press statement. “Sadly, too many nursing homes are run by companies more interested in making money than protecting patients.”

Staff Ratios

The bill to establish minimum direct care staff-to-resident ratios in nursing homes is a result of the Manatt Report citing longstanding staffing shortages as one of the systemic issues that exacerbated the industry’s COVID-19-response challenges. 

The law now requires one certified nursing assistant to every eight residents for the day shift; one direct care staff member to every 10 residents for the evening shift; and one direct care staff member to every 14 residents for the night shift.

Additionally, a Special Task Force on Direct Care Workforce Retention and Recruitment will be formed to evaluate job supports and incentives, training opportunities, wages and benefits, educational initiatives, and certification reciprocity rules. The Task Force will be required to submit a report to the governor as well as Legislature.

“New Jersey got an F rating and was ranked 43 out of 50 in direct care staffing hours per nursing home resident. These gaping problems have become even more apparent since the start of the COVID-19 pandemic. This is unacceptable and we all know we can do better,” said State Sen. Brian Stack (D-33). “These are our parents and grandparents and soon, they will be us. This law will ensure that every resident in our nursing homes receives the care and attention we all deserve.”

Social Isolation

The bill mandating long-term care facilities to implement policies to prevent social isolation of residents is intended to address the strain experienced by long-term care residents and families of residents as a result of the prohibition of and limitation on visitation during the pandemic. 

The bill requires facilities to create social isolation prevention policies to engage residents in in-person contact, communications, and religious and recreational activities with other facility residents and with family members, friends, and other external support systems.

Additionally, policies to promote virtual visitation and resident recreational activities during periods where in-person engagement is limited/prohibited are required as well facilities maintaining the appropriate technology to implement the mandate.

Staying Connected

“For months at the start of the pandemic, family and friends were not allowed to visit their loved ones in long-term care facilities to mitigate the spread of COVID-19,” said Assemblywoman Valerie Vainieri Huttle (D-37), chair of the Assembly Aging and Senior Services Committee. “Though this precaution was intended to protect the physical health of residents, for many the sustained social isolation took a toll on their mental health.”

“Eight months into this crisis, we’ve learned social distancing doesn’t have to mean isolation or loneliness. Whether it be a natural disaster or a public health crisis, we must ensure that residents in these facilities can stay connected to their families and loved ones remotely when in-person visits are not feasible,” said Vainieri Huttle.

Persichilli Promoted

“Long term care facilities can be lonely places for our elderly residents. The limitations we saw on visitation early on in the pandemic, while in the best interest of patients, had an immense impact on their mental wellbeing,” said State Sen. Nellie Pou (D-35). “This program will help to ensure our facilities are better equipped to prevent feelings of social isolation in the event of future public health emergencies that require them to go into lockdown to prevent the spread of illness.”

Health Commissioner Judith Persichilli said due to her experience as a nurse, she knows there is no more important role than as a caregiver and all of those working in these facilities are healthcare heroes. 

“Staff caring for our most vulnerable residents in long-term care settings are the backbone of these facilities,” said Persichilli. “We have to support this workforce and give them an opportunity to grow and advance in their careers, so it is not only a more rewarding job, but also results in improved care.”

Daily Data

As of Oct. 30, the cumulative number of coronavirus cases in New Jersey reached 236,523 with 2,089 new cases reported and seven new deaths, bringing that total to 14,546. The state listed probable deaths at 1,793, bringing the overall total to 16,339.

For North Jersey counties, Essex had a total of 273 new cases, Hudson 235 new cases, Bergen 208 new cases, Passaic 180 new cases, Morris 102 new cases, Sussex 20 new cases and Warren 13 new cases.

State officials noted 14 deaths occurred in the last 24 hours of reporting that have not yet been lab confirmed.  

Of the total confirmed deaths in North Jersey, Essex County has the most with 1,914, followed by Bergen at 1,819, Hudson with 1,373, Passaic at 1,120, Morris at 693, Sussex at 161 and Warren with 158.

In regards to probable deaths, Bergen has 243, Essex has 230, Hudson has 157, Morris at 145, Passaic at 141, Sussex has 36 and Warren has 13.

State Testing 

The daily rate of infections from those tested as of Oct. 22 was 6.5%. By region, the North has a rate of 6.8%, Central at 6.9% and the South at 5.7%. The state is no longer using serology tests as health officials explained those results show a past presence of the disease as well as a current one. 

As for the rate of transmission, it increased to 1.26 from 1.25 to the day before. Officials have continually cited transmission rate and positivity rate as health data they rely on to track how the coronavirus is being contained in New Jersey, guiding them in determining when restrictions have to be tightened or lifted.

Officials reported 1,058 patients are hospitalized; by region, there were 577 in the North, 216 in the Central and 265 in the South.

Of those hospitalized, 221 are in intensive care units and 79 on ventilators, while 167 patients were discharged.

Bergen Tops County Count

Bergen has the most cumulative cases in the state with 25,235, followed by Essex at 24,970, Hudson at 23,357, Middlesex at 22,444, Passaic at 21,060, Union at 20,413, Ocean at 16,804, Monmouth at 14,242, Camden at 11,729, Mercer at 9,340, Morris at 9,243, Burlington at 8,587, Somerset at 6,527, Gloucester at 5,550, Atlantic at 5,208, Cumberland at 4,034, Sussex at 1,739, Warren at 1,607, Hunterdon at 1,603, Salem at 1,180 and Cape May at 1,129.

Another 522 cases are still under investigation to determine where the person resides.

In regards to cases related to in-school transmissions, a total of 28 outbreaks involving 122 cases have been reported in 15 of the 21 counties in the Garden State, up from 25 outbreaks involving 111 cases a week previous. For North Jersey, Bergen County has three confirmed outbreaks with nine cases, Passaic County has one confirmed outbreak with nine cases, Hudson County has one confirmed outbreak with four cases, and Sussex County has one confirmed outbreak with two cases. 

Long-term Care Facilities

Health officials noted 177 long-term care facilities are currently reporting at least one case of COVID-19, accounting for a total of 4,690 of the cases, broken down between 2,626 residents and 2,064 staff. 

Cumulatively, 813 long-term care facilities reported a case infecting 25,620 residents and 14,122 staff, for a total of 39,742 cases. 

The state’s official death total will now be reported as those that are lab confirmed, sits at 7,225 on Oct. 30. The facilities are reporting to the state 6,852 residents deaths and 121 staff deaths.

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