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Bills Aiming To Improve New Jersey Nursing Home Infection Control, Reporting Standards Advance

After the COVID-19 pandemic devastated nursing homes, New Jersey lawmakers began searching for ways to ensure better handling of outbreaks, improved quality of care for residents and safer working environments for staff.

The state Legislature recently advanced four bills aimed at boosting nursing home safety, including measures to improve infection control standards and increase transparency from facilities.

Senate President Steve Sweeney (D-3), who authored two of the bills, said, “We need a long-term strategy to ensure the nursing home industry in New Jersey is focused on the safety of residents and caregivers, as well as the quality of services the facilities provide.”

LTC Homes Were ‘Ill-Equipped’

Since the outbreak began in March 2020, there has been 1,225 outbreaks in long-term care facilities in New Jersey, with 425 active outbreaks as of Feb. 1. State data shows 7,748 of the state’s 19,384 confirmed virus-related deaths were either residents or staffers at nursing homes.

“As we saw during the early deadly days of the spread of the coronavirus in New Jersey, our nursing homes were often overwhelmed and ill-equipped to handle the mass infection rates and were caught flat-footed in trying to respond effectively,” State Sen. Joe Vitale (D-19) said.

“The state has a role to play in making sure these facilities follow procedure or pay a price for failing to do so,” said Vitale, the primary sponsor of the four bills. “The lives of residents and workers at nursing homes depend on it.”

Statewide Plan For Infection Control, Prevention

S-3032 would require the New Jersey Department of Health to assess infection control and prevention policies, and then develop a statewide plan that sets benchmarks for improvements.  

The measure came in response to Manatt Heath’s finding that one-third of the state’s nursing homes were cited for infection control deficiencies in 2017.

The bill, which was sponsored by Sweeney and Vitale, advanced out of the Senate Health, Human Services and Senior Citizens Committee earlier in January. A companion bill, sponsored by Assembly members Valerie Vainieri Huttle (D-37), Daniel Benson (D-14) and Nicholas Chiaravalloti (D-31), is still under review by the Assembly Appropriations Committee.

Reporting Requirements, Penalties For Non-Compliance

S-2759, introduced by Vitale and State Sen. Fred Madden (D-4), would establish rules for reporting requirements for facilities and create the Nursing Home Advisory Council, which would be in charge of advising the state Department of Health on oversight-related matters.

It would also work to “foster better communication with the public regarding nursing homes,” according to the bill’s sponsors.

Under the legislation, facilities could face penalties for repeated non-compliance with state and federal requirements.

Financial Documentation

“We need more data on financial information from these facilities, as well as greater transparency in general,” said Madden. “We also need more detailed reporting on the number of facility-acquired infections occurring among residents of the nursing home in the preceding year.”

“The simple fact is the state needs to have a much better idea of what is going on inside our state’s homes, and be able to respond quickly and decisively,” he went on.

The Senate Budget and Appropriations Committee unanimously approved the bill Jan. 21. A companion bill, A-4478, was approved by the state Assembly in October 2020. Its primary sponsors include Assembly members Holly Schepisi (R-39), Shanique Speight (D-29) and BettyLou DeCroce (R-26), along with Vainieri Huttle.

Infection Control Training

S-3031 would direct the state Department of Health to work with the Association for Professionals in Infection Control and Epidemiology to develop an infection prevention course specifically designed for registered nurses and certified nurse aides employed in long-term care facilities.

The measure, which was sponsored by Sweeney and Vitale, advanced out of the Senate Health, Human Services and Senior Citizens Committee . An accompanying bill, introduced into the Assembly by Vainieri Huttle and Benson in November, is awaiting further action.

S-2789, sponsored by Vitale and State Sen. Loretta Weinberg (D-37), seeks to revise certain requirements regarding licensure and operations of long-term care facilities.

Revised Requirements For Licensure

The bill seeks to modify existing state law to prohibit nursing homes from increasing their total bed capacity by transferring them or selling to another facility without obtaining a certificate of need.

It would also revise the application and approval process for transfer of ownership of nursing homes, requiring increased reporting by involved parties.

Weinberg said “given the epic tragedy” that occurred in New Jersey’s long-term care system “it is all too obvious that licensure requirements governing these facilities need closer scrutiny and more oversight and review going forward.”

The Senate Budget and Appropriations Committee approved the bill Jan. 21. A companion bill was reported out of the Assembly Appropriations Committee in October 2020.

Ongoing Effort To Improve

More than a dozen bills aimed at strengthening the system against future outbreaks have been introduced, many of which incorporate recommendations from the Manatt Health report

The state-commissioned review found nursing homes were unprepared to deal with the pandemic and presented a series of recommendations on how to improve long-term care in the Garden State.

New Jersey has already implemented several recommendations from the report, including the distribution of 30 million pieces of personal protective equipment, testing of 310,000 residents and 495,000 staffers and 450 infection control surveys.

3 comments

  1. Do any of these Bills address the root cause of epidemics within nursing homes, which is that the staff go and out of the facilities and between facilities, bringing the virus with them?

    No amount of training, PPE and bureaucratic reports and procedures will stop the spread. The historic solution, which is foolproof and inexpensive, is total quarantine: absolutely no one goes in or out of the facilities until the epidemic is fully under control. The banning of visitors shows that public health officials were aware of the need to isolate the nursing homes, but it was an ineffective half-measure because staff continued to go in and out of the facilities,

    Total isolation means the staff must stay in the facility, perhaps for many weeks. And if the pandemic lasts for months, teams of staff are cycled through at regular intervals with the incoming teams quarantined for 10-14 days in a separate part of the facility. The staff should be generously compensated for performing this grueling duty and that’s where the State can and should help: it should pay very generous bonuses to staff members who participate in the total quarantine.

    Total quarantine has been tried in a few nursing homes (none in New Jersey) and the results are no case, no deaths.

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