Bills to Boost New Jersey Nursing Homes’ Infection Controls Clear State House

State Democratic lawmakers pointed to COVID-19’s large death toll on seniors as they steered through New Jersey’s state house bills aimed at implementing greater infection control measures in the state’s long-term care facilities.

One of the bills that recently passed both chambers unanimously would require action by state government officials to improve curriculum for New Jersey nurses. A second proposed law would mandate state officials to study long-term care facilities’ infection control and prevention practices and policies and develop a statewide plan to improve them.

Both bills await a signature from Gov. Phil Murphy, who suffered much political fallout from thousands of deaths of seniors and long-term care facility employees early in the pandemic after directives from his administration led many New Jersey long-term care facilities to confusion if they were required to readmit COVID-positive residents who were discharged from hospitals.

Manatt Report

Additionally, a 2020 review of the long-term care industry by Manatt Health found that about one-third of New Jersey’s nursing homes were cited for infection control deficiencies in 2017.

“After the tragedies we saw in nursing homes last Spring, it became abundantly clear that our long-term care industry needed swift and comprehensive reform. We all can agree that residents and their families deserved far better,” said Assemblywoman Valerie Vainieri Huttle (D-37). “We must learn from our past missteps and pursue a path forward that prioritizes resident safety and high-quality care.”

The State Senate June 3 unanimously passed a bill (S3031, A5059) that would require state health officials to develop infectious disease instructional programs for nurses who work in New Jersey’s long-term care facilities. The Assembly unanimously passed the measure in March.

Bill Seeks to Enhance Nurse Training

Senate President Stephen Sweeney (D-3) and Sen. Joseph Vitale (D-19), chairman of the Senate Health, Human Services and Senior Citizens Committee, were the lead sponsors of the measure.

“It has become increasingly evident that we are overdue for a long-term strategy to ensure that our state’s nursing homes are focused on the safety of residents and caregivers,” Sweeney said in a press statement. “By providing additional education to nurses and nurse aides, we will be able to deliver the best care for our senior citizens while keeping their health and safety a top priority.”

The bill would require the state’s Board of Nursing to review the current nursing curriculum and clinical experience requirements and incorporate the Nursing Home Infection Preventionist Training Course offered through the federal Centers for Disease Control and Prevention.

Nursing Bill Details

As part of the review, the board would be authorized to make or recommend additional changes to the curriculum, as they deem appropriate, “to ensure that licensed practical nurses and registered nurses receive adequate training on post-acute care,” Sweeney and Vitale said in a summary of the bill.

Additionally, the bill stipulates that the state’s Department of Health would review the nursing curriculum and clinical experience for the certification of certified nurse aides “and may require them to complete any appropriate portions of the Nursing Home Infection Preventionist Training Course, or a similar course offered through the Association for Professionals in Infection Control and Epidemiology.”

Additionally, the legislation calls for the health department to work with long-term care facilities and labor groups to start a pilot program that would create standards for the advancement of certified nurse aides.

Nursing Home Study

The Assembly May 20 unanimously passed a related measure (A4855, S 3032) that would require the New Jersey Department of Health to assess long-term care facilities’ infection control and prevention policies and to develop a statewide plan to improve them. The Senate unanimously passed the legislation in March.

The bill states that the health department’s assessment would include:

  • a count of the total single-resident rooms in nursing homes throughout the state, including a percentage of total nursing home beds utilized in single-resident rooms, as well as a review of nursing homes’ capacity to expand single-resident room availability;
  • a survey of the maintenance status of heating, ventilating, air conditioning, and refrigeration systems in nursing homes;
  • an assessment of the use of negative pressure rooms and other physical plant features designed to boost infection control and prevention throughout nursing homes; and
  • assessments of any other infrastructure-related infection control or prevention considerations recommended by the New Jersey Task Force on Long-Term Care Quality and Safety. The bill stipulates that the department request recommendations from the task force.

Vainieri Huttle along with fellow Democrats Daniel Benson (D-14) and Nicholas Chiaravalloti (D-31) sponsored the bill in the lower chamber; Sweeney and Vitale sponsored the Senate version of the bill.

‘Stronger’ Long-Term Care System Sought

“To build a stronger, more resilient long-term care system, we’ll need to evaluate our resources and identify areas for improvement. That’s exactly what this bill aims to accomplish,” said Chiaravalloti. “As we combat a second wave of COVID-19, it’s never been more important to better prepare our nursing homes to keep residents safe.”

Under the legislation, the Department of Health would develop a statewide plan for improving New Jersey’s long-term care facilities within 180 days of the assessment’s completion.

“The goal would be to establish standards and requirements for improvements and a long-term strategy to redesign the nursing home industry to promote resident safety. It would review best practices in other states and create specific timelines for improvement,” Vainieri Huttle added.

Show of Unity

The unanimous passage of the bills in both chambers was a show of unity in a year marked by wrangling over the Murphy administration’s early handling of COVID-19 in the state’s long-term care facilities.

Republican state lawmakers have been demanding for over a year that Democrats, who control both the Senate and Assembly, form a bipartisan investigative committee to probe nursing home deaths and other components of what they said was Murphy’s flawed COVID-19 response.

Sweeney had said in May 2020 that he would create a bipartisan committee to probe COVID-19 deaths in long-term care facilities and other issues related to the pandemic, but he ultimately did not proceed with the panel. Republicans held their own hearings in March 2021.

Vaccine Distribution

The number of COVID-19 vaccines administered in New Jersey totaled 9,124,192 in-state, plus an additional 357,974 administered out-of-state for a grand total of 9,482,166 as of June 11. Of those who have received the vaccine, 4,514,515 received their second dose or the one jab Johnson & Johnson dose in state and another 170,482 out of state, bringing those fully vaccinated to 4,514,515. 

Demographically, 54% of those vaccinated are women and 46% men. As for ethnicity, 51% are White, 14% Hispanic, 11% Asian, 7% Black, 9% other and 8% unknown. In regards to the age of those having received the vaccine, 26% are 65 years old or olders, 28% are between the ages of 50-64, 29% are between the ages of 30-49, and 18% are between the ages of 12-29.  

In North Jersey, Bergen County has delivered 999,797 doses (478,880 fully vaccinated), Essex 755,845 doses (355,486), Hudson 653,106 doses (302,467), Morris 590,589 doses (282,364), Passaic 464,761 doses (218,359), Sussex 137,237 doses (66,290), and Warren 89,279 doses (43,084). 

Daily Data

As of June 11, the cumulative number of confirmed coronavirus cases in New Jersey was 889,779 with 194 total new PCR cases reported. There were 135 probable cases, bringing the cumulative total of antigen tests to 129,328. The total number of individual cases for the state is 1,019,107. 

As for those that have passed, the state reported four new deaths, bringing that total to 23,639. The state listed probable deaths at 2,685, bringing the overall total to 26,324. State officials noted two deaths occurred in the last 24 hours of reporting that have not yet been lab confirmed.  

For North Jersey counties on June 11, Bergen had a total of 20 new confirmed cases and 14 new probable case, Essex 15 new cases and 13 new probable cases, Hudson 14 new cases and 19 new probable cases, Morris nine new cases and seven new probable cases, Passaic nine new cases and 10 new probable case, Sussex seven new cases and three new probable cases, and Warren had two new cases and no new probable cases.

Of the total confirmed deaths in North Jersey, Essex County has the most with 2,712, followed by Bergen at 2,588, Hudson with 2,087, Passaic at 1,739, Morris at 985, Sussex at 246, and Warren County at 220.

In regards to probable deaths reported June 9, Essex has 300, Bergen has 299, Morris has 261, Hudson has 215, Passaic has 199, Sussex has 68 and Warren has 26.

State Testing 

As for the rate of transmission reported June 11, it increased to 0.80 from 0.77 the day before. The daily rate of infections from those tested June 6, was 1.6%; by region, the rate was 1.5% in the North, 1.6% in the Central region and 1.8% in the South. 

Officials reported 385 patients were hospitalized; by region, there were 202 in the North, 102 in the Central and 81 in the South. Of those hospitalized, 85 are in intensive care units and 53 on ventilators. A total of 70 patients were discharged, while 19 were admitted.

Officials have continually cited transmission rate, hospitalizations, intensive care units, ventilators 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.

Bergen Tops County Count

Bergen has the most confirmed cumulative cases in the state with 89,858, followed by Middlesex at 84,894, Essex at 84,733, Hudson at 78,843, Monmouth at 67,531, Ocean at 65,726, Passaic at 65,671, Union at 60,482, Camden at 49,015, Morris at 41,917, Burlington at 38,288, Mercer at 31,658, Gloucester at 26,562, Atlantic at 24,938, Somerset at 24,299, Cumberland at 14,876, Sussex at 11,712, Warren at 8,964, Hunterdon at 8,921, Salem at 5,549, and Cape May at 4,622.  

In regards to probable cases, Bergen had the most at 14,658, followed by Union at 11,052, Ocean at 10,257, Essex at 9,515, Hudson at 9,273, Morris at 8,293, Monmouth at 8,130, Middlesex at 7,498, Passaic at 7,392, Camden at 6,699, Atlantic at 6,636, Burlington at 5,965, Somerset at 5,779, Cape May at 4,589, Gloucester at 4,026, Mercer at 2,421, Sussex at 2,319, Cumberland at 2,271, Warren at 1,027, Hunterdon at 899, and Salem 541.

Another 720 cases are still under investigation to determine where the person resides.

Long-term Care Facilities

Health officials noted 68 long-term care facilities are currently reporting at least one case of COVID-19, accounting for a total of 1,706  of the cases, broken down between 647 residents and 1,059 staff. 

Cumulatively, 1,474 long-term care facilities reported a case infecting 32,770 residents and 22,223 staff, for a total of 54,994. 

The state’s official death total will now be reported as those that are lab confirmed, sits at 8,058 on June 11. The facilities are reporting to the state 7,869 residents deaths and 144 staff deaths.

One comment

  1. The nursing home legislation and studies and reports are all useful small steps. But, from the reporting, it seems that the legislature missed the most important and easiest, least costly means for protecting nursing homes and other care facilities: if a pandemic is declared, EVERY care facility should be totally quarantined, meaning NO ONE — particularly staff — goes or comes out until the pandemic is under control. Teams of staff would have to live on the premises until relieved by another team that has been separately quarantined to ensure that none of the incoming team is infected. This would also mean that the staff won’t be bringing the virus to their homes and their communities.

    The State’s role would be: 1) to provide money to generously compensate the staff for the burden forced on them and to provide additional qualified staff if the facility can’t provide enough; and, 2) to provide, if needed, FEMA trailers, mobile homes/campers or similar accommodations needed to house the staff.

    A few care facilities (none in NJ) implemented this total quarantine approach at the beginning of the covid pandemic and it was highly successful: no cases and therefore no deaths among a highly vulnerable population.

    This is a proven strategy that originated in the Middle Ages in Europe to combat the plague: close the city gates, no one comes in, no one goes out. Food, medicines and other essentials are left at the gates but no contact.

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