Governor Phil Murphy today announced a series of recommendations and actions from Manatt Health’s rapid review of New Jersey’s long-term care facilities to address systemic challenges in long-term care and mitigate the impact of COVID-19 and reduce impacts of future outbreaks.

The nationally recognized Manatt Health team, led by Cindy Mann and Carol Raphael, provided several recommendations for the New Jersey Department of Health and long-term care facilities, as well as for state and federal action, to improve quality, safety, and resilience within New Jersey’s long-term care system. These recommendations outline how long-term care facilities can move forward both in the near- and long-term.  The report gives guidance for new residents and visitors after the current COVID-19 outbreak and addresses mitigation, protection, and resiliency against future outbreaks, both in the near- and long-term. The recommendations also present a roadmap for rebuilding a high-functioning long-term care system that emphasizes quality of care, patient safety, robust data infrastructure, and strong staff supports.

“The sad fact is that eldercare is a national problem and, too often, a national failure. During this crisis we have seen that in state after state, seniors and those who work with them in long-term care facilities made up a disproportionate number of the positive cases and tragically the losses.  We are all humbled by that,” said Murphy.“The solutions recommended by the Manatt team provide a comprehensive and systemic approach to ensuring the safety of the residents and staff of New Jersey’s long-term care facilities. My Administration looks forward to implementing Manatt’s recommendations to mitigate and protect one of our most vulnerable populations from future outbreaks.”

“I want to thank Manatt for a thorough, in-depth review and recommendations that will help to

strengthen New Jersey’s nursing homes and improve their resiliency,” said New Jersey Department of Health Commissioner Judith Persichilli. “Nursing homes care for our most vulnerable residents–our mothers, fathers, and grandparents. Their caregivers are healthcare heroes for what they do every day. These workers—and the residents who call these facilities home—need a system that supports a culture of quality, care, and infection prevention.” 

  “COVID-19 has brought to the forefront underlying weaknesses in our long-term care system. Manatt is honored to have been able to work with New Jersey in its efforts to provide the best support possible to the state’s nursing homes and their vulnerable residents and staff, and to develop a set of recommendations to not only address the COVID-19 crisis but to ensure that New Jersey has a sustainable, high-quality, safe and resilient long-term care system,” said Cindy Mann, partner with Manatt Health.

“Long-term care facilities have been at the epicenter of this pandemic,” said Carol Raphael, special advisor with Manatt Health.“It’s never been more important to ensure the safety of all residents, workers and their families. Equally important is the opportunity to learn from the collective experiences of the past few months to ensure we can make meaningful, lasting changes that transform care and elevate quality well into the future.”   

Based on their assessment, the Manatt report outlines the following recommendations to improve New Jersey’s long-term care facilities:

Strengthen Emergency Response Capacity by strengthening the ability to plan, coordinate, and execute effective responses to the emergency protentional surges.

• Consolidate and strengthen response through a central Long-Term Care Emergency Operations Center that would coordinate all activity and communications for nursing homes and long-term care facilities and obtain real-time input regarding staffing, supplies, and operational issues;
• Implement a “reopening” and forward-looking testing plan; and,
• Reinforce existing pathways for resident and family communications.

Stabilize Facilities and Bolster Workforce by increasing the responsibilities of and support for New Jersey’s nursing homes and their workers in the short and long-term.

• Recognize, stabilize, and resource the workforce by
  • Ensuring staff have access to paid sick leave;
  • Instituting wage enhancements;
  • Implementing minimum staffing ratios for direct care;
  • Establishing a wage floor and wage pass-throughs for Medicaid rate increases; and,
  • Strengthening training and career development opportunities;
• Institute COVID-19 relief payments for facilities and review rates.
• Create a Medical Loss Ratio to ensure payments to nursing homes, including any increases, are used for patient care.

Increase Transparency and Accountability by implementing stronger mechanisms to ensure a greater degree of accountability and increase transparency through data and reporting.

• Institute new procedures to regulate and monitor facility ownership, with a focus on increasing transparency;
• Improve oversight of and increase penalties for nursing homes; and,
• Centralize long-term care data collection and processing.

Build a More Resilient and Higher Quality System by establishing structures for stronger collaboration and advance payment and delivery reforms and increased reliance on home and community-based services.

• Improve safety and quality infrastructure in nursing homes by requiring facilities to maintain Infection Control Preventionists and by supporting the state’s current surveillance efforts;
• Strengthen state agency organization and alignment around long-term care operations; and,
• Create Governor’s Task Force on transforming New Jersey’s long-term care delivery system.

“The COVID-19 pandemic ravaging New Jersey has shed light on the fragility of our state’s long-term care system. It is critically important that we increase transparency and provide necessary resources across all affected Departments to enhance oversight in order to address the deficiencies that led to outbreaks within our long-term care facilities,” said Senator Joseph Vitale and Assemblywoman Valerie Vainieri Huttle in a joint statement. “It is equally important to build a resilient and stabilized health care system with strong workplace protections and adequate staffing in place to swiftly respond to future outbreaks. We look forward to working with Governor Murphy, his Administration, Senate President Sweeney, Speaker Coughlin and our colleagues to implement these much needed, overdue reforms outlined by Manatt to ensure the safety every resident and staff member within our long-term care system .”

For a copy of the complete report by Manatt, please click here.