Carenet Inc.

On October 23, 2020, in response to the outbreak in nursing homes of the pandemic, Governor Murphy signed two bills (S2712 and S2785) ordering reforms to the long-term care industry. This is a direct response to the Media news articles basically condemning the industry, in particular the Veteran’s Home in Paramus.

Most of the protocols in the bills were implemented months ago, e.g. limiting visitation. Others are a result of public outcry that families have not been able to interact with residents in a positive way since March 2020 when the pandemic struck in full force. Social isolation of residents resulted in many families not being able to visit loved ones prior to death, which created an amazing amount of stress and sorrow on the residents and on the families.

One of the new rules is to prevent social isolation of residents primarily with the use of Zoom or other virtual visitation methods.

S2712 establishes minimum direct care staff-to-resident ratios in nursing homes. Specifically, the law requires:
• One CNA to every eight residents for the day shift;
• One direct care staff member (RN, LPN, or CNA) to every 10 residents for the evening shift; and
• One direct care staff member (RN, LPN, or CNA) to every 14 residents for the night shift.

Increasing staffing has always been the fall back position of the State of New Jersey when a nursing home is criticized. Most of the above standards have been present in facilities prior to the implementation of these new laws. So this is mostly blowing smoke to impress the public that Murphy is actually doing something.

Unfortunately, the reimbursements for Medicaid are so pathetically low that it rarely covers the cost of care. Inevitably that will drive the cost for private-paying patients up. Since the costs in nursing homes have been escalating at approximately 8% per year in New Jersey with nursing homes in North Jersey ranging from $ 12,000 to $ 15,000 per month in 2020, it is difficult to see how far this can go.
The real issues are being avoided. They are as follows:

(1) Nurses’ aides often work multiple jobs at different facilities to survive. These individuals go home at night to their families. Exposure to COVID is greatly enhanced by these facts.

(2) There is no way to monitor every RN and aide in a nursing home or HOSPITAL , 24-7, to ensure that they never violate protocols, e.g. handwashing; changing plastic gloves and/or gowns after treating a COVID patient.

(3) Patients are admitted from hospitals that have been deemed COVID free by the hospital. However, this is not a guarantee that the patient is not a carrier or COVID free. This could lead to a general outbreak in the facility should the new admission be contagious.

(4) Outside consultants, e.g. Doctors, Therapists; delivery people enter the facility and may be carriers.
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Nursing Homes are taking every precaution possible and yet the number of cases continues to rise.

These laws may mitigate the situation for a few facilities, but we are a long way from eradicating the problem in skilled nursing facilities.

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