February 4, 2023

Volume XIII, Number 35

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February 03, 2023

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February 02, 2023

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NJ Nursing Homes Fail to Improve Following Medicaid Fraud Report

In February of this year, the state comptroller issued a report examining New Jersey’s lowest-rated nursing homes participating in the Medicaid program.

Of the 368 nursing homes in New Jersey, 15 were identified as the worst long-term care facilities in the state, ranked “one-star” by the Center for Medicare and Medicaid Services (CMS) based on criteria such as staffing levels, health inspections, and quality measures.

Several months later, more than half of these facilities have failed to improve their quality of care—and continue to cost Medicaid hundreds of millions of dollars annually.

What’s changed since the February report?

Since the initial report was issued, six of the 15 identified nursing homes have made their way off the list of lowest-ranked facilities. Nine remain on the list—including Woodland Behavioral and Nursing Center, which was forcefully shut down last month due to charges of neglect and abuse—and three have been added.

An updated September report shows that the current 12 lowest-ranked facilities are receiving $107 million per year in Medicaid funding, despite repeated health and safety citations.

These facilities include:

  1. Cedar Grove Respiratory and Nursing Center (formerly Meadowview Nursing and Respiratory Care)

  2. Forest Manor HCC

  3. Grove Park Healthcare and Rehabilitation (formerly New Grove Manor)

  4. Hamilton Grove Healthcare and Rehabilitation

  5. Oceana Rehabilitation and NC

  6. Palace Rehabilitation and Care Center

  7. Phoenix Center for Rehabilitation and Pediatrics (formerly Wanaque Center for Nursing and Rehabilitation)

  8. Silver Healthcare Center (formerly Alaris Health at Cherry Hill)

  9. South Jersey Extended Care

  10. Sterling Manor

  11. Warren Haven Rehab and Nursing Center

  12. Woodland Behavioral and Nursing Center (recently closed)

Disputing the findings

Some industry officials have disputed the report’s findings.

“The comptroller’s report does not reflect timely or accurate information,” said Andrew Aronson, president and CEO of the Health Care Association of New Jersey. “Several of the facilities that have not yet ‘graduated’ from the list since February are long overdue for state survey that would confirm their improvement.”

Aronson cites the Department of Health’s staffing shortages as a factor preventing the state from acquiring correct information.

That said, according to the comptroller, CMS ratings dating back to 2013 reveal that a number of nursing homes on the list have held their low rankings for several years, showing little to no signs of improvement.

Taking steps to promote quality care

According to the report, all of these one-star facilities were operated by for-profit companies. According to Tom Hester, spokesman for the New Jersey Department of Human Services, quality incentive payments (QIPP) have been cut to each of the 12 nursing homes.

“Delivering safe and high-quality health care coverage and spending resources effectively is at the core of Medicaid’s mission,” he said. “We will continue to work with partners across the state and federal government to ensure the best possible care for residents at New Jersey’s long-term care facilities.”

This follows recommendations from the initial report to incentivize higher-quality care, rather than paying the lowest-rated facilities at the same rate as those that are higher-rated. Essentially, if a nursing home wants to remain in the Medicaid program, it must provide quality care to its residents.

COPYRIGHT © 2023, STARK & STARKNational Law Review, Volume XII, Number 288

About this Author

Jonathan Lauri Negligence Attorney

Jonathan Lauri is an Associate and member of Stark & Stark’s Nursing Home Negligence Group. Mr. Lauri concentrates his practice in wrongful death, catastrophic injury, negligence, and abuse claims arising in nursing homes, assisted-living facilities, psychiatric facilities, hospitals, boarding, and group homes. Mr. Lauri works tirelessly to ensure that all deserving individuals have a fair chance at justice through the legal system—even when it means taking on the most powerful people and corporations.

Prior to joining Stark & Stark, Mr. Lauri was a Litigation Associate for...