Additional Long-Term Facilities Needed for NJ’s Sickest Kids?

State attempts to elicit industry interest in creating more capacity have gone largely unanswered

An attorney who represented several families whose children survived an infectious adenovirus — that roared unchecked through the Wanaque Center for Nursing and Rehabilitation last fall and killed 11 patients — said three of his clients have had to place their children back at the same place where they almost died.

The families had no choice, he said, because New Jersey has such an acute shortage of these expensive, long-term care beds for kids with severe, lifelong disabilities who need extraordinary care.

“It’s all about the money. All about those Benjamins,” said Sen. Dick Codey (D-Essex). “Disgraceful. Disgraceful. Disgraceful.”

Codey sat on a legislative panel investigating the adenovirus deaths at Wanaque. The facility admitted one new patient this month and said it is evaluating two more after the state recently approved new infection-control protocols there.

But Wanaque is one of only four such facilities in New Jersey — including Children’s Specialized Hospitals in Mountainside and Toms River, and Voorhees Pediatric Facility. In all, there are just 283 beds statewide and they’re typically at full capacity. Getting more is problematic.

Little response from the industry

“We released … a certificate-of-need call for applications for more beds and there was only interest for about 17 or 18 beds. And what we want to do is actually reach out to the industry and see what the barriers are to getting more interest in those beds, and then issue a different call a little bit later on,” New Jersey Department of Health Commissioner Shereef Elnahal said.

“The healthcare industries, you know, are built around their own financial modeling that tells you whether or not you can sustain a facility,” according to Matt D’Oria, director of Medicaid policy at the New Jersey Health Care Quality Institute.

Money plays a major role. Long-term care facilities get reimbursed by state Medicaid programs and New Jersey pays $546 a day for a bed at Wanaque. But New York pays $300 a day more, and former Wanaque staffers testified it preferred New York clients. New York, unlike New Jersey, also keeps paying even if a child has to be hospitalized for a period.

“It is very expensive care and it’s predominantly government-financed care. So government has its responsibility to the taxpayers and I’m sure it monitors its reimbursement very closely,” said D’Oria.

“We want to work with the existing facilities to make sure, preferentially, they’re taking more New Jersey residents,” Elnahal said.

State report on Wanaque in offing

A scathing federal investigation reportedly faulted Wanaque for lack of oversight and delayed response to the outbreak, which the facility disputes.

Elnahal will soon issue a report on the Wanaque outbreak, calling for several reforms including training staff in outbreak control, updating plans to quarantine sick patients from the rest, requiring a lab on site to test for pathogens, and improving county and state surveillance.

“As a state, I think we have to band together and say we love these kids and we love their families and we’re going to take care of them,” Codey said.

New Jersey should consider subsidizing beds for the kids, he said —because that might persuade facilities to provide more of them.