Federal Look at COVID-19 Nursing Home Deaths May Be Very Limited

DOJ request for details omits nearly all long-term care facilities
Credit: NJTV News
Patients from St. Joseph’s Senior Home in Woodbridge were evacuated March 25 after multiple residents contracted COVID-19 and some died.

Gov. Phil Murphy has said little about the state’s plans to respond to a recent federal request for data related to select nursing homes, but suggested the inquiry would not impact New Jersey’s own quest to better understand the beleaguered industry’s coronavirus response and ensure mistakes aren’t repeated in the future.

The federal Department of Justice appears to be focused on just a tiny sliver of nursing homes in its request to New Jersey, New York, Pennsylvania and Michigan, which were hard hit by the virus and are led by Democratic governors. In fact, the data inquiry could apply to fewer than a dozen facilities in New Jersey — or less than 3% of the state’s nursing homes, according to an NJ Spotlight analysis of state health department records.

While dismissed by many as a partisan stunt by the Republican Trump administration, DOJ sent letters to the four governors last week seeking data on COVID-19 cases, deaths and hospitalizations at nursing homes “owned, operated or managed by” the state. The agency said it would use the information to determine if residents’ civil rights were violated during the pandemic.

According to a facilities database compiled by the New Jersey Department of Health, this definition of “public” appears to include just eight nursing homes owned by various counties, as well as three state-run veterans residences, which have struggled to protect residents and staff during the pandemic. Health department officials declined to confirm which facilities would be included in their response, noting the federal request is under review.

“We obviously take (the request) seriously; we’ll obviously respond in an orderly fashion,” Murphy said Wednesday at his regular media briefing. “We are obsessed with long-term care and we have been since moment one. (COVID-19) exploded there, whether it’s in our own veterans homes, (or) whether it’s in the entire industry.”

Since March, 38,200 long-term care residents and staff have been diagnosed with the novel coronavirus and more than 7,000 have died as a result — roughly half the state’s 14,181 total lab-confirmed fatalities. Another 388 cases and 146 deaths are connected to the three veterans homes. According to federal figures, New Jersey has the highest long-term care case rate nationwide and the second-highest death rate, after Massachusetts.

Infection control guidance

Murphy has repeatedly pledged to evaluate how the state and the nursing home industry responded to the pandemic. In May, DOH hired consultants Manatt Health to provide short and longer-term guidance on how to improve infection control at the state’s 372 skilled nursing facilities and the three veterans homes; the consultants were paid $500,000 for roughly three weeks worth of work, which cumulated in a 100-page report released in early June.

That report served as a blueprint for a package of legislation that aims to expand the state’s oversight power of the industry, require greater transparency around nursing home ownership, boost wages for frontline workers and ensure all caregivers have paid sick leave. It also prompted Murphy to commit $155 million to help fund pay increases, testing programs and infection control at these facilities.

Murphy said Wednesday the state would continue to examine how it can help nursing homes better address the pandemic. The process will involve “not only trying to figure out what happened, but also trying to figure out what happened (so it) doesn’t happen again,” he said. “If the question is, ‘Do we need the Department of Justice to establish that focus?,’ the answer is no.”

Federal DOJ officials appear particularly focused on controversial state orders relating to how hospital patients were discharged to nursing homes, where individuals can regain strength before going home. “New York, New Jersey, Pennsylvania, and Michigan required nursing homes to admit COVID-19 patients to their vulnerable populations, often without adequate testing,” it noted in a news release.

In New Jersey, DOH Commissioner Judy Persichilli issued a directive in late March that forbid long-term care operators from denying admission to anyone with COVID-19, in part to relieve pressure on overcrowded hospitals. The order — which was based on federal guidance at the time but has since sparked strong criticism — also required facilities to carefully separate patients with symptoms and to alert state officials if they could not safely accommodate infected individuals.

More than five months later, the impact of the virus has diminished significantly in New Jersey’s communities and long-term care facilities. According to the state’s COVID-19 dashboard, there were active coronavirus outbreaks at 156 nursing homes, as of late August.

The “active outbreak” list includes three of the eight county-owned facilities, which together reported a total of 325 cases among residents and staff and 41 deaths — all connected to infections diagnosed within the past month. Cumulative case and death numbers are not available for individual facilities; veterans homes are tracked separately.

County-owned nursing homes

While New Jersey once had 21 county-owned nursing facilities, only eight remain today. They include the following, according to the DOH database and dashboard data:

  • Bergen County Health Care Center, in Rockleigh. Owned by Bergen County, the facility has a current outbreak that involves 51 resident cases, 38 staff cases and 10 resident deaths.
  • Bergen New Bridge Medical Center, in Paramus (formerly Bergen Regional). Owned by the Bergen County Improvement Authority, it currently has one resident with COVID-19 and one staff case.
  • Crest Haven Nursing & Rehabilitation Center, in Cape May Court House. Owned by Cape May County, the facility does not have any active cases.
  • Meadowview Nursing & Rehabilitation Center, in Northfield. Owned by Atlantic County, with no active cases.
  • Preakness Healthcare Center, in Wayne. This Passaic County-owned site is home to 114 active cases among residents and 121 staff cases, with 31 resident deaths.
  • Roosevelt Care Center, in Edison. Owned by the Middlesex County Improvement Authority, it does not have a current outbreak.
  • Roosevelt Care Center at Old Bridge; also owned by the Middlesex County Improvement Authority, with no current cases.
  • Shady Lane Nursing Home, in Clarksboro. This facility is owned by the Gloucester County Improvement Authority and reports no current outbreak.