On June 3, New Jersey Governor Phil Murphy announced a series of steps he will take based on recommendations from Manatt Health concerning how COVID-19 has impacted residents and staff in the state’s 370 nursing homes. Following a rapid review commissioned by the state, Manatt laid out a set of actionable proposals for the state to reduce impacts of future COVID-19 outbreaks and strengthen the state’s long-term care (LTC) system.

Led by partner Cindy Mann and special advisor Carol Raphael, a Manatt Health team partnered with the state of New Jersey to undertake an intensive three-week review. The resulting Manatt report outlines recommendations on what it will take for the state and LTC facilities to move forward with confidence to reopen for new residents and visitors after the current COVID-19 outbreak. Notably, the report offers both near- and long-term recommendations for building a high-functioning LTC system that emphasizes quality of care, patient safety, strong supports for staff, a robust data infrastructure and better communication and coordination between the state and a fragmented LTC system. These recommendations include:

Strengthening Emergency Response Capacity to plan, coordinate and execute effective responses to future crises.

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

Stabilizing Facilities and Bolstering 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;
  • longer term, establishing a wage floor and wage pass-throughs for Medicaid rate increases; and
  • strengthening staffing ratios and training and career development opportunities.
• Institute COVID-19 short-term relief payments for facilities, subject to certain requirements, and undertake a comprehensive review of rates.

Increasing Transparency and Accountability by implementing stronger mechanisms to ensure a greater degree of accountability, and increasing transparency through data and reporting.

• In light of the influx of for-profit facilities and frequent turnover in facility ownership, institute new procedures to regulate and monitor changes in ownership, with a focus on increasing transparency and ensuring that facility revenues are spent on direct care.
• Improve oversight of and increase penalties for nursing homes with serious deficiencies.
• Centralize LTC data collection and processing.

Building a More Resilient and Higher Quality System by implementing structures for stronger collaboration and advancing 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 providing facilities support for improving performance and creating a “culture of quality.”
• Strengthen state agency organization and alignment around LTC operations.
• Create Governor’s Task Force on transforming New Jersey’s LTC delivery system, including by expanding options for people to receive long term services and supports at home.

Access Manatt’s complete report here.

For more information, read Governor Murphy’s announcement on this here.