Essex County Nursing Home On List Of 15 ‘Lowest-Rated’ In NJ – Patch

ESSEX COUNTY, NJ — A nursing home in Essex County is one of 15 that were recently cited for being among the “lowest-rated long-term care facilities” participating in New Jersey’s Medicaid program, authorities say.

Last week, the Office of the State Comptroller included Grove Park Healthcare and Rehabilitation Center on North Grove Street in East Orange – formerly known as New Grove Manor – on a list of 15 nursing homes that have repeatedly gotten the lowest possible rating from the U.S. Department of Human Services’ Centers for Medicare & Medicaid Services (CMS). Read the full report here.

Other facilities named to the list include:

• Marlton – Care One At Evesham, 870 East Route 70
• Williamstown – Cedar Grove Respiratory and Nursing Center, 1420 S. Black Horse Pike
• Paterson – Complete Care At Fair Lawn Edge, 77 East 43rd Street
• Cranford – Cranford Park Rehabilitation and Health Care Center, 600 Lincoln Park East
• Hope – Forest Manor HCC, 145 State Park Road
• Wayne – Lakeview Rehabilitation and Care Center, 130 Terhune Drive
• Cape May Court House – Oceana Rehabilitation and NC, 502 Route 9 North
• Maple Shade – Palace Rehabilitation and Care Center, 315 West Mill Road
• Riverton – Riverview Estates, 303 Bank Avenue
• Cherry Hill – Silver Healthcare Center, 1416 Brace Road
• Bridgeton – South Jersey Extended Care, 99 Manheim Avenue
• Maple Shade – Sterling Manor, 794 N. Forklanding Road
• Tinton Falls – Wardell Gardens At Tinton Falls, 524 Wardell RoadAndover – Woodland Behavioral and Nursing Center, 99 Mulford Road

In general, the Garden State’s nursing homes perform well on CMS inspections. The overall average rating for LTCs in New Jersey is 3.6 stars out of five, which is above the national average of 3.1.

However, 15 nursing homes in the state have repeatedly gotten the lowest possible rating over the past decade: one star. In addition, a few – New Grove Manor, Silver Healthcare Center and Woodland Behavioral and Nursing Center – received an overall rating of zero while in the CMS Special Focus Facility Program.

How are the CMS ratings compiled? According to the comptroller’s office:

“The linchpin of the CMS rating system is the health inspection score. This score is developed based on unannounced site visits conducted by a team of state surveyor health care professionals who spend several days in the LTC assessing a variety of practices and policies in such areas as resident rights, quality of life, medication management, skin care, resident assessment, nursing home administration, environment, and kitchen/food services. After the CMS establishes an LTC’s health inspection score, it adds or subtracts points based on the LTC’s quality and staffing measure scores to arrive at an aggregated score. For an LTC to be among the lowest performers for the first month of each quarter for at least six of the past eight quarters means that the LTC consistently has had more widespread, serious and uncorrected deficiencies than LTCs with higher star ratings.”

Other CMS measures used to calculate the overall score include “quality” and “staffing.”

When the comptroller’s office took a look at the numbers, it revealed some concerning trends, administrators said. According to the report:

“During the period we examined, from 2013 to 2021, the lowest-rated LTCs provided care for Medicaid beneficiaries and received substantial government funding, while consistently receiving the lowest ratings for health inspections, quality measures and staffing rates. This means that every day, thousands of Medicaid beneficiaries have lived in and received health care from LTCs that have been repeatedly cited by state inspectors for serious, widespread and uncorrected deficiencies that placed patients at great risk of harm. Because Medicaid funds follow Medicaid beneficiaries — and the state’s recent effort to incentivize higher quality care thus far has failed to distinguish in a meaningful way between the highest and lowest rated facilities — the state has paid the lowest-rated LTCs at virtually the same rate as it paid higher-rated LTCs.”

THE HIGH COST OF CARE

The financial stakes are high when it comes to Medicaid, state officials said.

Medicaid is a joint federal and state program administered by states. In New Jersey, the state Division of Medical Assistance and Health Services (DMAHS) administers the Medicaid program, which provides health insurance for about two million residents, including people who are aged or have disabilities, as well as people who have low-and moderate-incomes.

In state fiscal year 2019, the state Legislature budgeted more than $14 billion in state and federal funds to New Jersey’s Medicaid program.

In total, the 15 named facilities provide services to about 1,850 Medicaid beneficiaries, or 6.5 percent of the 28,500 Medicaid beneficiaries residing in New Jersey LTCs. The Medicaid program pays these facilities an average of $103 million annually, according to the comptroller’s office.

But that’s not all, officials said.

In addition to the payments noted above, beginning in state fiscal year 2020 (July 1, 2019), the Medicaid program, through the Division of Aging Services within the DHS, instituted a quality incentive payment program (QIPP), which provided additional payments to facilities that demonstrated higher quality and performance.

According to the comptroller’s office:

“The QIPP measures consider antipsychotic medication use, incidence of pressure ulcers, use of physical restraints, falls with major injury, and CoreQ survey results (a customer satisfaction survey). Through the QIPP, [facilities] were eligible to receive an additional $0.60 to $3 per resident per day for meeting or exceeding these five quality measures – a maximum of $0.60 for each measure.”

LOOKING TO THE FUTURE

There needs to be stiffer consequences when nursing homes don’t make the grade, state officials said in their report.

“In the absence of some consequence for their continued low ratings, the lowest-rated LTCs, some of which have had low ratings for many years, appear unlikely to improve the conditions and care in their facilities,” the comptroller’s office wrote.

Almost all of the 15 lowest-rated LTCs – about 93 percent – are for-profit organizations, with most operating as a corporation or limited liability company.

What can be done to turn things around? Here’s what the comptroller’s office said:

“This report recommends changes to New Jersey’s Medicaid program to require one-star LTCs to improve their quality of care if they want to remain in the Medicaid program, with a goal of aligning Medicaid payments with improved LTC performance. OSC recommends that the Department of Human Services (DHS) and the Division of Medical Assistance and Health Services (DMAHS), with support from the Department of Health, institute a phased approach through which DMAHS imposes increasing levels of restriction on these LTCs while affording the LTCs an opportunity to improve their ratings before the most severe restrictions are imposed. If the LTCs do not improve, DMAHS may bar them from participating in the Medicaid program.”

“The recommendations in this report, if implemented, will complement and supplement the various legislative and regulatory reforms that DOH and DHS are implementing, including the recently enacted law that revises reporting requirements for nursing homes and establishes additional requirements for DOH to assess sanctions and impose penalties on nursing homes,” the comptroller’s office added.

State officials noted that of the 15 lowest-rated LTCs listed above, five of the owners/managers/third-party administrators are also involved in at least two other LTCs on the lowest-rated LTC list. One of these is affiliated with 39 different facilities in New Jersey.

The list includes:

• A manager of South Jersey Extended Care, and Sterling Manor, is affiliated with six LTCs that received a two-star or lower score in October 2021 and with a total of nine LTCs in New Jersey
• An owner of Cranford Park Rehabilitation and Health Care Center, Silver Health Care Center, and Wardell Gardens at Tinton Falls, is affiliated with three LTCs that received a two-star or lower score in October 2021 and with a total of five LTCs in New Jersey
• An owner of Silver Health Care Center, and Wardell Gardens at Tinton Falls, is affiliated with three LTCs that received a two-star or lower score in October 2021 and with a total of three LTCs in New Jersey
• An administrator of Complete Care at Fair Lawn Edge, Lakeview Rehabilitation and Care Center, Palace Rehabilitation and Care Center, Silver Health Care Center, and Wardell Gardens at Tinton Falls, is affiliated with eight LTCs that received a two-star or lower score in October 2021 and with a total of 39 LTCs in New Jersey
• An owner/manager of Oceana Rehabilitation and Nursing Care, South Jersey Extended Care, and Sterling Manor, is affiliated with three LTCs that received a two-star or lower score in October 2021 and with a total of three LTCs in New Jersey

Send news tips and correction requests to eric.kiefer@patch.com

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