New legislation enacted by the New Jersey legislature changed the number of residents on the day, evening, and overnight shifts whose care one nursing assistant will be responsible to provide. The bill set caregiver-to-resident ratios at 1:8 for the day shift, 1:10 for the evening shift, and 1:14 for the overnight shift. A task force was also created to examine workforce recruitment and retention.
The changes are applauded by elder advocates and labor leaders as a way to “fundamentally improve standards of care in nursing homes by ensuring that facilities hire sufficient frontline staff to meet the basic needs of residents.”
Nursing home operators expressed concern about the changes due to the cost and the lack of available staff . They expressed a desire to have measures enacted that would help increase the availability of frontline workforce nursing assistants.
About one-half of the confirmed 14,500 statewide deaths from COVID-19 occurred in long-term facilities, and concern regarding that fact precipitated a state ordered study that was conducted by Manatt Health. A report with the results of the study was provided on June 3. The report made both long and short-term recommendations for improving the COVID-19 response within the 272 nursing homes and is being used by the legislature to enact needed changes.
Compliance Perspective
Providing the level of staffing to meet the aggregate care needs of all the residents in a facility is an ongoing challenge that has been exacerbated by the COVID-19 pandemic. As the crisis continues, failure by facilities to examine the effectiveness of their response in adhering to all the state and federal guidelines and laws and to implement needed changes may be deemed provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review and revise staffing policies and procedures as necessary to ensure adherence to state mandated staffing levels on all shifts.
- Train staff regarding required staffing levels and protocols for controlling the spread of an infectious virus like COVID-19.
- Periodically audit to ensure that staffing levels are being met in accordance with state mandated levels on all shifts.
RECRUITING NEW EMPLOYEES – PAVING THE ROAD TO OBTAINING COMPETENT STAFF
