A bill aiming to crack down on repeat offenders of nursing home state and federal codes is headed to New Jersey Gov. Phil Murphy, after the measure passed the state legislature on Monday.

The state’s Department of Health would implement a “system of scaling actions and penalties” under the measure, if a nursing home repeatedly violates government requirements tied to administration and operations.

Such actions and penalties include special licensure survey programs for facilities with three or more violations over three inspection cycles. Surveys would be conducted once every two years, or more frequently and over a longer period of time if “circumstances warrant greater or more frequent oversight,” according to bill text.

“Clearly, our nursing homes were unprepared for the numbers of infection rates that occurred, and their staffs were overwhelmed and in some cases left unprotected,” state Sen. Joseph Vitale (D-Middlesex), chairman of the Senate Health, Human Services and Senior Citizens Committee, said in a statement. “Going forward, we must make sure nursing homes and those who run them are held accountable, and following strict protocols beforehand, so that we never again see a tragedy like this repeat itself.”

Gov. Murphy deployed the New Jersey National Guard late last week to assist nursing homes with spiking cases due to the omicron variant and the continued staffing crisis – about 150 soldiers and airmen will help facilities with administrative and logistical support, the governor’s office said in a statement.

Currently, there are 527 facilities with active outbreaks, according to the state’s DOH COVID dashboard. Facilities have reported 8,158 resident deaths and 165 staff deaths since the onset of the pandemic.

While the measure doesn’t specify how much a facility could be fined for repeat offenses, the bill does say sanctions and penalties would apply to facilities cited two or more times for the same violation in a six-month period.

If violations result in “severe adverse health consequences” for residents or staff, a facility could have its license suspended, terminated or revoked, the bill states.

In response to the legislation’s progress, the Health Care Association of New Jersey (HCANJ) said the organization will continue working with the legislature to provide support to facilities and residents. HCANJ President and CEO Andrew Aronson pointed out state vaccination rates of more than 90% for residents, and booster rates at just over 80%, adding members are doing an “outstanding” job in protecting residents.

The bill would also require nursing home owners to post owner-certified financial statements, or IRS Form 990s for non-profit organizations, and cost reports filed with the Centers for Medicare & Medicaid Services (CMS). The NJ DOH would also evaluate staffing levels as part of the legislation.

In an effort to streamline reporting requirements for operators, another aspect of the bill asks the DOH to take steps to standardize and consolidate data sent to other authorities in addition to CMS – the NJ Department of Human Services, Medicaid managed care organizations and state long-term care ombudsmen.

“We need more data on financial operations from these facilities, as well as more transparency through documents that will reveal past failings and inconsistencies,” Sen. Fred Madden Jr. (D-Camden/Gloucester) said in a statement. “These are straightforward steps we can take so as to help mitigate the sort of haphazard, disastrous response to an emergency health event like we saw in the spring of 2021.”

Bill A4478/S2759 was first introduced in July of 2020 – sponsors include Vitale and Madden, among four other primary sponsors and 21 co-sponsors. The Assembly passed its version of the bill more than a year ago; the Senate version passed 39-0.