Nursing home surveys in New Jersey have fallen behind state and federal regulatory requirements, with inspections frequently delayed. State officials say the delays are due to Covid backlogs, hiring freezes and loss of staff.
Federal policy requires each of the state’s 350 nursing homes to be inspected at least every 15 months, while statewide average for all inspections needs to be under 12 months.
The state Department of Health is “falling significantly short” of meeting these timeframes, State Auditor David Kaschak said in a report based on his office’s audit of the department between July 2022 and March 2026.
As of February, state inspectors were conducting surveys every 20 months on average, and more than a quarter of nursing homes hadn’t been inspected in at least two years. And, more than 80% of inspections resulting from a complaint were delayed.
In one case, an incident that should have triggered a facility visit within 3 days took 215 days for the state team to examine, according to the report. Auditors also found that complaints were improperly classified, further contributing to delays. Despite nursing homes management raising concerns, such complaints could still take state surveyors more than a year to inspect.
The report found that there are only eight inspection teams in the state when there should be 12. The state outsourced inspections to a third party, but the contract expired in June, auditors reported.
The state has had to triage its supply of surveyors as a result of staffing issues, only surveying nursing homes that haven’t been recently reviewed or have complaints or poor outcomes in the past.
Andy Aronson, president and CEO of the Health Care Association of New Jersey, told the New Jersey Monitor he expects the federal risk-based survey program to help with inspection backlog in the state as well, allowing surveyors to focus on facilities that are in the most need.
But state auditors will still be tasked with citing nursing homes that don’t meet a state-based staffing law – five of 11 recently visited nursing homes didn’t meet staffing levels required under the law, which stipulates one certified nurse aide (CNA) for every eight residents during the day, and then one CNA for every 10 residents in the evening, and one per 14 residents on night shifts.
Industry leaders including NJHCA are part of an ongoing lawsuit against the law, arguing it is unconstitutional and impossible to meet considering staffing shortages.
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