The Health Care Association of New Jersey and six long-term care facilities are suing their state over its nursing home staffing mandate, which has resulted in buildings being fined $1,000 per day for being out of compliance. 

The lawsuit, filed in late August in New Jersey Superior Court, claims the fines were an “inevitable” outcome of the 2020 law – a consequence the state knew would happen. 

“The result of the Staffing Law’s impossible mandate was inevitable— widespread noncompliance despite all reasonable efforts by Nursing Homes to attract and retain the requisite number of [certified nursing aides],” the suit says. 

The lawsuit alleges that the staffing law is unconstitutional and violates providers’ due process and right not to face excessive fines. It does not say when the state Department of Health, which is named as a defendant, actually began issuing fines. State Health Commissioner Kim Baston is also named as a defendant. 

New Jersey’s staffing law took effect Feb. 1, 2021, and requires facilities to have at least one CNA for every eight residents on a day shift, one registered nurse, licensed practical nurse or CNA for every 10 residents on evening shifts, and one RN, LPN, or CNA for every 14 residents overnight. Failure to maintain those staffing levels results in fines of up to $1,000 for every day out of compliance. 

Since the pandemic ended, the Health Care Association of New Jersey and providers have spoken out about their inability to hire enough staff to meet the mandate. In June 2023, association President Andy Aronson told McKnight’s Long-Term Care News that fining facilities would not result in hiring more staff. 

“The notion of punishing a nursing home that is making best efforts to comply with the ratios, but can’t find staff because of workforce shortages, seems counterproductive and overly punitive,” Aronson said at the time. “The penalties are not a solution to the workforce shortage and would only serve to take money away from patient care.”

Aronson declined to comment Friday on the lawsuit; the cited providers could not be reached for comment. They are are Complete Care at Bey Lea LLC in Toms River with 120 beds; Complete Care at Woodlands in Plainfield (also 120); Atlas Rehabilitation and Healthcare Center at Maywood in Maywood (120); Aspen Hills Healthcare Center in Pemberton (204), Family of Caring of Teaneck in Teaneck (107), and Coral Harbor Rehabilitation and Healthcare Center in Neptune City (110).

More called for from shrinking workforce

“The critical shortage of long-term care employees is undeniable,” said the association’s attorney, Peter Slocum of Lowenstein Sandler LLP, in an email to McKnight’s. “Penalizing businesses for failing to do the impossible — hire workers that do not exist — is unconstitutional and cannot stand.”  

The lawsuit references an April 2024 report from the New Jersey Task Force on Long-Term Care Quality and Safety, which looked at the extent of staffing shortages throughout the industry. 

“New Jersey’s direct care workforce is shrinking and cannot meet the needs of the growing elderly population,” the report stated, adding that the nursing home workforce had declined by nearly 15% since the pandemic. 

According to the US Department of Health and Human Services, New Jersey will have a deficit of approximately 11,400 RNs by 2030. The lawsuit notes that the state requires CNAs to have 90 hours of training and pass a state Department of Health evaluation. Becoming an LPN or RN requires significantly more, the suit points out.