Consumer advocates cheered when the New Jersey State Comptroller recently suspended four nursing homes from Medicaid — calling the enforcement tactic a “model for nursing home enforcement nationwide.” Provider leaders pushed back on the oversight method Thursday, however, warning it would be a “dangerous” trajectory for the sector.
The state’s acting comptroller, Kevin Walsh, temporarily suspended four nursing homes from Medicaid in January, following years of reports warning about some state facilities delivering what was characterized as a poor standard of care.
The suspensions targeted owners whom the state considered responsible for neglectful care or financial fraud. Several of the facilities had been required by the state to host a consultant, financial monitor or health monitor. The owners in question also were ordered to divest ownership of the facilities.
“To protect New Jersey Medicaid and the residents who rely on it, we must stop the flow of Medicaid funds to these individuals, and we must require them to step aside,” Walsh said, announcing one of the suspensions in late January.
The approach is an effective way to target bad actors in long-term care ownership, said Toby Edelman, senior policy attorney for the Center for Medicare Advocacy.
“The goal of suspensions is replacing owners, not closing facilities,” she wrote last week. “The New Jersey State Comptroller’s actions to prevent owners/operators with a very poor record from continuing to operate any facilities in the state are a model for nursing home enforcement nationwide.”
Contentious reactions
Edelman argued that such regulatory actions fall under the comptroller’s legal authority to suspend or disqualify Medicaid providers taking actions that harm their residents.
Not all agree. Such actions are an overreach beyond established nursing home regulatory procedures, said Andy Aaronson, president and CEO of the Health Care Association of New Jersey.
“There are existing statutes and regulations that establish a model for nursing home enforcement,” Aaronson told McKnight’s Long-Term Care News Thursday. “For the state comptroller’s office to bypass that model in order to establish itself as the ‘judge, jury, and executioner’ with authority to suspend any provider it deems a ‘bad actor’ is an incredibly dangerous abuse of power.”
Consumer advocates, meanwhile, have made it clear they would like to see this additional avenue of enforcement expanded to other states.
James McCracken, president and CEO of nonprofit association LeadingAge New Jersey & Delaware, agreed that poor providers should be held accountable for inadequate care but also cautioned that actions leading to a closure should be a “last resort.”
“There are several tools at the government’s disposal to ensure compliance and penalize bad actors,” he told McKnight’s Thursday. “The New Jersey Department of Health has Mission Critical Teams, composed of experienced healthcare administrators, that are available to providers who are experiencing challenges. This is a valuable resource that was created under the tenure of DOH Commissioner Judith Persichilli. Hopefully, any closures will be scarce.”
