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Nursing home SWAT team descends on N.J. veterans home plagued by safety violations

Rally by veterans groups and union workers at the state run Menlo Park nursing home for veterans, where at least 65 residents and one staff member died of cover, in Edison, N.J. September, 16, 2020 Ed Murray | NJ Advance Media for

The Gov. Phil Murphy‘s administration dispatched a team of long-term care professionals to the Veterans Memorial Home at Menlo Park on Tuesday to help the state-run nursing home correct glaring problems of abuse and safety violations that were uncovered in a recent inspection and put residents in “immediate jeopardy.”

A nurse consultant and an administrator with expertise in running long-term care facilities that state Health Commissioner Judith Persichilli described as a “mission critical” team arrived at the Edison campus, with a third member, an infection control preventionist, expected next week.

The action comes about a week after the U.S. Centers for Medicare and Medicaid Services, or CMS, notified the Murphy administration it may withhold funding for new admissions unless serious deficiencies in pandemic infection control and resident care are remedied.

CMS on Tuesday said the matter remains under review.

“Veterans Memorial Home at Menlo Park is currently not in substantial compliance, and CMS is currently reviewing the latest survey findings,” said a CMS spokesman.

Fines and other penalties are pending as well, the federal regulators have warned.

Brig. Gen. Lisa J. Hou, the Adjutant General of New Jersey and Commissioner of the New Jersey Department of Military and Veterans Affairs, said she requested the assistance.

“I requested the team as another tool in the toolbox to continually improve the quality of care for our residents, evaluate our staff processes, and renew our dedication to the Veterans in our care,” Hou said.

State health evaluators found the problems during an inspection in August and September of the 312-nursing home that cares for military veterans and their spouses. The conditions placed some of its residents in “immediate jeopardy” following charges of improper care and abuse, according to the inspection report.

In one incident, a registered nurse who apparently did not know how to remove a Foley catheter — a skill taught in nursing school — simply cut it with a scissor. The resident had to be taken to the emergency room to remove the rest of tube that had been placed in the bladder to drain urine, and then transported to a hospital to be treated for a urinary tract infection.

When a certified nursing aide with experience in the procedure was asked why she had not spoken up while watching the nurse cut the catheter, she was said to have replied: “She is an RN. She is supposed to know,” the inspectors said.

The RN was subsequently suspended and then terminated.

Another resident who repeatedly rang a call bell to get his medication was allegedly confronted by an angry nurse and an aide in what was described in the report as an emotionally and physically abusive episode.

And the facility reportedly failed to conduct contact tracing to contain what became a massive COVID-19 outbreak that began last Thanksgiving, inspectors charged. Menlo Park was cited for failing to “ensure that staff who were exposed were tested prior to working at the facility,” and failing to ensure that federal, state, and infection control guidelines were followed.

“The Department sent this team to collaborate with leaders and staff to improve and sustain the quality of care in the veterans home,” Persichilli said in a statement late Tuesday. “The team has already begun their assessment and collaboration with onsite staff to make needed improvements. The care and safety of our residents who call Menlo Park home remain our priority.”

Menlo Park and a second veteran’s home in Paramus reported some of the highest COVID-related death tolls in the nation when the pandemic swept through the facilities. The third state-operated facility is in Vineland.

Overall, COVID claimed the lives of more than 200 residents and staff in all three facilities, according to the state, although one attorney who represents dozens of families who sued the state suggests the number of fatalities may actually be more than 240.

The coronavirus has claimed the lives of 9,813 long-term care residents and employees, according to the state Health Department’s COVID data dashboard.

State Sen. Joseph Vitale, D-Middlesex, and Assemblyman Herb Conaway, D-Burlington, sponsored legislation creating “Mission Critical Long-Term Care Teams” in June, although Persichilli had already begun assembling the teams. They will act as an adviser and collaborator to correct financial and operational problems at the facility, “with a focus on resident health and safety,” according to the bill, (S2894). Nursing homes may request help or the state may dispatch the team at its discretion, the bill said.

Vitale and a group of central Jersey legislators who say they have been meeting to discuss the ongoing problems at Menlo Park said in a statement the team’s involvement was necessary.

“We welcome the deployment of a special ‘Mission Critical Team’ to the Menlo Park Veterans Home to help correct the problems that have compromised the health and safety of veterans. It underscores the need for institutional reforms to improve the quality of care at Menlo Park and the other state-run homes for veterans,” according to the statement from Sens. Vitale, Joseph Cryan, D-Union, Vin Gopal, D-Monmouth, Joe Lagana, D-Bergen, and Patrick Diegnan, D-Middlesex.

“We need to work to develop a thoughtful and thorough plan that ensures the best possible care and treatment of the residents, their families and caregivers. We believe that wholesale, permanent changes are needed so that our veterans receive the best possible care, regardless of the costs,” they said.

Earlier in the day, the entire Republican contingent of the state Senate sent a letter to Senate President Nicholas Scutari, D-Union, to hold public hearings “to investigate continuing failures at State-run veterans homes.”

“Recent reports have highlighted how new outbreaks have resulted in the additional loss of life that might have been prevented,” the letter from the 16 Republicans said. “Additionally, our veterans homes are now at risk of losing federal Medicare and Medicaid funding that is critical to their operations. The simple fact is the Legislature has done next to nothing to improve protections for veterans home residents, and it hasn’t worked.”

The state Department of Military and Veterans Affairs operates three veterans homes, which are in Edison, Paramus and Vineland.


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