WASHINGTON, D.C. – A scathing new report by the U.S. Department of Health and Human Services’s Office of Inspector General concludes that New Jersey’s oversight of long-term care facilities has been worse than previously reported.
According to the report released Wednesday morning, New Jersey paid out $721 million but failed to make sure the funds were being properly spent.
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“New Jersey did not ensure that its MCOs complied with certain Federal and State requirements for beneficiaries enrolled in its Medicaid MLTSS program,” the report explains. “For 68 of the 100 monthly capitation payments in our random sample, MCOs did not comply with the requirements to adequately assess and cover the associated beneficiaries’ needs for long-term services and supports. Specifically, MCOs did not comply with requirements for (1) providing adequate service planning and care management to the beneficiaries and (2) conducting and documenting assessments; and developing, reviewing, and updating beneficiaries’ care plans.”
“These deficiencies occurred because New Jersey did not adequately monitor MCOs for compliance with certain Federal and State requirements,” the auditor’s office added. “MCOs’ failure to meet contract requirements for adequately assessing and covering beneficiaries’ needs for long-term services and supports could have resulted in beneficiaries not getting the services that they needed and may have put their health and safety at risk. On the basis of our sample results, we estimated that New Jersey made monthly payments totaling approximately $386 million (Federal share) to MCOs that did not comply with certain Federal and State requirements.”
Long-term care facility deaths have accounted for nearly 51% (5,965) of New Jersey’s 11,770 COVID-19 deaths. It’s increasingly clear that – in addition to other major errors coming to light – the state’s initial decision to force facilities to accept admissions without COVID-19 screening tests doomed thousands to die.
Approximately 1 in 10 New Jersey nursing home residents have died from COVID-19 since the pandemic began.
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Correction: the original headline of this story stated that the inspector’s office was criticizing a Murphy Administration era practice; while the Murphy Administration apparently continues to defend the state’s practices cited in the audit, it also appears that the audit’s data set was primarily drawn from 2016 before Phil Murphy took office. Therefore, the cited practices go back to at least Christie despite the fact that the Murphy Administration isn’t denying retaining at least some of them through the present COVID-19 crisis. Our headline has been updated accordingly for maximum accuracy.
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