NJ A3944

New Jersey Department of Health must develop minimum standards for nursing homes across three categories: physical well-being (bed sores, falls, restraints, infections, hospitalizations, weight changes), mental well-being (antipsychotic use, group activity participation, depression symptoms), and operational metrics (CoreQ scores, vaccination rates, staff turnover, room occupancy, abuse/neglect incidents).

Nursing homes receiving a one-star CMS rating or failing to meet standards in three of four consecutive quarters must submit an 18-month improvement plan to the Division of Medical Assistance and Health Services, with noncompliant facilities becoming ineligible for Medicaid reimbursement.

Escalating sanctions for low-performing nursing homes may include prohibiting new Medicaid admissions, limiting total Medicaid enrollees, reducing quality incentive payments, removing current Medicaid residents, and barring owners/operators from obtaining interests in other New Jersey nursing homes.

Quality incentive payments will be made biannually, with a portion reserved for nursing homes that demonstrate 20% or greater cumulative improvement in DOH standards over four consecutive quarters.

The DHS and DOH must submit joint annual reports to the Governor and Legislature evaluating the effectiveness of sanctions, improvement plans, and incentive payments in improving nursing home health, safety, and quality of care.