In a significant win for New Jersey’s long-term care providers, a State Superior Court judge has denied the state’s bid to dismiss a lawsuit challenging its controversial minimum staffing mandate. The ruling by Judge Douglas Hurd allows six nursing homes and the Health Care Association of New Jersey (HCANJ) to continue their fight against a law they argue is unconstitutional and impossible to meet given severe workforce shortages.
The state’s staffing mandate, which took effect in February 2021, has drawn fire from providers for imposing daily fines of $1,000 for non-compliance, with some facilities already racking up fines well over $100,000. Providers contend these penalties violate their due process rights and are excessive, particularly as the direct caregiver workforce has seen a dramatic decline.
“It is impossible for the Nursing Home industry to comply with the Staffing Law — there are not enough workers available in the system,” stated the original August 2024 complaint.
The mandate requires facilities to maintain specific ratios: one certified nursing assistant (CNA) for every eight residents on day shifts, one registered nurse (RN), licensed practical nurse (LPN), or CNA for every 10 residents on evening shifts, and one RN, LPN, or CNA for every 14 residents overnight.
The lawsuit highlights the dire reality facing New Jersey’s more than 320 nursing homes. The long-term care workforce has declined by nearly 15% since the pandemic began, exacerbating an already challenging hiring environment. This has left many facilities unable to meet the mandated minimums, with 60% of New Jersey nursing homes reportedly lacking enough CNAs to comply, according to court documents.
“In the years prior to 2020, there were already long-standing staffing shortages or low staffing ratios in nursing homes,” the complaint detailed. “Too few people were willing to perform such intimate care for infirm residents in exchange for the prevailing wages supported by the market. The pandemic that followed made an already difficult situation exponentially worse.”
New Jersey has attempted to bolster its workforce through various incentives, including value-based payment initiatives like quarterly lump sum bonuses for CNAs and increased Medicaid reimbursement rates for nursing homes. However, providers maintain these efforts have not sufficiently addressed the underlying workforce crisis.
The ruling is a significant development in the ongoing tension between state regulators and nursing home operators over staffing levels. As facilities grapple with persistent shortages and mounting fines, this legal battle underscores the profound challenges facing the industry in balancing regulatory compliance with the practical realities of a strained labor market.
The six nursing homes involved in the lawsuit include Complete Care at Bey Lea LLC in Toms River, Complete Care at Woodlands in Plainfield, Atlas Rehabilitation and Healthcare Center at Maywood in Maywood, Aspen Hills Healthcare Center in Pemberton, Family of Caring of Teaneck in Teaneck, and Coral Harbor Rehabilitation and Healthcare Center in Neptune City.