On Easter Sunday weekend, two years ago, in a quiet neighborhood of Sussex County.
The death toll from the epidemic began as the country's largest nursing homes became a national story amid complaints by workers of chronic personnel shortages and increasing anger by families fueled by the facility's refusal to take appropriate care of their loved ones.
The owners of the long-term care facility in a remote and still rural area of New Jersey promptly changed their name to Woodland Behavioral Health and Nursing Center at Andover, as if it were to erase the memory of the situation.
The Centers for Medicare and Medicaid Services has found a nursing home, just a month after the discovery of bodies in April 2020.
According to state inspectors, a nursing home has received the lowest rating for employee and quality of care. On any given day, there aren't enough individuals to care for its residents.
Earlier this month, based on its continuing "one-star" ratings by federal regulators that the watchdog agency claimed had resulted in very few or nothing serious consequences.
Despite the federal enforcement action in May 2020 that discovered significant interruptions in patient care and failures in infection control practices in the wake of the deadly epidemic that had killed at least 66 people there, the number of deaths committed to the deadly virus continues to climb.
According to state health officials, 109 confirmed COVID-19 fatalities have occurred among residents at Woodland and its sister campus, the Limecrest Subacute and Rehabilitation Center, since the epidemic began. COVID is suspected, but was not lab-confirmed, in the deaths of another 26 persons.
The nursing home has been slammed by state and federal authorities in a declaration of "imminent jeopardy" owing to health care failures they accuse, which they say pose threats to the lives and safety of the more than 450 residents there.
members of the New Jersey National Guard are on site to assist out. The Department of Health has announced that it would appoint a monitor to serve in an oversight role, while threatening Woodland with a possible closure by a suspension or revocation of its license. All new admissions have been barred.
The actions of the Centers for Medicare and Medicaid Services were even more harrowing.
CMS officials said the facility was not in compliance with federal regulations to continue to participate in the Medicare and Medicaid program until March 3 to correct what has become a difficult situation, or CMS said it may.
If this happen, it might be able to shut down the facility, which is highly dependent on Medicaid as well as Medicare reimbursement.
Closing any long-term care facility is a difficult process that is never a first option. For most residents, a nursing home isn't like a hospital where a stay is temporary. It's their home.
New Jersey has not revoked the license of a long-term care facility since 2018, when the state ordered the closing of a dementia care home in Warren County because of persistent abuse allegations that the Department of Health posed a serious threat to the health, safety, and well-being of residents.
Make no mistake, the process of moving medically vulnerable people from one facility to another might be traumatic for that resident. It isn't something New Jersey is taking lightly, according to Laurie Facciarossa Brewer, the state's long-term care Ombudsman.
Officials at Woodland say they are working to ensure the facility is compatible with state and federal requirements.
Many advocates, elected officials, and others all too familiar with the continuing difficulties at the nursing home have almost lost their patience with Woodland.
They claim that time has gone by.
State Sen. Joseph Vitale, D-Middlesex, is the chairman of the Senate Health, Human Services, and Senior Citizens Committee. Noting the penalties and enforcement actions that have come, he added, "There is nothing the state can do to encourage them to be a better player. Find another place for residents and suspend their license."
Rep. Josh Gottheimer is a dismal moment as a result of Woodland's indiscretions over the years.
What's clear is that ownership and management are not up to taking care of their fellow Americans here. Theyre just not up to it, said the Democratic congressman, who serves Andover. They apparece that they have no desire or capacity to fix it. It's unacceptable.
Chaim "Mutty" Scheinbaum of Lakewood and Louis Schwartz, a former vice president of Skyline Healthcare and the eldest son of Joseph Schwartz, who was in connection with Skyline, his failed multi-state nursing home network, who once tried to purchase the long-term care facility in Andover.
Even before the revelations of unclaimed bodies in a makeshift morgue put the nursing home in the spotlight,.
According to the United States Attorney General in New Jersey, the nursing home reportedly charged New York Medicaid "for materially inadequate or worthless nursing services provided to certain patients that failed to meet federal standards of care and regulatory requirements" between July 1, 2010, and December 31, 2012.
The case was settled without giving up any responsibility for the payment of $395,508 to the United States, $492,492 to New York, and Andover signed a five-year corporate integrity agreement.
Skyline Healthcare, a company owned by Scheinbaum and Louis Schwartz, fell in love before the deal closed. It was unable to make payrolls and fulfill other financial obligations. Instead, the facility was purchased by Scheinbaum and Louis Schwartz.
The issue was jeopardized, however.
A state investigation determined staff members failed to respond to a door alarm after a 76-year-old resident who was deemed at risk of leaving the building walked out undetected in minus 4 degrees degrees. In a lawsuit, attorneys for the woman, who suffered from advanced dementia, claimed the facility failed to provide adequate personnel and services to suit her and other residents of Andover. They alleged and the nursing home "actively sought residents with similar medical and nursing needs"
A former employee in another lawsuit complained of staffing issues, alleging that unsafe understaffing of nurses and certified nurse assistants stifled the situation.
In April of 2020, a resident leaves the facility in an ambulance, causing national headlines about the facility's significant death toll.Ed Murray | NJ Advance Media for NJ.com
In the wake of the ongoing omicron wave, Woodland continues to report new cases of COVID-19, according to statistics from the state Health Department. There were 16 individuals with the virus who had tested positive.
According to Department of Health statistics, the percentage of residents and employees vaccinated against COVID remains significantly below the state average in nursing homes in New Jersey.
The bottom line for regulators is the litany of charges that have shaken many, according to state surveyors following a blistering breach notice issued in early January. In a report, Vitale said the victim was "stunned," there were widespread abuse and neglect, including failures to seek resuscitation of several residents in cardiac arrest.
A resident on October 8 was found without a pulse or a respirations. Despite a medical decline, there was no call for cardiopulmonary resuscitation, or CPR, a standard practice for emergency resuscitation. Nor was 911 called.
According to surveyors, a nurse assigned to the resident told them that CPR was not implemented because the resident "was visible blue" and had a "locked jaw," and assumed that the unnamed person was "too far expired" after entering "a state of irreversible death."
The failures of a nurse and an assistant to respond to a resident who called for help when a suprapubic catheter was stuck in a motorized wheelchair were also highlighted. The state said, however, Pleas and complaints of pain were ignored for more than 40 minutes.
At times, the nursing home was operated with only half the state's workforce. During a two-week period from late December to January, not a single day went by when there were enough certified nurse assistants on duty to care for more than 450 residents. On some days, the nursing home was operated with only half the state's workforce.
Last week, the leader of a federally funded legal group that advocates for the human, civil, and legal rights of persons with disabilities
Nearly 200 individuals are isolated from traumatic brain injuries, mental illness, developmental disabilities, or recovering from strokes on a locked floor, according to Gwen Orlowski, the nursing home. They live three to a room, located in a space that is visiblely dirty and smells like urine and feces.
Some residents should be relocated out and receive supervised care at a group home, according to her.
CMS may, like it has in the past, enforce large penalties as a result of recent findings.
Attorney Paul da Costa of Snyder Sarno D'Aniello Maceri and da Costa of Roseland, who represented a number of families in a lawsuit alleging New Jersey with gross negligence incompetence in its handling of the COVID outbreak in the state's veterans homes. He said the fines that Woodland may be subjected to "are nothing but a blip on the radar for ownership" and have a negative effect.
Money talks with the owners of these for-profit facilities and six-figure fines will not make them even blink, da Costa said. A facility such as this should not be permitted to accept new patients and receive Medicaid.
According to state officials in New Jersey, the Medicaid program paid Woodland and Limecrest $19.8 million last year. New York, which has 151 fee-for-service Medicaid members at Woodland, representing about a third of the actual resident population, paid the facility $8.7 million last year.
The New Jersey Health Department claims that the state took immediate action after discovering the facts.
"Our first objective is to protect the more than 400 residents living in the facility, which required that it comply with the most serious violations," said the department's spokeswoman. "We then issued an order curtailing admissions and required the facility to retain a nursing administrator, an certified infection control practioner, and a facility administrator."
On January 10, the first of two teams of National Guard troops was deployed to the facility. A second team was added on January 28, bringing the total number of Guard personnel on site to 18, according to authorities. There are currently between 18 and 20 Guard personnel on site, and they are expected to continue there until March 11.
Leusner said that the department and the CMS are reviewing the facility's correction plans and that they have begun the process of installing a state monitor.
While the state has yet to pursue a shutdown of Woodland, a doomsday scenario may already be taking shape. The monitor was tasked to develop a closure strategy for residents' safe and effective treatment "in the event of a change in ownership, or in the event the department solely suspends or revokes the facility's license."
Leusner said that "the Department intends to ensure planning for all kinds of scenarios."
Woodland has not explained anything about the situation yet and did not answer specific questions about pressure that might impede its closure.
"Woodland Behavioral is in close communication with the New Jersey Department of Health and the Centers for Medicare & Medicaid Services to ensure that the facility is in consistent compliance with all applicable standards. "Position health and safety remain our top priority," the facility said this week.
Given the enormous personnel shortages that Woodland has experienced, Facciarossa Brewer, the state's long-term care Ombudsman, said reducing the facility's census and maintaining the existing staff is probably the most effective way to ensure compliance. However, while cautious about closing down a place that is the home of so many people, she wondered if Woodland had reached the end of the road.
"I have concerns about how a decertification might impact residents in Woodland. However, this facility cannot be allowed to continue to provide poor care to those living there year after year," she said.
Facciarossa Brewer said that these efforts have almost always resulted in a long-term improvement of the condition in the facility, but that inevitably, the situation worsens again, and the quality of care is deteriorating.
"The enforcement actions are like throwing a dime in a bucket of water. "Any gains or improvements that are made as a result of enforcement actions are erased pretty quickly," she said.
She believes that the most recent issues at Woodland today are even more serious.
Some of the difficulties identified in this facility are unbelievable and cause serious harm to residents. So I believe there is a real possibility that the federal government could decertify this facility, which would basically close it down because they would not receive any Medicaid or Medicare funding, said Facciarossa Brewer.
Massive institutions, according to the advocate, are unsustainable, which include moving three persons into a room. She questioned how it ever received a license for 543 beds.
There are a lot of changes, she said. This area must be smaller, requires more staff, and is in need of to provide better health care and a better life conditions for those living there. Or it must be closed.
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