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Another budget season, another June surprise from the Health Care Association of New Jersey (HCANJ), the trade organization for New Jersey’s for-profit nursing homes. This latest effort is a low blow, even by their standards. The organization that runs to court to nullify nurse staffing standards now acts as if they care about providing quality care.
Their proposal is to extract $100 million from home- and community-based services (HCBS) to give a no-strings-attached windfall to nursing home owners. HCANJ put out a misleading flyer about the increase in HCBS over 30 years and paints it as a negative that somehow restrains nursing home funds.
The truth is that the growth in HCBS was a policy decision to promote the best interests of our citizens. People want to live in their own homes in the community, and many of them are perfectly able to do so with the right supports. That is the reason behind the growth in HCBS funding. It is a person-centered policy goal, and we should protect every dollar, especially now when the Medicaid funds that support the services are under threat by the federal government.
As for the nursing homes, we want any increase in the Medicaid rate to be tied to greater transparency and better performance. For-profit nursing homes across the state are skimping on the residents at every turn. In 2024, the average for-profit nursing home spent less than $9 per resident per day on food. Important infrastructure like elevators and HVAC systems are neglected until they break down. Staffing levels are well below the 4.1 hours per resident day that experts say is the level needed to provide safe, quality care.
I can already hear the excuses. They will claim that they cannot recruit and retain enough nurses and aides to fully staff their nursing homes. It is odd that many non-profits are able to do it. Perhaps removing the profit motive is magic.
Our position remains clear: We should not give massive handouts to nursing homes without greater transparency into how the dollars are spent. In 2024, nursing homes across New Jersey paid $900 million to related parties — that is, companies they own. We are talking about exorbitant management fees paid to themselves; astronomical “rent” on buildings they own; and payments to staffing companies and other vendors.
How much of that money actually goes to the care and support of residents? We really don’t know, and any efforts to get more insight — such as nursing home fiscal transparency bills S2980/A4722 — face a knockdown, drag-out fight from groups like HCANJ.
The Legislature should resist this money grab, protect the people who are well-served by HCBS, and sign onto the financial transparency legislation.
It is long past time that we should know where all the money goes.
The Office of the New Jersey Long-Term Care Ombudsman is an independent state agency dedicated to the mission of advancing the rights, dignity, and self-determination of adults living in long-term care, including nursing homes, assisted living, and residential health care facilities. Learn more.
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