Nursing Homes Push Back Against New Jersey Staffing Laws: What’s at Stake for Residents?

In 2020, New Jersey enacted a staffing law to improve the quality of care in nursing homes. The law created specific requirements for staffing levels – understaffed facilities are more likely to lead to neglect and other mistreatment of residents. Those facilities that did not comply with the law face fines and other penalties. Now, six New Jersey nursing homes are suing the state over the law, claiming it is “unconstitutional” and creates unfair requirements. The case has implications for anyone in a nursing home and their loved ones who rely on these facilities to provide care to some of the most vulnerable residents in the state. 

Background on the understaffing law

The law requires specific staffing ratios to provide enough certified nursing assistants (CNAs) to care for residents adequately. Specifically, the law states that there must be:

• One CNA per eight residents during the day shift
• One CNA per ten residents in the evening
• One CNA per 14 residents overnight

The law allows RNs/LPNs to fill in and cover shifts, but they must receive additional pay. 

Legislators enacted the new regulations in response to the COVID-19 pandemic and the negative attention nursing homes gained. Specifically, the COVID-19-related deaths at nursing home facilities in New Jersey sparked concerns and the focus on reform. At the time, long-term care facilities reportedly accounted for about half of the state’s confirmed COVID-19 deaths.

The legal challenge

In August of 2024, the Health Care Association of New Jersey and six facilities filed their lawsuit against the state. The facilities involved include:

• Complete Care at Bey Lea, LLC
• Complete Care at Woodlands
• Atlas Rehabilitation and Healthcare Center at Maywood
• Aspen Hills Healthcare Center
• Family of Caring at Teaneck
• Coral Harbor Rehabilitation and Healthcare Center

The basis of the complaint is a claim that the law is unconstitutional because there is a lack of available direct care workers, making compliance “impossible.” The complaint cites a report indicating that since COVID-19, the workforce has shrunk significantly, with professionals leaving the field to retire or because of burnout and not enough new people entering the field. They also claim that higher wages and other incentives have not successfully attracted more staff members. 

Additionally, the complaint states that the penalties for failing to comply with the law are excessive and punitive. While early enforcement required corrective plans, facilities are now facing $1,000 fines daily for noncompliance, leading to some nursing homes owing over $100,000. Fines also increase for repeat violations. According to the complaint, this is creating financial strain. 

New Jersey is arguing that enforcement is necessary for resident safety. The Ombudsman agrees that the law is critical for protecting nursing home patients. 

Implications for residents and families 

According to nursing home operators, the laws prioritize penalties rather than looking for practical solutions to the staffing shortages. They argue that the fines create financial instability for the industry, which they claim is already strained. 

Alternatively, the state’s position is that staffing shortages are reducing the quality of care for residents and placing them at risk. If the nursing homes succeed, they could weaken regulations, potentially allowing neglect to persist, resulting in injuries and harm. 

Nursing homes and the state agreed to suspend administrative penalty appeals while the lawsuit proceeds. The crux of the debate is how to balance financial realities with the dire need for quality care for residents. 

Looking forward, the situation might become worse

The pushback by nursing homes against the staffing regulations showcases the state of nursing homes in New Jersey. Understaffing is a complicated issue that is unlikely to resolve anytime soon. In fact, The New Jersey Task Force on Long-Term Care Quality and Safety issued a recent report that warned that staffing shortages will only get worse. That report claimed that low wages, high costs for training, a lack of opportunities for career advancement, and other factors are discouraging would-be caretakers from entering the field. As the state’s population ages, the shrinking workforce could make the circumstances even more challenging. 

Resident rights and legal protections

Prior to the pandemic, about one in ten Americans ages 60 and up experienced some type of elder abuse. COVID-19 worsened the situation, according to a study that indicated that during that time period, the rate of abuse increased to one in five. However, many cases of abuse go unreported, so the numbers could be even higher. Although not all abuse cases happen in a residential facility, many do. 

It’s important for families to understand that regardless of the staffing law, facilities have the responsibility to properly care for residents. Residents also have specific rights, which include:

• The right to have input on a care plan
• The ability to choose a physician for their medical care
• Freedom from restraints
• Freedom from abuse
• The right to manage their finances
• The right to a clean and safe environment
• Access to nutritious food
• Privacy
• The right to communicate and visit with friends and family
• The right to be treated with respect, courtesy, and dignity
• A say regarding any transfers and discharges

Residents in nursing homes don’t always have the ability to assert their own rights or even express that their rights were violated by staff. In such cases, it’s important for families to stay vigilant and look for signs of abuse like unexplained injuries, poor hygiene, or STDs. 

In the event of nursing home abuse, there are legal options. A nursing home abuse lawyer can help hold the facility accountable and recover damages for the victim or their loved ones. 

Contact Ferrara & Gable for a free consultation

If you or a loved one experienced abuse or neglect in a nursing home facility in New Jersey, contact Ferrara & Gable to speak to an experienced attorney. Our nursing home neglect lawyers offer free consultations. Call us or fill out our contact form today to discuss your case.