New Jersey is increasing penalties on nursing homes that repeatedly violate state regulations, strengthening programs designed to reward quality care and investing heavily in expanding the long term care workforce.

These changes were born out of recommendations from a report released by the State Nursing Home Task Force in April.

So how are the changes impacting the industry and is it enough?

To discuss that and more, I'm joined by health care reporter Lilo Stainton.

We all thanks for joining me.

Thanks for having me.

You know, no doubt we have seen longstanding problems amongst more than 230 licensed nursing homes in the state during COVID especially.

But now there is $50 million being allocated to funding reforms.

What kind of reforms are we talking about?

Sure.

Well, a lot of this would go to a quality incentives program that is designed to encourage nursing homes to do the right thing when it comes to higher staffing levels, avoiding things like bedsores and falls, which are closely related to staffing.

And that's just part of it.

That's part of a medicaid program.

But it's you know, the state has taken a lot of different steps.

You know, according to Human Services, they've invested more than 100 million in staffing efforts to try to build build back a workforce on the front lines in nursing homes and home health care.

But, you know, one of the things that this report pointed out, this is the state's long term care task force, is that no matter what we do at nursing homes, eight out of ten people prefer to age.

Or if you're talking about someone who might have a disability, prefer to live at home or in their community in some kind of smaller group home type situation.

So the question is really what can the state do to move more people to that model?

Right.

Right.

We know it's expensive.

It's not easy.

And and the other thing is you're absolutely right.

It's expensive.

And there's a huge lack of affordable housing in general.

So with the lack of housing, a lack of housing for programs like this or people that might need, you know, to be government funded for that, housing is really hard to do.

So, yeah, it's a challenge for sure.

Well, going back to the reforms, are they working then?

Is this enough?

Well, I think it's a little too soon to tell on a lot of this, because a lot of this is new, you know, but some of these are pretty novel.

For example, the state has it has a law where 90% of the Medicaid money spent on the dollar has to go to direct care.

How that defined is always a challenge.

But one of the challenges that the report also points out is, you know, enforcement of this is up to state inspectors.

And the Department of Health has been struggling with staffing issues throughout its ranks and in some parts.

And and this is one of their issues.

They have a lot of vacancies in inspectors.

So not all nursing homes are being checked on as frequently as you know, advocates for the residents would like.

And that's a you know, again, it comes back to money.

The state is looking to put, I think, around 5 million into more staffing to do so.

That's important.

But, you know, it's it's a process.

It's a.

Process.

You know, just staying on the topic of Medicaid, you know, when we think about that, what are the biggest challenges?

What what is being recommended to solve that problem?

Yeah, well, the report talks about how, you know, so they're about 68,000 roughly people in Medicaid who are receiving these long term support services.

And that means either either just under 24,000 who are getting them in a nursing home.

And that's, I think six or seven out of ten nursing home beds is funded through the state and federal Medicaid program.

Another 45,000 or so, a little less than are getting those supports in the community.

So numbers wise, there already were supporting more people across than we are in nursing homes.

The thing is, I know the report said we'd like to move at least another 10,000 from nursing homes into community housing in the in the coming few years.

And to do that, you really have to rethink housing.

Yeah, a lot of work still needs to be done.

Lilo, Lilo, thank you for joining me.

Thank you Raven.