AARP NJ is Advocating for a Safe and Quality Long-term Care System

SAFE AND QUALITY LONG-TERM CARE SYSTEM
While the COVID-19 pandemic has taken an overwhelming toll on all New Jerseyans, it has impacted older adults the most. Tragically, nearly 95% of deaths from COVID-19 have been among people 50 and older. The COVID-19 pandemic has exacerbated longstanding deficiencies within our long-term care system, highlighting the need to improve the quality and safety and serve more people at home, where they want to be.

Eighty-seven percent of New Jersey voters 50 and older would prefer to receive long-term services and supports at home. Not only is home care preferred, but it’s also much less expensive. Nursing home care in New Jersey costs approximately $12,000 per month, while home care costs approximately $5,600 per month.

AARP supports expanding home and community-based services by balancing funding.
Most New Jersey voters 50 and older would prefer to receive long-term services and supports at home. A high-performing long-term services and supports system (LTSS) is a person- and family-centered approach allowing for consumer choice and control of services. A well-trained and adequately paid workforce is available to provide LTSS. Home and community-based services (HCBS) are widely available. Provider choice fosters equity, and consumers across communities have access to a range of culturally competent services and supports.

While New Jersey has made strides to better balance Medicaid and state funding to improve access to home and community-based services, more can be done. The top-performing state in the U.S. spends 83% of its LTSS funding on HCBS. NJ currently spends 56% (including funding for individuals with intellectual and developmental disabilities). AARP supports establishing enforceable benchmarks to increase NJ’s spending on HCBS in order to provide more services to support older residents at home.

AARP supports allowing presumptive Medicaid eligibility for in-home services.
Medicaid is the primary payer nationwide for long-term care services. New Jerseyans who cannot afford to pay for in-home services out-of-pocket must wait until a final eligibility determination before Medicaid will start home services. The time between application and final approval can be perilous for individuals with limited resources.

A major driver of the widespread transmission of COVID-19 in traditional nursing homes is their physical environment—typically large buildings with shared rooms. AARP supports the development of small house nursing homes, which incorporate individual rooms with innovative staffing models and culture change, throughout New Jersey as a vital step in transforming our long-term care system. Today, no such models of care are available in New Jersey. New Jersey should incentivize the development of small house nursing homes.

AARP supports increasing transparency and accountability in nursing homes:

• S2769/A4484: Nearly 75% of New Jersey’s nursing homes are for-profit facilities, and complex ownership structures of some nursing homes may allow money to be siphoned away from resident care. The bill requires submission of financial reports that provide a clear overview of the flow of money across related parties and show where taxpayer dollars are going.

• S2892: NJ taxpayers, through the NJ Medicaid program, continue to provide substantial funds to nursing homes that consistently perform poorly. This bill represents a critical step forward toward changing this system and improving safety and quality in our nursing homes by establishing requirements for sanctions and other actions involving low-performing nursing homes.
  

AARP also supports increasing the number of Programs of All-Inclusive Care for the Elderly (PACE) and the people they serve. PACE is another model of home and community-based care supporting people 55 and older who need the skills of a nursing home, but are able to live safely in the community with support. PACE is one of the oldest and most successful models of integrating services for people with acute and long-term care needs. New Jersey should increase the number of people served by current PACE organizations in their current communities and increase the number of PACE organizations and number of communities served by the current PACE model.

AARP Supports:
Safe and Quality Nursing Homes
New Jersey should establish a pay-for-performance system to improve nursing facility quality and safety that incentivizes:

• A registered nurse on every shift
• Maintaining or exceeding minimum direct care staffing levels
• A full-time infection control specialist on staff
• Lowering staff turnover rates
• Eliminating multi-occupancy rooms and incentivizing small-house nursing homes
• Implementing a program to reduce pressure sores among nursing home residents

COVID-19 VACCINES
AARP believes all eligible Americans should get vaccinated to protect themselves and their loved ones. AARP urges all eligible Americans to get the booster shot to ensure they stay protected from COVID-19. Nursing homes must prioritize steps to increase up-to-date vaccination rates among residents and staff. AARP believes every American should have access to the vaccine, including those who are homebound.  

For more information on AARP New Jersey’s advocacy priorities, visit aarp.org/NJAdvocacypriorities.