Last March, as Gov. Phil Murphy (D-N.J.) ordered nursing homes to admit patients recovering from COVID-19, nursing home administrators warned New Jersey Health Commissioner Judith Persichilli that the new policy amounted to a death sentence for elderly residents.
“Patients will die,” an unidentified administrator declared, according to a recording of the March 21, 2020 meeting first reported by NJ Advance Media. “You understand that by asking us to take COVID patients, by demanding we take COVID patients, that patients will die in nursing homes that wouldn’t have otherwise died had we screened them out.”
About 8,000 COVID-19 deaths — roughly 40 percent of New Jersey’s 21,000 COVID-19 deaths — trace back to nursing homes and other long-term care facilities. On March 31, Murphy’s administration directed nursing homes to re-admit residents who had been discharged from hospitals while recovering from COVID-19.
While Persichilli’s guidance also directed nursing homes to house these residents in a separate wing, in order to avoid infecting other patients, many nursing home administrators warned that such separation would be incomplete and would fail to prevent the spread of the virus.
“You have asked us to separate safely and create our own wing and take in COVID-19′s from the hospital,” one nursing home official noted. “The problem, of course, is there is no separating safely. It’s almost certain that even though you have staff only on that unit, something will migrate.”
The day after Persichilli issued the order, 99 long-term care facility operators called the health department, saying they did not have the room or staffing to pull off her “cohort” recommendations when it comes to separating COVID-19 patients from others. “Within a week, 200 facilities notified us that they could not accept new admissions,” health department spokeswoman Donna Leusner told NJ Advance Media.
Murphy and Persichilli do not face allegations that they intentionally lied to cover up nursing home-related COVID-19 deaths like Gov. Andrew Cuomo (D-N.Y.) allegedly did in neighboring New York. However, New Jersey officials initially declined to share the tally of COVID-19 cases and deaths by facility, despite pleas from families who said nursing homes had kept them in the dark.
On April 20, however, the Trump administration mandated that all states publicly report the COVID-19 data by facility. This order came just as authorities discovered 17 bodies inside a makeshift morgue at the Andover Subacute facility in New Jersey — on Easter weekend.
Last Monday, Murphy defended his nursing home policy. “It was crystal clear,” the governor said. “If you were going to readmit a formerly COVID-positive resident, they had to be separated by floor, by wing, by building. The staff could not co-mingle.”
The governor stressed that nursing home residents were not just going to a facility — they were returning home. “This is not like they’re going to some abstract location. This is their home,” he said. He also argued that in order to readmit residents, nursing homes “had to meet certain strict black-and-white standards” to “make sure they’re separated. Different wings, different hospitals, floors, different buildings; that staff is separated.”
Yet nursing home operators had warned that this separation would not be enough, and it seems the horrific death toll at nursing homes in New Jersey confirmed their warnings.
The New Jersey Department of Health insisted that its nursing home guidance “was consistent with” federal guidance, but House Republicans on the Select Committee on the Coronavirus argued otherwise last July, when they sent a letter to Murphy demanding answers about his nursing home policy.
On March 13, about two weeks before New Jersey’s guidance, the Centers for Medicare and Medicaid Services (CMS) explicitly said, “This guidance does not direct any nursing home to accept a COVID-19 positive patient, if they are unable to do so safely.” Instead, CMS advised that “nursing homes should admit any individual that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present” only if the nursing home can follow CDC guidance.
CMS Administrator Seema Verma also warned, “Under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patients’ needs.”
The nursing home scandal in New Jersey is nowhere near as nuclear as the scandal engulfing Cuomo, but Persichilli’s order likely still amounted to a death sentence for elderly nursing home residents who were particularly vulnerable to the pandemic.
Tyler O’Neil is the author of Making Hate Pay: The Corruption of the Southern Poverty Law Center. Follow him on Twitter at @Tyler2ONeil.