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New Jersey nursing homes that violate the state’s staffing minimums could be fined up to $500 per violation under new regulations proposed by the Department of Health. 

The state approved staffing ratios for certified nurse aides in February 2021, but fines and other penalties have not been levied. Nursing homes are required to have one CNA per every eight residents on the day shift. For the evening shift, facilities must have one direct care staff per every 10 residents, and no fewer than half of all staff members must be CNAs. On the night shift, there must be one direct care staff member for every 14 residents, and each of those employees “shall sign in to work as a CNA and perform CNA duties,” the regulations stipulate. 

Facilities have had a hard time meeting these minimums, according to the Health Care Association of New Jersey. 

“We have seen since that time that workforce shortages prevent the vast majority of nursing homes from meeting the mandates,” Andy Aronson, president and CEO of the Health Care Association of New Jersey, said in a statement to McKnight’s Long-Term Care News Monday. 

While New Jersey appears ready to move forward, other states have stepped back from enforcement after adopting tough new staffing standards, worried that increased pressure could drive more providers out of business.

New Jersey did allow for updated criteria to certify CNAs to include persons employed in a long-term care facility for fewer than 120 days who will either complete the skills and written test within 120 days of employment or who have completed training and been given conditional approval pending a criminal background check. The updated criteria also include a certified homemaker-home health aide who is also enrolled in a qualified CNA program and actively working toward certification.

Facilities that are found in violation of the staffing minimums would be required to submit a corrective action plan to the Department of Health. A second violation would require another correction plan and could see the facility fined up to $500 per violation per shift, plus being charged with additional violations equal to the number of staffers for which the shift is short. 

“The notion of punishing a nursing home that is making best efforts to comply with the ratios, but can’t find staff because of workforce shortages, seems counterproductive and overly punitive,” Aronson said. “The penalties are not a solution to the workforce shortage and would only serve to take money away from patient care.”

The New Jersey Office of Legal and Regulatory Compliance will accept written comments on the proposed fines through Aug. 19.