Feds declare care at state-run veterans’ homes constitutionally deficient

Two state-run veterans’ homes whose early-pandemic blunders left about 200 residents dead continue to provide such inadequate care that federal authorities are now accusing New Jersey of violating residents’ constitutional rights.

Residents of the New Jersey Veterans Memorial Homes at Menlo Park and Paramus face “unreasonable harm and risk” because of entrenched, deficient infection control practices and inadequate medical care, the U.S. Department of Justice’s civil rights division and the U.S. Attorney’s Office for the District of New Jersey said in a scorching new report released Thursday.

The problems at the two long-term nursing homes have exposed residents — hundreds of military veterans and their families — to uncontrolled, serious, and deadly infections and made the homes among the deadliest of similarly sized nursing homes in the region, investigators wrote.

The deficiencies predated the pandemic and persist today, despite outside help the homes received to reform operations after their coronavirus fatalities drew national attention and resulted in more than $68 million in lawsuit settlements, investigators wrote.

The report pins the blame for the continuing failures on the state Department of Military and Veterans Affairs, which operates the homes “without sufficient support and substantive oversight.”

“Those who served to protect this nation and their families are entitled to appropriate care when they reside at a veterans’ home,” U.S. Attorney Philip R. Sellinger said in a statement. “The Paramus and Menlo Park veterans’ homes fail to provide the care required by the U.S. Constitution and subject their residents to unacceptable conditions, including inadequate infection control and deficient medical care.”

Gov. Phil Murphy called the report “a deeply disturbing reminder that the treatment received by our heroic veterans is unacceptable and, quite frankly, appalling.”

Murphy said his administration has worked to improve conditions there, including recently “securing private management and assistance for these two homes.”

“However, it is clear that we have significantly more work to do and we are open to exploring all options to deliver for our veterans the high level of care they deserve and are entitled to under the law,” Murphy said in a statement.

Republicans for years have criticized the Murphy administration for failures they say drove up nursing home deaths and called for an investigation that Senate Democrats have blocked.

The two homes have a combined bed count of 648, although they averaged nearly half that in 2022, with about 375 residents, according to the report.

Disturbing details

Federal investigators launched their civil rights probe at the Paramus and Menlo Park homes in October 2020 under the Civil Rights of Institutionalized Persons Act. The state operates a third veterans home in Vineland that was not part of the investigation.

Investigators found alarming lapses, including failures to follow state-ordered social distancing, contact tracing, and other infection controls. Staff failed to separate sick, exposed, and healthy residents, contributing to the spread of infections, investigators found.

Staff wore no masks, gloves, or other protective gear, or wore it improperly, with administrators in the early days of the pandemic threatening to discipline staff who wore such gear, according to the report.

Both homes were dirty, with one investigator finding “ants/bugs everywhere.”

Poor morale in the pandemic’s early days also led to staff shortages, with so many employees calling out sick that nurses on some shifts at the Menlo Park home had to tend to 100 patients each, according to the report.

The homes’ staff underreported coronavirus deaths so much it’s “impossible” to determine how many residents died of COVID-19 during the pandemic’s first wave, investigators wrote. Before the pandemic, about 100 residents died in each home in an entire year, but in April 2020 alone, 190 died in both homes, the report notes. The homes sent many gravely ill residents to hospitals or otherwise discharged them, further obfuscating the death toll.

Administrators at both homes operated under an “information blackout,” taking such a “defensive and occasionally hostile stance” toward panicked relatives that they gave them no or limited information during the pandemic’s early days and even lied about or hid residents’ causes of death, the report said.

Problems persist today, with staff failing to create individualized care plans for residents, follow fall prevention protocols, administer medication properly, ensure proper wound care to treat and prevent bedsores, and even follow basic hand-washing and other hygiene requirements, investigators said.

“Systemic breakdowns” in infection control continue, the report found. The homes still fail to train staff properly in infection control, ensure staff compliance with infection control protocols, and implement the use of protective gear, contact tracing, COVID testing, COVID isolation, and cleaning, investigators said.

If the state doesn’t correct the deficiencies investigators documented, the U.S. Attorney General could sue within the next 49 days to compel reforms.

Mounting outrage

The report fired up critics who have long decried the pandemic’s death toll and mismanagement at the nursing homes.

“The DOJ’s report will be a permanent stain on this administration and revealed what we long knew to be true — that Gov. Murphy violated the U.S. Constitution by sweeping the suffering of veterans under the rug,” said Assemblyman John DiMaio (R-Warren), his chamber’s GOP leader. “Unfortunately, his administration’s egregious failures have continued to bring harm to these heroes. Murphy must take accountability and immediately address the conditions at Menlo Park and Paramus.”

Sen. Joe Pennacchio (R-Morris) said the report underscores the need for a special legislative hearing.

“People have to step up and say — ask the commissioner, ‘Why did you do this? Why would you want people to work and jump from one nursing home to another? Why would you put positive people in the same room?’ We were promised an investigative committee to get exactly to the bottom of this,” he said.

Pennacchio has pushed for such a committee to investigate how the homes’ mismanagement and regulations led to so many deaths, but Senate Democrats repeatedly voted his resolution down in May.

“It seems people are more interested in what’s going on with the whales than what happened with the 10,000 souls that perished in these state-run homes,” he said.

Democrats pledged to respond.

Senate President Nicholas Scutari (D-Union) in a statement said the report “will undoubtedly require us to take further action,” though he did not elaborate. Assembly Speaker Craig Coughlin said in a statement the Legislature “will take whatever steps necessary to ensure improved care and conditions for New Jersey veterans.”

“The COVID-19 crisis might be over, but the virus remains with us and we must take the steps necessary to ensure nothing like this ever happens again,” Scutari said.

Sen. Joe Cryan (D-Union), who chairs the Military and Veterans Affairs Committee in the state Senate, said he regards the report as a call to action for lawmakers. The report recommends more oversight of the Department of Military Affairs and Veterans Affairs.

“It’s the obligation to move forward with what we can do now, and that’s the restructuring piece of the veterans department to move it out of the nursing home business,” said Cryan.

More than 10,200 residents and staff in all of New Jersey’s nursing homes died of coronavirus, according to the state Department of Health.

State GOP spokeswoman Alex Wilkes said investigators’ “devastating” findings underscore Republicans’ longstanding objections to the wide-ranging emergency powers Murphy declared during the pandemic.

“It is despicable that veterans, who bravely swore an oath to protect our country, survived of some of the greatest conflicts of our time, but not Phil Murphy’s nursing homes,” Wilkes said. “All of the Democrats who did not have the courage to stop Murphy will face voters this November.”

Nikita Biryukov contributed.