State blocks admissions to Andover nursing home after damning new report

No new residents will be admitted to Woodland Behavioral and Nursing Center, after a damning report that cited dangerous conditions and fatalities stemming from neglect.

“The state of New Jersey has suspended new admissions at Woodland Behavioral,” tweeted the New Jersey Long-Term Care Ombudsman (@NJOmbudsman), which investigates allegations of abuse and neglect of residents in long-term care facilities. “Recent inspections at the nursing home showed that staff allegedly failed to do CPR or call 911 for unresponsive patients or provide lifesaving medicine for Covid patients.”

Sixteen residents were reported dead of Covid-19 as of Feb. 16, according to New Jersey Department of Health’s report on outbreaks in the state’s long-term care facilities. Outbreaks are considered concluded after 28 days without a new case.

In Feb. 17, the Sussex County Commissioners issued a press release adding that “the facility is also facing the possibility of closure by the state.”

The commissioners say Carol A. Novrit, the county’s administrator for the Department of Health and Human Services, “had no knowledge and was not made aware of the state Health Department’s findings.”

The commissioners reiterated their stance, often repeated through the nursing home’s pandemic-era scandals, that the county has “no statutory authority to regulate nursing homes and other long-term care facilities within its borders and must rely on the state to do so. Oversight of these facilities rests entirely with the Murphy Administration.” They did, however, ask potential whistleblowers – residents, staff, and family members – to use Sheriff Mike Strada’s Crime Stoppers Hotline to report any abuse or improper activity at long-term care facilities in Sussex County. The hotline’s telephone number is 973-300-CRIME. Reports can be filed online at sussexcountysheriff.com.

The Woodland facility is owned by Alliance Hc 11 LLC. Owners and managers listed at Medicare.gov with a more than 5 percent stake include Chaim Scheinbaum and Louis Schwartz, both 50 percent owners since May 31, 2017. The administrator is listed as Menachem Spiegel of Lakewood, N.J. The nursing home’s license expires on May 31.

A total of 83 residents have died of Covid at the nursing home since the pandemic began.

Cascading scandals

Woodland was formerly known as Andover Subacute and Rehabilitation II. Early in the pandemic, 17 bodies were discovered there in a morgue with a capacity of four. It was the toll of a single deadly weekend in April 2020, as Covid-19 ravaged New Jersey’s most vulnerable residents.

The 543-bed facility is now at the center of cascading new scandals that stem from state health inspections. In January, the first of two National Guard deployments were sent to Andover to help staff overwhelmed by the Omicrom wave. At the time, it was the worst outbreak of any long-term care facility in the state.

In a new report this month, state inspectors cite cases of extreme neglect at Woodland that led to great suffering and at least four deaths. In two of the deaths, monoclonal antibody treatments for patients with Covid-19 were ordered and received, but the patients never actually received them.

The report also cites the precipitous rise in Covid cases, severe understaffing, and very low vaccination rates. The statewide rate of booster shots among residents at longer-term care facilities is 70.6 percent; no booster shots are reported among residents at Woodland.

At Woodland, 84.9 percent of residents are vaccinated, three points below the statewide average for nursing homes; and the staff vaccination rate is 78 percent, 13 points below the statewide average.

“Covid-19 vaccinations and boosters can be extremely effective at protecting nursing home residents from Covid-19 infections, symptoms, and severe outcomes, like hospitalization or death,” said The New Jersey Office of the State Comptroller in its executive summary of the report. “When higher levels of residents and staff are vaccinated and receive boosters, the level of protection from Covid-19 increases for all residents, staff, and visitors. You should also ask a nursing home about any recent Covid-19 information, like if there have been any recent outbreaks, or the percent of residents and staff who have received a vaccine booster dose.”

‘Much below average’

Medicare/Medicaid has given Woodland its lowest overall, one-star, rating — “much below average” — even as the facility’s private operators have continued to accept federal money. One of its pre-pandemic owners has been arrested for Medicare fraud.

The one-star rating is based on three sources — health inspections, staffing, and quality measures — over three years. State inspectors look into nursing homes for their annual compliance report with Medicare and Medicaid regulations, as well as infection control and prevention standards. An inspection may also be triggered by a complaint. The top 10% of LTCs in a state receive five-stars, the middle 70% receive two, three, or four-stars, and the bottom 20% receive one-star. DOH has regulatory authority over LTCs in the state and acts as both the federal and state survey agency, performing inspections and investigations of LTCs.

Woodland also received one star for its staffing, which is based on hours provided per resident by registered nurses, licensed practical nurses (LPN), and nurses’ aides, on average, over the last reported three-month quarter.

Woodland received three stars, an “average” rating, for quality measures, which evaluates whether residents have gotten their flu shots, are in pain, or are losing weight.

State: Cut off funding

The state comptroller recommends changes to New Jersey’s Medicaid program that require one-star nursing homes to improve their quality of care if they want to remain in the Medicaid program, enlisting the Department of Human Services, Division of Medical Assistance and Health Services, and the Department of Health in a phased approach allowing nursing homes to improve before the most severe restrictions are imposed.

New Jersey’s 15 one-star nursing homes provide services to approximately 1,850 Medicaid beneficiaries, for whom Medicaid annually pays these facilities an average of $103 million, according to the comptroller.

“This means that every day thousands of Medicaid beneficiaries have lived in and received health care from LTCs that have been repeatedly cited by state inspectors for serious, widespread, and uncorrected deficiencies that placed patients at great risk of harm,” says the comptroller’s report. “Because Medicaid funds follow Medicaid beneficiaries — and the State’s recent effort to incentivize higher quality care thus far has failed to distinguish in a meaningful way between the highest and lowest rated facilities — the State has paid the lowest-rated LTCs at virtually the same rate as it paid higher-rated LTCs.”

Gov. Phil Murphy mentioned the crisis in Andover during a Feb. 16 press conference on Covid.

“We’re still in this thing,” he said. “I won’t get into the details again. It’s illegal, but you’ve seen the Department of Health under Judy’s leadership go — landing pretty hard on this place that used to be called Andover Subacute that’s now called Woodland, I think. We take this stuff deadly seriously, and I promise you complete mirrors will be held up on this.”