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An Examination of the Lowest-Rated Long Term Care Facilities Participating in New Jersey’s Medicaid Program -- September Update

  • Posted on - 09/8/2022

Table of Contents

  1. Executive Summary
  2. Findings

Executive Summary

This report provides an updated list of New Jersey’s residential long-term care facilities (LTCs) — also known as nursing homes1 — that consistently receive the lowest possible rating. The report addresses how the New Jersey Medicaid program (Medicaid) continues to provide substantial funds to these LTCs despite their longstanding failure to improve the safety and quality of their care.

Based on public data from the U.S. Department of Human Services, Centers for Medicare & Medicaid Services (CMS), the Office of the State Comptroller (OSC) found that New Jersey’s 12 lowest-rated LTCs provide services to approximately 1,835 Medicaid beneficiaries. The Medicaid program annually pays these facilities an average of $107 million.

The list of lowest-rated LTCs includes nursing homes that have received the lowest CMS overall rating (one-star) in the first month of each quarter for six of the past eight quarters from October 2020 to July 2022. OSC’s first list of lowest-rated LTCs was released in a February 2, 2022 report. That report identified 15 lowest-rated LTCs. Since that report was issued, 6 LTCs have moved off the list and 3 new LTCs have joined the list. Nine LTCs are on both lists. One of the nine LTCs on both lists was recently shut down.

OSC’s February report recommended that the Department of Human Services (DHS) modify the Quality Incentive Payment Program (QIPP). The QIPP provides supplemental payments to LTCs that meet or exceed five quality measures. Effective July 1, 2022, DHS implemented changes to QIPP eligibility standards. These eligibility requirements excluded all of the 12 lowest-rated LTCs from the QIPP in state fiscal year (SFY) 2023.

This update should be read in conjunction with the original February report and the recommendations made in that report to Department of Human Services (DHS) and the Department of Health (DOH).

Findings

A. New Jersey’s lowest-rated LTCs consistently have performed poorly for many years.

State and federal inspectors regularly inspect New Jersey’s LTCs and provide their findings to CMS. The data that results from those inspections allows CMS to compare the quality of LTCs over multiple years, using a one to five-star rating system, with one-star being the lowest and five-stars the highest. CMS compiles this information in its Care Compare website.[1]

1. CMS Ratings

The linchpin of the CMS rating system is the health-inspection score. This score is developed based on unannounced site visits conducted by a team of state surveyor healthcare professionals who spend several days in the LTC assessing a variety of practices and policies in such areas as resident rights, quality of life, medication management, skin care, resident assessment, nursing home administration, environment, and kitchen/food services. After CMS establishes an LTC’s health-inspection score, it adds or subtracts points based on the LTC’s quality and staffing measure scores to arrive at an aggregated score. For an LTC to be among the lowest performers for the first month of each quarter for at least six of the past eight quarters means that the LTC consistently has had more widespread, serious, and uncorrected deficiencies than LTCs with higher star ratings.

2. Ratings for New Jersey’s LTCs

OSC examined CMS data from 2013 to 2022, with particular focus on data for October 2020 to July 2022 to assess whether New Jersey LTCs that accept Medicaid beneficiaries performed poorly over an extended number of years.

As one method to evaluate New Jersey’s use of Medicaid funds to pay the lowest-rated LTCs, this update focuses on the LTCs that for the first month of six of the past eight quarters (i.e., January, April, July and October) received one-star. Using this metric, OSC identified 12 LTCs that received one-star on these quarterly intervals for at least six of the prior eight quarters. We refer to these LTCs as the “12 lowest-rated LTCs.” Nine of these LTCs were included on OSC’s original February 2, 2022 list of “15 lowest-rated LTCs.” As the Tables below show, we analyzed these LTCs not only in terms of their performance on a quarterly basis for the past eight quarters, but also looking back eight years to 2013.

Table A
12 Lowest-Rated LTCs
LTC Name Location County

CEDAR GROVE RESPIRATORY AND NURSING CENTER1

CMS Care Compare Page
NJ DOH Page

1420 S. Black Horse Pike Williamstown, NJ 08094

Gloucester

FOREST MANOR HCC

CMS Care Compare Page
NJ DOH Page

145 State Park Road

Hope, NJ 07844

Warren

GROVE PARK HEALTHCARE AND REHABILITATION2

CMS Care Compare Page
NJ DOH Page

101 North Grove Street

East Orange, NJ 07017

Essex

HAMILTON GROVE HEALTHCARE AND REHABILITATION*

CMS Care Compare Page

NJ DOH Page

2300 Hamilton Avenue

Hamilton, NJ 08619

Mercer

OCEANA REHABILITATION AND NC

CMS Care Compare Page
NJ DOH Page

502 Route 9 North Cape May Court House, NJ 08210

Cape May

PALACE REHABILITATION AND CARE CENTER

CMS Care Compare Page
NJ DOH Page

315 West Mill Rd Maple Shade, NJ 08052

Burlington

PHOENIX CENTER FOR REHABILITATION AND PEDIATRICS*3

CMS Care Compare Page

NJ DOH Page

1433 Ringwood Avenue

Haskell, NJ 07420

Passaic

SILVER HEALTHCARE CENTER*@4

CMS Care Compare Page

NJ DOH Page

1416 Brace Road Cherry Hill, NJ 08034

Camden

SOUTH JERSEY EXTENDED CARE*

CMS Care Compare Page

NJ DOH Page

99 Manheim Ave- nue

Bridgeton, NJ 08302

Cumberland

STERLING MANOR

CMS Care Compare Page

NJ DOH Page

794 N Forklanding Road

Maple Shade, NJ 08052

Burlington

WARREN HAVEN REHAB AND NURSING CENTER5

CMS Care Compare Page

NJ DOH Page

350 Oxford Road

Oxford, NJ 07863

Warren

WOODLAND BEHAVIORAL AND NURSING CENTER*@6

CMS Care Compare Page
NJ DOH Page

99 Mulford Road Andover, NJ 07821

Sussex

*LTC identified by the CMS Special Focus Facility Program in July 2022, due to its history of serious quality issues.

@ LTC was cited for abuse by CMS in July 2022.

† Woodland Behavioral Health recently closed.

1. Formerly Meadowview Nursing and Respiratory Care – 2019
2. Formerly New Grove Manor – 2021
3. Formerly Wanaque Center for Nursing and Rehabilitation – 2019
4. Formerly Alaris Health at Cherry Hill 2016
5. Formerly Warren Haven 2015
6. Formerly Andover Subacute and Rehab II - 2020

As shown in Table B, these 12 lowest-rated LTCs include 3 that received one-star for all 8 quarterly intervals, 6 that received one-star for 7 out of the 8 quarterly intervals, and 2 that received one-star for 6 out of the 8 quarterly intervals dating back to October 2020.

Table B
Ratings of 12 Lowest-Rated LTCs: October 2020 - July 2022
image: Table B Ratings of 12 Lowest-Rated LTCs: October 2020 - July 2022

Note: Hamilton Grove Healthcare and Rehabilitation received an Overall Rating of zero (0) while in the CMS Special Focus Facility Program.

CMS Overall Ratings back to 2013 reveals that many of the 12 LTCs have been among the lowest-rated LTCs for many years. Others appear to have deteriorated over the past several years and remained low. Some experienced fast and precipitous declines, and have remained among the lowest-rated in recent years.

Table C
12 Lowest-Rated LTCs - Overall Ratings Q1 2013 to July 2022
image: Table C -- 12 Lowest-Rated LTCs - Overall Ratings Q1 2013 to July 2022

Note: Grove Park Healthcare and Rehabilitation, Hamilton Grove Healthcare and Rehabilitation, Silver Healthcare Center, and Woodland Behavioral and Nursing Center received an Overall Rating of zero (0) while in the CMS Special Focus Facility Program.

In sum, the LTCs identified above currently provide low quality care to their residents and many of them have been providing low quality care for an extended period of time, in some cases dating back more than eight years. (Click here to view larger version of Table C.)

B. New Jersey pays more than $107 million annually to the 12 lowest-rated LTCs.

The 12 lowest-rated LTCs identified in this update together received $215 million in Medicaid funds in 2020 and 2021, or more than $107 million annually.

Table D
12 Lowest-Rated LTCs - NJ Medicaid Payments, State Fiscal Year 2017 through 2021
image: Table D -- 12 Lowest-Rated LTCs - NJ Medicaid Payments, State Fiscal Year 2017 through 2021

*LTC has a skilled nursing facility and/or ventilation unit and receives higher per patient reimbursement rates.
** SFY 2020 was extended three months (July 1, 2019 to September 30, 2020), resulting in increased payments. SFY 2021 was shortened by three months (October 1, 2020 to June 30, 2021), resulting in decreased payments.

 

LTC Name

NJ Medicaid FY 2017

Payment

NJ Medicaid FY 2018

Payment

NJ Medicaid FY 2019

Payment

NJ Medicaid FY 2020**

Payment

NJ Medicaid FY 2021**

Payment

TOTAL

CEDAR GROVE RESPIRATORY AND NURSING CENTER*

$9,499,218

$9,925,533

$9,848,009

$12,303,770

$8,632,318

$50,208,848

FOREST MANOR HCC

$2,839,779

$3,417,690

$3,788,677

$4,721,195

$2,925,676

$17,693,018

GROVE PARK HEALTHCARE AND REHABILITATION CENTER

$7,836,262

$7,088,088

$7,331,599

$9,564,758

$6,630,921

$38,451,630

HAMILTON GROVE

HEALTHCARE AND REHABILITATION

$8,456,140

$8,636,114

$8,007,881

$9,612,073

$5,661,416

$40,373,625

OCEANA REHABILITATION AND NC

$6,575,589

$6,908,865

$6,608,123

$8,025,822

$5,495,053

$33,613,453

PALACE REHABILITATION AND CARE CENTER

$9,392,263

$9,360,536

$9,605,673

$11,998,548

$8,307,617

$48,664,637

PHOENIX CENTER FOR REHABILITATION AND PEDIATRICS

$13,780,762

$14,286,442

$13,368,005

$15,340,200

$10,637,739

$67,413,148

SILVER HEALTHCARE CENTER*

$13,663,222

$15,548,399

$15,707,423

$17,719,576

$9,348,197

$71,986,818

SOUTH JERSEY EXTENDED CARE

$6,938,114

$5,798,655

$5,956,001

$8,916,509

$6,066,692

$33,675,971

STERLING MANOR

$6,007,859

$5,956,657

$6,117,147

$7,447,286

$4,996,995

$30,525,944

WARREN HAVEN REHAB AND NURSING CENTER

$6,121,166

$5,528,356

$5,457,345

$5,561,708

$3,173,058

$25,841,631

WOODLAND BEHAVIORAL AND NURSING CENTER

$14,743,534

$14,917,030

$14,917,860

$19,800,195

$11,728,814

$76,107,433

 

In addition to the payments noted above, beginning in state fiscal year 2020 (July 1, 2019), the Medicaid program, through the Division of Aging Services (DOAS) within DHS, instituted a quality incentive payment program (QIPP) for LTCs. DHS designed the QIPP to provide additional payments to LTCs that demonstrated higher quality/performance. Through the QIPP, LTCs were eligible to receive an additional $0.60 to $3.60 per resident per day for meeting or exceeding these five quality measures.2

In state fiscal year 2022, the 12 lowest-rated LTCs received an average of $2.20 per resident per day in QIPP payments. The average QIPP payments for all LTCs for this same period was $2.55, just $0.35 more. Following OSC’s February 2022 Report, DOAS implemented changes to the eligibility requirements for the QIPP program. Specifically, effective starting July 1, 2022, DOAS excluded from QIPP eligibility LTCs that received a One-Star Overall Rating, were a CMS Special Focus Facility, and/or had two or more high severity deficiencies during a DOH inspection. These eligibility requirements effectively excluded each of the 12 lowest-rated LTCs from the QIPP in SFY 2023. See Table E.

Table E
12 Lowest-Rated LTCs - NJ Medicaid Quality Incentive Payments, Per Resident Per Day
image: LTCs Table E

*LTC is a skilled nursing facility and/or ventilation unit and receives higher per patient reimbursement rates.

C. ALL of the lowest-rated LTCs are for-profit companies.

Most New Jersey LTCs operate under for-profit ownership models. We note that of the 12 lowest-rated LTCs listed above, four of the owners/managers/3rd party administrators are also involved in at least two other LTCs on the lowest-rated LTC list. One of these owners/managers/ administrators is affiliated with 34 LTCs in New Jersey. Set forth below is a complete breakdown of the affiliations of all five of these owners, managers, and administrators. 3

  • An owner of Forest Manor HCC and Warren Haven Rehab and Nursing Center is affiliated with two LTCs that received a two-star or lower score in July 2022 and with a total of two LTCs in New Jersey.
  • A manager of South Jersey Extended Care, and Sterling Manor, is affiliated with six LTCs that received a two-star or lower score in July 2022 and with a total of eight LTCs in New Jersey;
  • An administrator of Palace Rehabilitation and Care Center and Silver Health Care Center is affiliated with 10 LTCs that received a two-star or lower score in July 2022 and with a total of 34 LTCs in New Jersey; and
  • An owner/manager of Oceana Rehabilitation and Nursing Care, South Jersey Extended Care, and Sterling Manor, is affiliated with three LTCs that received a two-star or lower score in October 2021 and with a total of three LTCs in New Jersey.
Table F
Owners of the 12 Lowest-Rated LTCs

(Owners of more than one One-Star LTC on the list are noted in red.)

FACILITY NAME

OWNERSHIP

OWNER/MANAGER NAME & ROLE IN FACILITY

CEDAR GROVE RESIPRATORY AND NURSING CENTER

Legal Business Name
GARDENVIEW OPCO LLC

For profit - Limited Liability Company

 

  • BAK, PINCHOS, 5% OR GREATER DIRECT OWNERSHIP INTEREST -17%/ DIRECTOR
  • BROYDE, YISROEL, MANAGING EMPLOYEE
  • FRIEDMAN, LEOPOLD, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%
  • GOLDBERGER, SHLOMO, 5% OR GREATER DIRECT OWNERSHIP INTEREST -17%
  • SONNENSCHEIN, MOSHE, 5% OR GREATER DIRECT OWNERSHIP INTEREST -16%

FOREST MANOR HCC

Legal Business Name
FOREST MANOR MANAGEMENT, LLC

For profit – Partnership

  • FARKAS, ZEV, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -50%/ MANAGING EMPLOYEE
  • FOREST MANOR AQUISITION 1LLC, 5% OR GREATER DIRECT OWNERSHIP INTEREST -100%
  • NICHOLSON, WILLIAM, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -50%

GROVE PARK HEALTHCARE AND REHABILITAITON CENTER

Legal Business Name
GARDEN STATE NURSING HOME INC.

For profit – Corporation

  • COHEN, CHAYA, 5% OR GREATER DIRECT OWNERSHIP INTEREST -100%/ MANAGING EMPLOYEE

HAMILTON GROVE HEALTHCARE AND REHABILITATION

Legal Business Name
HAMILTON GROVE HEALTHCARE AND REHABILITATION LLC

For profit – Partnership

  • DREW, ZALMAN, 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • FEIGENBAUM, AVRAHAM, 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • FEIGENBAUM, DEBORAH, 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • GOLDSTEIN, PINNY, MANAGING EMPLOYEE
  • MAIEROVITS, AVROHOM, 5% OR GREATER DIRECT OWNERSHIP INTEREST

OCEANA REHABILITATION AND NC

Legal Business Name
OCEANA REHAB AND NURSING LLC

For profit - Corporation

  • OCEANA REHAB & NURSING LLC, OPERATIONAL/MANAGERIAL CONTROL
  • WEISZ, MARK, 5% OR GREATER DIRECT OWNERSHIP INTEREST/ MANAGING EMPLOYEE

PALACE REHABILITATION AND CARE CENTER

Legal Business Name
THE PALACE REHABILITATION AND CARE CENTER LLC

For profit - Corporation

  • ROSENBERG, ESTHER, 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • ROSENBERG, JONATHAN, 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • SHAPIRO, CHAIM, MANAGING EMPLOYEE
  • STERN, SAM, OFFICER
  • THE PALACE REHABILITATION AND CARE CENTER LLC, 5% OR GREATER DIRECT OWNERSHIP INTEREST

PHOENIX CENTER FOR REHABILITATION AND PEDIATRICS

Legal Business Name
NORTH JERSEY PEDIATRIC AND ADULT NURSING AND WELLNESS CENTER, LLC

For profit - Individual

  • ISLAM, NATASHA, OPERATIONAL/MANAGERIAL CONTROL
  • KRAUS, ABRAHAM, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%
  • PHILIPSON, BENT, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%

SILVER HEALTHCARE CENTER

Legal Business Name
THE SILVERCARE LLC

For profit - Corporation

  • LANDA, BENJAMIN, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -20%
  • LOWDEN, SANDRA, MANAGING EMPLOYEE
  • MARINA CH, LLC, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -10%
  • MTC FAMILY, LLC, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -31%
  • PHILIPSON FAMILY LIMITED LIABILITY COMPANY, LLC, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -20%
  • STERN, SAM, OFFICER
  • THE SILVERCARE LLC, 5% OR GREATER DIRECT OWNERSHIP INTEREST -100%

SOUTH JERSEY EXTENDED CARE

Legal Business Name
HW WEIDCO REN LLC

For profit - Limited Liability Company

  • COMPREHENSIVE HEALTH CARE MANAGEMENT SYSTEMS LLC, OPERATIONAL/MANAGERIAL CONTROL
  • KRAUSMAN, STEVEN, OPERATIONAL/MANAGERIAL CONTROL
  • WEISZ, MARK, 5% OR GREATER DIRECT OWNERSHIP INTEREST

STERLING MANOR

Legal Business Name
HW WEIDCO STER LLC

For profit - Limited Liability Company

  • KRAUSMAN, STEVEN, MANAGING EMPLOYEE
  • WEISZ, MARK, 5% OR GREATER DIRECT OWNERSHIP INTEREST -100%

WARREN HAVEN REHAB AND NURSING CENTER

Legal Business Name
WH HOLDINGS 1 LLC

For profit - Limited Liability Company

  • FARKAS, ZEV, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -25%
  • JL WARREN 1 LLC, 5% OR GREATER INDIRECT OWNERSHIP INTEREST
  • LOBELL, JONAH, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -50%
  • SCHLANGER, JOSEPH, 5% OR GREATER INDIRECT OWNERSHIP INTEREST -25%/ MANAGING EMPLOYEE
  • WHZJ HOLDINGS 1 LLC, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%

WOODLAND BEHAVIORAL AND NURSING CENTER

Legal Business Name
ALLIANCE HC 11 LLC

For profit - Limited Liability Company

  • BRADFORD, CYNTHIA, MANAGING EMPLOYEE
  • SCHEINBAUM, CHAIM, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%
  • SCHWARTZ, LOUIS, 5% OR GREATER DIRECT OWNERSHIP INTEREST -50%

[1]See CMS Nursing Home, Care Compare Technical Details: https://data.cms.gov/provider-data/topics/nursing-homes/technical-details.

[2] See DOAS website at: https://www.state.nj.us/humanservices/doas/resources/.

[3] OSC downloaded NJ Medicaid payment data from fiscal years 2017, 2018 and 2019 from the NJ Medicaid System/Shared Data Warehouse and combined Medicaid claims payment data for both Fee for Service and Managed Care Organizations for total payment amounts. The amounts provided are estimates/averages and do not account for future claim edits and/or retractions.

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