Testimony from Gottheimer, Pascrell highlights catastrophic COVID-19 impact on NJ long-term care facilities

On July 29, 2020, U.S. Congressmen Josh Gottheimer (NJ-5) and Bill Pascrell (NJ-9) both questioned witnesses at a House Veterans Affairs Subcommittee on Health hearing addressing the nationwide crisis in veterans care homes ravaged by COVID-19.

Pascrell and Gottheimer were both invited to participate in the hearing and submit testimony on the devastating coronavirus outbreak at the state-run New Jersey Veterans Home at Paramus (NJVHP) — in Bergen County, New Jersey — where 81 residents and 1 staff member died of COVID-19.

Watch footage from today’s hearing HERE.

“In North Jersey, the ongoing tragedy at the New Jersey Veterans Home at Paramus has stunned the nation and laid bare the terrible vulnerability of these facilities,” said Congressman Bill Pascrell (NJ-9), who has helped lead efforts in Congress to highlight senior home vulnerability. “As the pandemic continues, we must act right now to learn from the failures at Paramus and elsewhere and do whatever is possible to shield our most vulnerable neighbors. This includes reversing the unconscionable cuts by the Trump administration to long-term care protection. I want to thank my colleague and neighbor Josh Gottheimer for his work on NJVHP, and Chairman Mark Takano and Chairwoman Julia Brownley for their dogged attention to protecting our senior homes from this scourge. Continued oversight and reforms will save lives.”

“I’ll never forget the first phone call we received about the state-run veteran’s home in Paramus, in the Fifth Congressional District I represent. It was from a panicked loved-one of a facility resident — his brother-in-law, a Korean War veteran. He had just learned, second-hand, that there was a massive outbreak of the coronavirus in the facility. His family hadn’t heard a peep from the facility’s administrators. Unfortunately, he wasn’t alone. Overnight, the story broke that 37 people had died in the facility in just two weeks,” said Congressman Josh Gottheimer (NJ-5) during today’s hearing. “Immediately, Congressman Bill Pascrell and I wrote to the Secretary of the VA requesting immediate assistance – strike teams of nurses and doctors – as well as PPE to protect staff and residents. Eventually, at our urging, 56 VA personnel and 65 NJ National Guard members would be sent to the home, helping stem the tide of the outbreak. We even sent top doctors and infectious disease experts from North Jersey’s world-class hospitals to help advise and monitor the facility.”

Upon learning of the outbreak at this facility, on April 10th, Gottheimer and Pascrell contacted the U.S. Secretary of Veterans Affairs (VA) and the VA Inspector General requesting they open an immediate federal investigation and take additional measures to protect remaining residents. Following Gottheimer and Pascrell’s requests for assistance and additional personnel, the VA then announced that 90 nurses would be sent to support the veterans’ facilities throughout New Jersey, including the Paramus Veterans Home. Following Gottheimer and Pascrell’s requests, and coordination with the State, the New Jersey National Guard also sent medics to assist at the Paramus Veterans Home.

Gottheimer and Pascrell also worked together, with coordination with NJ Department of Military and Veterans Affairs (NJ DMVA) Brigadier General Jemal Beale, to have the top COVID-19 experts and physicians from North Jersey hospitals begin consulting with the Paramus Veterans Home’s medical staff, to review protocols, collaborate on best practices, and help triage residents with pressing medical needs.

Gottheimer and Pascrell have continued to demand answers and accountability on behalf of all residents, veterans, and their families.

The current status of COVID-19 outbreaks in New Jersey’s state-run veterans homes from the NJ DMVA can be found here.

Testimony from both Pascrell and Gottheimer are found below.

Testimony of Congressman Bill Pascrell, Jr.
House Veterans Affairs Committee, Subcommittee on Health
Hearing on State Veterans Homes during COVID-19
Wednesday, July 29 

Thank you, Chairwoman Brownley, for your leadership in holding this critical hearing. I appreciate your gracious invitation to provide testimony regarding COVID-19 and our State Veterans Homes. You, Chairman Takano and the committee staff have been a valuable resource to us in taking on these issues since we first learned about the failures in Paramus over three months ago.
 
As of July 27, the New Jersey Veterans Home at Paramus (NJVHP) has 199 residents and 93 staff members who contracted COVID-19. Sadly, 81 residents and 1 staff member have died from the virus. This loss of life is devastating for families and our communities, especially when much of it could have been prevented.
 
The situation that continues to unfold at the New Jersey Veterans Home at Paramus provides insight into what has occurred in nursing homes across the country. The COVID-19 death toll in nursing homes did not happen in a vacuum. The Trump administration’s consistent deregulation of nursing homes and the excruciatingly inadequate response of facilities have left residents in every state unprotected from COVID-19 and highlighted the gaps that have long-existed in our long-term care system.
 
I saw unmistakably that the New Jersey Veterans Home at Paramus and other State Veterans Homes around our state were in terrible danger in early April when 37 residents at Paramus died within a two-week span. On April 10, Congressman Josh Gottheimer and I sent letters to the Department of Veterans Affairs (VA) Secretary Robert Wilkie and VA Inspector General Michael Missal urgently requesting additional VA personnel and an immediate federal investigation into the facility. The response from the VA Inspector General, received by my office on April 21, indicated that the New Jersey Department of Military and Veterans Affairs (NJ DMVA) had principal oversight of the State Veterans Homes. The response from Secretary Wilkie, received June 17, provided a list of VA personnel that were assigned to NJVHP from April 15 to June 1.
 
I was extremely disturbed by the lack of communication and incorrect information exchanged between the facility and the families of residents. For example, New Jersey announced a State of Emergency on March 9 and normal activity halted by March 13. I understand the first correspondence from NJVHP to families and loved ones regarding COVID-19 was sent on April 2. Incredibly, only on April 7 did NJVHP publicly acknowledge that COVID-19 infections had occurred in the facility. Additionally, cases of deceased patients being identified as alive to their families were reported, a devastating mix-up for families.
 
On April 24, Congressman Gottheimer and I sent a letter to NJ DMVA requesting a briefing from the state and answers to questions regarding COVID-19 cases and deaths, staffing shortages, and the steps NJ DMVA had taken up to that point to protect residents and staff at NJVHP. NJ DMVA staff briefed our staffs via phone on May 5, at which point there were 189 confirmed COVID-19 cases and 69 COVID-19 deaths at NJVHP. On May 5, I was encouraged to learn that NJVHP received 56 VA personnel, as we had requested, and 65 New Jersey National Guard personnel to address staffing shortages.
 
When asked if NJ DMVA had mandated that all state veterans home contractors identify any failures to meet quality standards as deficiencies during its inspections, as recommended by the U.S. Government Accountability Office (GAO), NJ DMVA told my staff that reports from the New Jersey Department of Health (NJ DOH) and the Centers for Medicare and Medicaid Services (CMS) indicated zero deficiencies and there was nothing to correct. However, on April 22, 2020, a targeted infection control survey by NJ DOH and CMS found the facility not in substantial compliance with 42 CFR 483 Subpart B, which governs requirements for long-term care facilities.
 
Even prior to the outbreak of COVID-19, the facility received a two star, or “below average” rating from CMS in the category of health inspection, indicating greater health risks to residents. The facility also struggled with resident assessment and care planning, nurse and physician staffing, and administrative deficiencies over the past three years. NJVHP’s Scope and Severity grade is currently “L,” indicating that there is immediate jeopardy to resident health and safety and that deficiencies are widespread and pervasive in the facility.
 
While NJ DOH and CMS provides oversight for State Veterans Homes that participate in Medicare, VA also conducts annual inspections in order to assess compliance with VA standards. According to a GAO Report released in July 2019, the lack of a requirement to identify all failures to meet quality standards as deficiencies during its inspections is a negotiated policy between the VA and State Veterans Homes. State Veterans Homes can also fix issues identified by the contractor while the inspectors are still onsite to avoid being cited on the inspection. As a result, these issues are not documented as deficiencies. And while VA tracks and monitors these inspection results, which are completed by contractors, the information is not posted publicly. I believe that VA has abdicated its responsibility of oversight of State Veterans Homes, likely causing unnecessary and preventable deaths to COVID-19.
 
The VA must take responsibility for greater oversight of State Veterans Homes by requiring inspection contractors to identify all failures to meet the VA’s quality standards as deficiencies, as CMS requires. The GAO review of VA and CMS inspection reports from a sample of five State Veterans Homes inspection reports shows that VA identified a total of seven deficiencies and made four recommendations from these homes, while CMS identified a total of 33 deficiencies for these homes for approximately the same time period. The VA must also publicly provide information on quality in State Veterans Homes through its Access to Care website. It is critical that the VA provides this information, similar to the information provided by CMS’ Nursing Home Compare website, so that veterans and their loved ones can make informed decisions regarding their care. While there is much more to be done to protect State Veterans Home residents, these policy adjustments would help to provide the transparency our veterans deserve.
 
This situation is tragic. We must do better. While New Jersey has worked with VA and state agencies to make significant progress in stemming the tide of infections in New Jersey State Veterans Homes, more could have been done to prevent the loss of life and high number of infections of residents and staff. I have attached the four letters referenced to this testimony for your convenience. Thank you for the opportunity to provide testimony at today’s hearing.

The Honorable Josh Gottheimer (NJ-05)
Before the House Veterans Affairs Subcommittee on Health Hearing Entitled:
“Who’s in Charge? Examining Oversight of State Veterans Homes During the COVID-19 Pandemic.”

Thank you Chairwoman Brownley, and Committee Chairman Takano and Ranking Member Roe, for calling this hearing on the unacceptable crisis in our state veterans homes, and for inviting me to participate today.

I’ll never forget the first phone call we received about the state-run veteran’s home in Paramus, in the Fifth Congressional District I represent. It was from a panicked loved-one of a facility resident — his brother-in-law, a Korean War veteran. He had just learned, second-hand, that there was a massive outbreak of the coronavirus in the facility. His family hadn’t heard a peep from the facility’s administrators.

Unfortunately, he wasn’t alone. Overnight, the story broke that 37 people had died in the facility in just two weeks.

Immediately, Congressman Bill Pascrell and I wrote to the Secretary of the VA requesting immediate assistance – strike teams of nurses and doctors – as well as PPE to protect staff and residents. Eventually, at our urging, 56 VA personnel and 65 NJ National Guard members would be sent to the home, helping stem the tide of the outbreak. We even sent top doctors and infectious disease experts from North Jersey’s world-class hospitals to help advise and monitor the facility.

At one point, up to 98% of residents had either tested positive for COVID-19, were awaiting test results, or were already hospitalized. In total, more than eighty veteran residents in Paramus – who served our country with honor – tragically died from the virus.

In early April, Congressman Bill Pascrell and I wrote to the VA’s Inspector General, requesting an immediate federal investigation to find out exactly what went wrong, how this could have been avoided, and why families were not notified sooner.

I would like to respectfully request unanimous consent to enter the correspondence into the Committee Record.

The IG replied: “The NJ DMVA has principal oversight of these facilities and the facilities are licensed by the New Jersey Department of Health. 

Those authorities would be the appropriate offices to make the information that you requested available concerning the care of veterans in those facilities. Moreover, with respect to your questions about VA’s oversight role and actions, VA would be in a better position to provide responses to those questions. Given VA’s relatively limited role with respect to state veterans nursing homes, we have not opened a review of this matter.”

That is simply unacceptable.

That is why this Committee is exactly right to ask, “Who’s in charge?”

It’s also why I’ve introduced bipartisan legislation — the Nursing Home Pandemic Protection Act of 2020 — to ensure much stronger and stricter Federal oversight of State Veterans Homes and other long-term care facilities, and helped introduce legislation— the SOS Act — to create rapid response “strike” teams of clinical and non-clinical staff to provide immediate support.

As we know, outbreaks of the coronavirus that could have been avoided did not just happen at the New Jersey homes in Paramus and Menlo Park, but also the Soldiers Home in Holyoke Massachusetts, the Charlotte Hall Veterans Home in Maryland, the Southeast Louisiana Veterans Home, the Veterans Community Living Center at Fitzsimons in Aurora, Colorado, and many others. This is a national problem.

What happened at these homes? What changes must be made to ensure this never happens again? What do we owe the families of the residents and staff we have lost to the virus?

These are the answers we seek with this hearing, and I look forward to learning from our witnesses.

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