Pascrell Offers Testimony on Veterans Home Covid Crisis
Urgent hearing shines light on catastrophic loss of life in Paramus
Washington, D.C., July 29, 2020
Tags: Veterans & Armed Forces
U.S. Rep. Bill Pascrell, Jr. (D-NJ-09) today submitted testimony before a hearing of the House Veterans Affairs Subcommittee on Health addressing the nationwide crisis in veterans care homes ravaged by COVID-19. Pascrell focused heavily on the COVID outbreak at the New Jersey Veterans Home at Paramus (NJVHP), including his efforts to provide relief to the facility, find answers for the devastation, and suggest policy changes to prevent a repeat of the tragedy.
A copy of Rep. Pascrell’s prepared testimony is available here, the full text of which is provided 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.
Upon learning of the outbreak at the NJVHP, Reps. Pascrell and Josh Gottheimer (D-NJ-05) have led numerous efforts to bring immediate assistance to the facility and get to the bottom the outbreak. On April 10, Pascrell and Gottheimer contacted the U.S. Secretary of Veterans Affairs (VA) and the VA Inspector General demanding they open an immediate federal investigation and take additional measures to protect remaining residents. Following Pascrell and Gottheimer’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 Memorial Home. Gottheimer and Pascrell have continued to demand answers and accountability on behalf of all residents, veterans, and their families.