Safer Staffing in NJ

New Jersey

New Jersey learned a valuable lesson from the tragic coronavirus pandemic. Starting February 1, 2021, New Jersey nursing homes will have safer staffing levels. Nursing homes must have one certified nursing assistant (CNA) per eight residents during day shifts, one direct caregiver for every 10 residents during the evenings, and one for every 14 during the overnights under new safety regulations.

During the evening and overnight hours, the direct caregivers can include CNAs, licensed practical nurses, or registered nurses, so long as at least half are CNAs. The new law will establish a retention and recruitment task force to help nursing home operators find sufficient and qualified caregivers.

“Sadly, too many nursing homes are run by companies more interested in making money than protecting patients,” New Jersey governor Phil Murphy said according to a report from “These long-sought reforms will help bring accountability to the industry and protect residents, staff, and family members with a loved one living in a long-term care facility.”

Safe Staffing and COVID-19

Staffing has emerged as a key indicator of COVID-19 outbreak risk in nursing homes. In fact, one credible study found that a facility’s federal staffing performance was the only reliable predictor of coronavirus cases among the CMS quality domains.

“Across 8 states, high-performing NHs for nurse staffing had fewer COVID-19 cases than low-performing NHs,” a study published online by the JAMA Network determined. “In contrast, there was no significant difference in the burden of COVID-19 cases between high- vs low-performing NHs for health inspection or quality measure ratings. These findings suggest that poorly resourced NHs with nurse staffing shortages may be more susceptible to the spread of COVID-19.”

Staffing shortages are a persistent problem in nursing homes across the country. Health experts and consumer advocates recommend increasing direct care staffing. Paying a living wage with health benefits would help retention and quality.

“Nurse staffing is a key contributor to the quality of care provided in nursing homes. This review, initiated before the COVID-19 pandemic emerged, focuses on staffing data from 2018,” the OIG observed in its report. “However, the 2020 pandemic reinforces the importance of adequate staffing for nursing homes, as inadequate staffing can make it more difficult for nursing homes to respond to infectious disease outbreaks like COVID-19.”