Nursing facility fined for inadequate staffing

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The Lawrence Rehab & HCC/The Meadows at Lawrence, formerly known as St. Lawrence Rehabilitation Center and Morris Hall, has been fined $69,000 by the New Jersey Department of Health and Human Services for inadequate staffing.

Lawrence Rehab & HCC/The Meadows at Lawrence belonged to the Roman Catholic Diocese of Trenton and was operated as a non-profit. The diocese sold it to investor Tryko Partners LLC in February 2023, according to published reports in The Trenton Monitor. Tryko Partners LLC is a for-profit entity.

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The $69,000 fine is based on the 69 days that Lawrence Rehab & HCC/The Meadows at Lawrence failed to comply with nurse staffing requirements, according to the “Notice of Assessment of Penalties” letter issued by the state agency on April 24.

The state agency assessed $69,000 in enhanced penalties “because the facility has incurred two or more of the same or substantially similar or higher level deficiencies as defined by the federal Centers for Medicare and Medicaid Services” within a three-year period, according to the letter.

“Subsequent to the staffing deficiencies found at the Dec. 21, 2021 survey,” the letter stated, “the March 11, 2024 and the April 9, 2024 surveys substantiated that the facility failed to meet the requirements (for adequate staffing) on 69 different days.”

It failed to meet the nursing staff requirements on 14 of 14 day shifts on the March 11, 2024 survey and on 55 of 67 day shifts on the April 9, 2024 survey, according to the letter.

Specifically, it was deficient in staffing during the weeks of Feb. 18-24 and Feb. 25 to March 2. The staffing deficiencies occurred on the day shift. The standard calls for one Certified Nurse Aide (CNA) per eight residents on the day shift.

During those weeks, the staffing called for 14 CNAs on the day shift – based on 109 to 116 residents. Records showed that the staffing varied from seven to 12 CNAs on the day shift during the two-week period.

An earlier survey in December 2021 – before the Roman Catholic Diocese of Trenton sold it to Tryko Partners LLC – revealed that minimum staffing requirements were violated on five of 28 day shifts.

Enforcement remedies are based on the severity and scope of the deficiencies, or levels of harm. There are four levels of harm. The second lowest level of harm, which was assessed against the facility, is described as “no actual harm, with a potential for more than minimal harm that is not (placing clients in) immediate jeopardy.”

“Immediate jeopardy” means a situation in which noncompliance with one or more requirements “has caused, or is likely to cause, serious injury, harm, impairment or death to a resident,” according to the Centers for Medicare and Medicaid.

There are also three levels of scope – isolated, a pattern or widespread, the Centers for Medicare and Medicaid said. The violations at Lawrence Rehab & HCC/The Meadows at Lawrence were deemed to be widespread.

In response to the violations, Lawrence Rehab & HCC has offered a plan of correction that includes daily meetings between the director of nursing, the staffing coordinator and the administrator to review recruitment efforts, staffing for the next day and staffing for the week.

It also plans to step up recruitment through job fairs, flexible scheduling and increased use of per-diem staff. A campaign to rehire staff that have resigned, as well as rate and benefit adjustments, also has been proposed.

The former St. Lawrence Rehabilitation Center/Morris Hall was established by the Roman Catholic Diocese of Trenton and operated as a non-profit entity. It had its beginnings in a bequest to the diocese by Col. Daniel Morris in 1898 to establish a home for the aged.

Morris Hall grew to include St. Joseph’s Skilled Nursing Center and St. Mary’s Assisted & Residential Living, as well as the St. Lawrence Rehabilitation Center on its main campus on Route 206. Morris Hall Meadows, which is a skilled nursing facility, is located on Franklin Corner Road.

The Roman Catholic Diocese of Trenton put it up for sale in October 2021 because of the financial strains resulting from the COVID-19 pandemic and overall changes in the health care environment, officials said.

Tryko Partners LLC, which bought the former St. Lawrence Rehabilitation Center/Morris Hall Meadows in February 2023, is based in Brick Township. It is a private equity investment group that buys healthcare facilities and service entities, tax liens and multifamily properties on the Eastern Seaboard and in the Midwest, according to its LinkedIn profile.

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