The federal government has imposed a $600,000 fine on a New Jersey nursing home where 11 children died and 36 became sick during a viru...
The federal government has imposed a $600,000 fine on a New Jersey nursing home where 11 children died and 36 became sick during a virus outbreak last fall.
The penalty results from inspections by state and federal health officials during the outbreak that found conditions at the Wanaque Center for Nursing and Rehabilitation posed an “immediate jeopardy” to the lives and health of the facility’s 53 ventilator-dependent children and 150 other pediatric and elderly residents.
Inspectors described lapses in hand-washing and infection control, substandard care, a lack of involvement by the medical director, and poor oversight by the facility's administration. Federal inspectors said those alleged failures “directly contributed” to the inability to prevent the outbreak and contain it once it started, leading to the deaths.
Those conditions existed from Oct. 9, the day the center learned that one of its patients had died of adenovirus, to Nov. 16, according to a letter from Lauren D. Reinertsen of the regional office for the Centers for Medicare and Medicaid Services, which regulates nursing homes.
The center is now in compliance with federal and state regulations, according to officials. But it is still barred from admitting pediatric ventilator patients while awaiting state approval for its written infection-control plan.
Wanaque center appeals
The Wanaque center strongly disputed the findings in the federal inspection report, first described this week by NorthJersey.com and the USA TODAY Network.
It is appealing the federal inspectors’ findings because “their conclusions are so wrong and so damaging,” Paul Fishman, the former federal prosecutor who represents the center’s owners, said in an interview Friday with NorthJersey.com.
A spokesperson for the federal agency, however, said it "stands behind the findings” in its report, which “stemmed from direct observation, interviews with facility leadership and staff, and medical record reviews.”
“We will continue to demand accountability from facilities that fail to meet the fundamental health and safety needs of the patients and residents they serve,” the spokesperson said.
The center has appealed to an Administrative Law judge at the Department of Health and Human Services and also asked for an independent mediator to try to resolve the dispute informally, before it goes to a judge. A conclusion is likely to take months.
The legal debate over responsibility for the catastrophe may obscure the disturbing details of how some of the Wanaque children spent their final days. Those details are contained in the 114-page federal inspection report of the facility.
Inspectors cite poor care
Some children were wracked with fever for days before the staff sent them to the hospital, where two died within hours of arriving at the emergency room, according to federal inspectors. Another child spent 19 days in the hospital before being sent back to the nursing home with a hole punched in her airway to help her breathe.
Even after the state had advised the Wanaque center how to control the outbreak of adenovirus, at least two children who’d been free of symptoms – but had roommates who were sick – became ill themselves and died, federal inspectors wrote, citing medical records.
The nursing home “failed to provide timely interventions and care in accordance with professional standards of practice,” the inspectors wrote. That pattern of substandard care put all of the home’s residents in jeopardy, they found.