Pursuant to the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. § 1997, the Civil Rights Division of the U.S. Department of Justice ("DOJ") conducted an investigation of conditions at the Mercer County Geriatric Center ("MCGC"), a public nursing home facility in New Jersey, evidently operated by Mercer County. The investigation resulted in an October 9, 2002, findings letter being sent to the County Executive. The letter stated that in December 2001, DOJ advised county officials of its intent to conduct an investigation of the facility pursuant to CRIPA authority, but the county and its' counsel wholly declined to cooperate in the investigation. The investigation occurred nonetheless, even though the county's attorney interfered with the investigators' access to the MCGC's residents. The letter stated that non-cooperation is one factor considered adversely when drawing conclusions about a facility, but the DOJ explained it also relied upon federal and state survey information, news articles, medical records, family interviews, private attorney and advocate interviews, and publicly available data.
The letter advised that the DOJ's investigation led it to find that certain conditions at MCGC violated residents' federal rights, in that (1) Mercer County did not maintain sanitary and safe living conditions at MCGC; (2) MCGC residents did not receive adequate medical and mental health care; (3) MCGC residents were denied rehabilitation, restorative care, and freedom from unreasonable restraints; (4) MCGC mealtime assistance, nutrition, and hydration practices were not adequate; (5) MCGC residents were not treated in the most integrated setting appropriate to individual resident needs; and (6) staffing, administration, and policy deficiencies contributed to inadequate care at MCGC. Among the policy deficiencies listed was the county's denial of MCGC residents' First Amendment right to communicate with federal officials who were conducting the CRIPA investigation.
The DOJ findings letter proposed remedial actions to remedy the deficiencies, invited the county to address the issues, and alerted the county to the possibility of a CRIPA lawsuit brought by the United States to compel remedial action.
Negotiations evidently followed, because the county and the DOJ eventually entered into a settlement agreement obligating the county to improve a wide range of policies and practices at MCGC. The settlement contained substantive provisions addressing (A) assessment and care planning, (B) restraints and medication usage, (C) mealtime assistance, resident nutrition, and hydration practices, (D) therapeutic activities, rehabilitation, and restorative care, (E) mental health care, (F) treatment in the most integrated setting appropriate to individualized needs, and (G) management, oversight, and training. The settlement allowed for DOJ and its' consultants to retain access privileges to MCGC, its residents, and documents and records, for monitoring and technical assistance purposes, as well as to have access privileges to alternative placement settings. Further, the agreement called for the county to fund a jointly agreed-upon monitor. The county had 180 days to implement the changes called for in the settlement document which, by its' terms, expired in three years. Attorneys for the county signed the agreement on December 28, 2004, followed by relevant DOJ officials' signatures being added on February 18, 2005, when the document and its' attached monitoring protocol were received by the U.S. District Court for the District of New Jersey. The same date, the United States filed its' complaint against the county and its subdivision and officials responsible for the operation of the MCGC. The CRIPA-based complaint sought declaratory and injunctive relief, citing the deficiencies at MCGC and alleging that the defendants' conduct violated residents' federal constitutional, statutory, and regulatory rights, including those provided by the First and Fourteenth Amendments, the Americans with Disabilities Act, 42 U.S.C. § 12101 et seq., the nursing home reform provisions of the Omnibus Budget and Reconciliation Act of 1987, 42 U.S.C. §§ 1395i-3 and 1396r, and Section 504 of the Rehabilitation Act, 29 U.S.C. § 794 (and implementing regulations).
District Judge Garrett E. Brown, Jr., signed the settlement as the order and judgment of the court October 14, 2005. The judge's unpublished order of November 29, 2005, appointed Marie Boltz as monitor in the case. Her subsequent reports were attached as part of the United States' status reports to the court on the case.
We have no post-December 2006, information about additional activities in this matter.Mike Fagan - 06/23/2008