TRENTON — Nearly half the boarding homes that house some of New Jersey’s most vulnerable residents — including the elderly and the mentally ill — were cited for being insect-infested, dirty or unsafe over the past two years, a Star-Ledger review of state inspection records has found. The boarding homes singled out by inspectors, many in cities, showed a...
TRENTON — Nearly half the boarding homes that house some of New Jersey’s most vulnerable residents — including the elderly and the mentally ill — were cited for being insect-infested, dirty or unsafe over the past two years, a Star-Ledger review of state inspection records has found.
The boarding homes singled out by inspectors, many in cities, showed a pattern of grim conditions posing safety and health risks, state Department of Community Affairs records show.
Many of the 2,800 people in the 125 "class c" boarding homes suffer from illnesses such as bipolar disorder, schizophrenia and severe depression. Some are former psychiatric patients and others have a history of drug abuse. Some homes only house seniors and people with dementia. While not nursing homes, these boarding homes provide an element of medical supervision.
The records show a handful passed annual inspections with flying colors, and many were cited for routine home-improvement issues: paint the ceiling, fix a banister, replace a broken mirror, clean a toilet.
But other recurring violations highlight basic sanitary and safety issues:
• More than a dozen had a bed-bug problem. Four were plagued by infestations of flies, including one in Trenton also cited for a mouse infestation. Mice also moved into the pantry of a home in Camden. A bedbug infestation at an Ocean Grove home began in January 2008 and wasn’t eliminated until this May.
• Housekeeping and sanitation is a consistent problem, records show. At least 14 homes were cited for not providing fresh linens often enough or having dirty bedding on residents’ beds, and 14 were ordered to deal with the "noxious odors" or urine smell in bedrooms and bathrooms. At a Plainfield home, inspectors found 14 of 54 residents had dirty bed sheets, or none at all.
• At least 10 homes were cited for having food beyond its expiration date, and others for improperly storing it. At a boarding home in Newark, owners were ordered to remove spoiled and undated food from the refrigerator, keep dogs out of the kitchen, and clean a puddle of dog urine on the kitchen floor.
• At least 25 homes were cited for safety issues, such as no carbon monoxide detectors, chirping or broken fire detectors, or no records of fire drills. At a Red Bank home, residents told inspectors there hadn’t been a fire drill in more than a year. Fire safety is a sensitive issue for the boarding home industry — in the early 1980s, more than 60 died in boarding home fires in Point Pleasant, Keansburg and Bradley Beach.
• At least 25 homes were cited for medicine-related violations, such as lacking records of drugs administered, signing off on wrong dosages or leaving medicine in common areas or residents’ rooms, where anyone could have access to it. Staff members are licensed to make sure residents take medication and that it is secured.
"The general conditions range from barely acceptable to deplorable," said Bob Davison, executive director of the Mental Health Association of Essex County. "About half of them are reasonably done. The other half are very problematic and the conditions are inhumane."
The homes, which provide a bed, meals and limited medical supervision at a low rent, are the cheapest option for people whose income is based on federal Supplemental Security Income, Social Security or welfare. Many residents can’t afford, or are mentally incapable of maintaining, their own apartments.
The homes are inspected annually by the state Department of Community Affairs, which can fine owners for a multitude of violations. Inspectors revisit until are the violations are fixed. The Department of Human Services handles discharges from state hospitals and follows up with the patients.
"In general, the department does not find boarding homes to be in bad condition," DCA spokeswoman Lisa Ryan said. "If a boarding home is found to be repetitively noncompliant, the facility is placed on probation and closely monitored until compliance is achieved."
The issue of boarding home conditions recently attracted attention when state Sen. Richard Codey (D-Essex) showed up for surprise inspections at some, television cameras in tow. Codey, a longtime advocate for mental health issues, demanded a Newark boarding home be shut down in May after a resident was assaulted outside the building. The state returned to the house but didn’t find sufficient violations to close it.
Advocates also worry elderly residents who now live at the Hagedorn Pyschiatric Hospital in Lebanon Township could wind up in these boarding homes after the hospital is closed.
Ellen Lovejoy, spokeswoman for the Department of Human Services, said patients are discharged to boarding homes from state psychiatric hospitals "sporadically" and with residents’ consent. She said Hagedorn’s closure is not expected to increase discharges to boarding homes.
Though it’s a privately run industry, advocates for the mentally ill say the state can do more to improve the quality of life for residents, including more inspections. Codey said responsibility for the homes should fall to Human Services or Health, instead of the DCA, which handles building codes but not mental health services. Ryan said the DCA inspects housing conditions across the state, and refers any health problems found to other departments.
Boarding home owners, meanwhile, say conditions would improve if the state provided financial help. "A reality of the boarding homes is you get what you pay for," said Steve Heisman, who runs a Monmouth County nonprofit agency that has two boarding homes. A home he runs in Red Bank was cited for expired food in the refrigerator, improperly administering medication, and for bed bugs.
Heisman said his group loses $100,000 a year, even with rigorous fundraising to help offset the cost of running the homes. "Because you can’t afford to pay a lot, maybe you don’t get the highest quality of help, which then leads to not-so-great judgment calls and you may have a problem once in a while," he said. "
Carolyn Beauchamp, president of the Mental Health Association of New Jersey, said boarding home conditions can vary.
"Many of them are very concerned (about residents), some of them could care less. It’s like any other industry," she said. "The problem is we don’t have a good system for setting the standard for these homes. I think we need to find a way to get these places up to snuff and improve them."