NJ group home staff are overburdened and underpaid, leading to care lapses

A caregiver left alone struggled to save four women with disabilities — only one who could walk unattended — when fire broke out at their group home.

Another group home worker said she was “thrown to the wolves,” forced to learn on the fly that one resident was prone to seizures and another would smear feces on walls.

An aide with a criminal record pulled a knife on a colleague who confronted him for having sex on the job with a woman he brought to the group home.

Workers on the front lines of New Jersey’s group home system provide critical care for adults with intellectual and developmental disabilities amid chronic understaffing, low pay, and a lack of preparation and support that puts them — and vulnerable residents — in jeopardy.

“It becomes a very scary situation because you don’t feel prepared,” said Charmaine Cohen, a former group home caregiver and manager.

To understand the challenges group home workers face, NorthJersey.com interviewed dozens of staffers — aides, managers and supervisors — across dozens of companies and read through thousands of pages of public records, including police reports, lawsuits and inspection reports.

Many workers spoke on the condition that their names not be used, fearing for their jobs or legal repercussions.

Direct support professionals, commonly known as DSPs, are responsible for bathing and feeding group home residents and helping them use the bathroom. They monitor health needs, bring people to doctor’s appointments and dispense medication — often a complex mix of prescriptions.

They are also tasked with helping residents learn new skills and taking them on outings in the community. They must grasp technical behavioral plans and strategies to de-escalate or prevent harmful habits, including residents who hit themselves or others, throw feces or break furniture. In many cases residents don’t speak, and it takes time, patience and experience for workers to understand what they want and need.

“It’s not a simple job. It is very complex, one that I would not do, or could not do,” said Valerie Sellers, CEO of the New Jersey Association of Community Providers.

And they’re supposed to do it all for little more than New Jersey’s $15.49 minimum wage — an average of about $20 an hour, according to the state.

“I have staff that are begging for overtime just so they can pay their rent,” Lynne Rockstroh, group home director at a Diocese of Paterson home, told state officials during a public listening session on direct care workforce needs.

Staffers churn through a system that has been slow to professionalize — certifications, licensing or other credentialing are not prerequisites for the job. New Jersey’s turnover rate for DSPs is 36%.

Desperate for staff, agencies lower standards; resident care suffers. Police reports show fights between group home workers, and theft by employees of money, medication and other items from residents. Worse, families point to caregivers who hurl insults such as “retard,” ignore resident needs, sleep on the job and strike residents in anger.

“It was like they were just hiring people just for a body in the house,” said Maurica James, a former manager at Community Options.

Longstanding issues with staffing were only exacerbated during the COVID-19 pandemic.

“If you could fog a mirror, they were putting you in a house and training you along the way,” said David Wyher, the president of Delta Community Supports. “That is something that obviously led to a lot of those issues for a lot of different organizations.”

What’s more, companies trying to entice potential workers leave out critical tasks. Not being up front about all the responsibilities increases turnover and leaves new staff members unprepared.

“When they do hiring, they need to let everyone know, no matter where you work at, if there’s diaper changing or what have you, you have to do it,” said Iris Mayfield, a former DSP at Allies. “If that’s something you cannot do, we cannot hire you.”

Workers who didn’t want to change diapers would leave the residents soaked or in their excrement so the next shift would do it instead, Mayfield said, echoing concerns expressed by other staff across the system.

“They hire these young kids straight out of high school — 19, 20 years old,” Mayfield said. “They don’t know nothing. The training when I started was two weeks straight. Now it’s only four to five days, and they put them out in the field. You got these young girls, saying ‘I’m not wiping nobody’s ass. I’m not cleaning up no shit. They didn’t tell me this.’”

“This is why,” she said, “we have a lot of failures.”

Persistent problems

Many of the issues the workforce faces today were baked into the system decades earlier, when the U.S. began shifting people with disabilities out of large institutions segregated from the public and into group homes scattered throughout communities.

“Historically it has been seen as an unskilled, entry-level type of job that basically anybody could do,” said Joseph M. Macbeth, president and CEO of the National Alliance for Direct Support Professionals. “In fact, this job requires a high level of judgment, independent decision-making abilities, dealing with crisis situations.”

Yet he said salaries are “shameful,” even in New Jersey, where the average wage for a DSP is the third-highest in the country. Workers are viewed as expendable and “aren’t trained for the complexity of the work,” he added.

“The reality is, a direct support professional who may make a mistake could cost a life,” Macbeth said.

Many in the industry, including some group home providers, say there’s a workforce crisis — but experts say that description belies the depth of the problem.

“These are persistent problems; they have been around since the inception,” said Amy Hewitt, the director of the Institute on Community Integration at the University of Minnesota. “To call it a crisis is a bit of a misstatement, because it’s so perpetual.”

The makeup of the workforce — overwhelmingly women, people of color and recent immigrants — plays a role. In New Jersey, DSPs are 72% female and 49% Black, according to a 2023 workforce survey.

“As a profession, the bias around those factors plays into what our society has been willing to do acknowledging and respecting the profession,” Hewitt said.

Finding people to do the job has always been hard, but recent societal and political forces are making it even tougher, agency leaders say.

Krystal Odell, the CEO of PennReach, said the agency lost young mothers who had to stay at home with their own children during the pandemic. And now, with the Trump administration’s crackdowns on immigration, the foreign workforce the company relies on is shrinking.

Hundreds of lawsuits by workers in New Jersey are a testament to the turmoil in the system, representing more than a third of the 1,000 cases filed against group home companies reviewed by NorthJersey.com, most within the last decade.

Many workers allege they were unjustly fired, robbed of pay, denied medical leave when injured on the job, harassed and discriminated against. Notably, there are whistleblower complaints, in which staff members say they alerted the state and their employers to understaffing or the abuse and neglect of residents.

Some cases are pending, settled, or dismissed. In other cases, workers may have signed arbitration agreements – and unlike a civil lawsuit, arbitration proceedings are kept confidential.

When something goes wrong, Macbeth said, the focus is often on the DSP, not the underlying cause. He said workers “can often be the scapegoat” during investigations when the issues are far wider.

New Jersey has taken steps to improve. In recent months, it doubled its basic training for DSPs and supervisors, increasing the requirements from about 30 hours to 60 hours. It added new online classes on topics such as ethics, Medicaid fraud, and life-threatening conditions, including seizures, pressure injuries and infections.

The state agency that oversees group homes, the Department of Human Services, declined to allow NorthJersey.com reporters to view those classes.

“Assigned access is authorized through the DSP’s employer, so Human Services is unable to provide access,” said department spokesman Tom Hester.

New Jersey recently launched a program to forgive student loan debt for about 450 DSPs and allocated $3 million to certify up to 3,000 direct support professionals. Put into perspective, there are an estimated 30,000 DSPs across New Jersey. The federal government doesn’t track DSPs as a distinct job category, so exact data is not available.

The state also created a job search website, aired ads to attract new workers, hosted listening sessions to learn about the workforce’s needs and challenges, and partnered with two community colleges to build DSP career development programs.

Since 2018, the Murphy administration has raised DSP and supervisor wages from $12.66 on average to roughly $20.87 an hour through this fiscal year — a cost of $1.5 billion in state and federal funds, Hester said. The system is primarily funded through Medicaid.

Job postings reviewed by NorthJersey.com show starting salaries as low as $17 an hour.

“We’re not valued the way that we want to be,” manager Melissa Duffy said at a state listening session. “We are all in this job for the individuals. No one is here to make a million dollars.”

Meanwhile, executives of the more than 130 nonprofit and for-profit companies operating group homes in New Jersey can collect large paychecks. Among New Jersey’s largest nonprofits, executive paychecks range from $428,000 to $1.2 million, according to tax filings.

DSP pay is far below the $25-an-hour goal that advocates say is a living wage.

Sellers, of the New Jersey Association of Community Providers, argues the system was underfunded from the start of New Jersey’s switch from a contract-based system to a fee-for-service one, where providers bill for services already provided. Inflation is exacerbating that gulf, she said.

At least one group home CEO disagrees.

“It’s easy to say, ‘We need more money.’ We don’t need any more money. The money is there,” said Steve Setteducati, CEO of New Concepts for Living. “They need to concentrate on efficiencies and concentrate on accountability. A lot of agencies have a lot of layers of management that they just simply don’t need.”

The state repeatedly documents low staffing levels, as well as a lack of proof that background checks on workers and training on the needs of group home residents have been done.

There are few consequences for providers who don’t follow the rules.

And so the dangers continue.

‘Don’t let me die here today’

The frightening event that transpired in the early hours of May 24, 2021, would continue to haunt Jeanne Monagon, waking her up at night with memories of the heat, the smoke, and the elderly resident she couldn’t get out of a burning group home before the fire intensified.

“Sometimes when I was sleeping at night, I can hear that lady screaming,” said Monagon, a native of Cameroon.

Monagon was alone at the home run by Allies caring for four women with disabilities — two of whom needed wheelchairs, and another who needed a walker — when the fire broke out.

She was nearly an hour late for the 11 p.m. shift, relieving another caregiver who by that point had worked nearly 17 hours — more than half of it alone.

Monagon did not want to work that evening.

The shift conflicted with her husband’s job. She argued with an Allies supervisor on the phone — and her husband — before finally leaving the house. She said she was told she was obligated to work; she recalls later texting to a supervisor that she wasn’t obligated to work alone.

Monagon was folding laundry at around 2 a.m. when she heard a popping or crackling noise. At first, she thought it was the radio that one of the residents kept on at night.

But when she opened the back door, she saw the fire.

She screamed out the name of the only resident who could walk on her own, ran to her room and directed her out.

Next, she maneuvered the youngest resident out of bed, into her wheelchair and out the door.

Monagon said she went back for a third woman who could walk slowly with a walker but “doesn’t like when you rush her.”

“When I try to push her a little bit, she sit down on the floor,” Monagon said. “She lay down on the floor.”

By then the fire was inside the house.

“At that point, I was pretty sure that I’m going to die,” said Monagon, her voice tinged with emotion. “I remember what I said in my language. I lift my head up, I start crying, and then I say, I say to God, ‘Please, look, my kids. They’re still little. Don’t let me die here today.’”

Monagon got her arms under the third resident and dragged her out the door.

By then police had arrived, and Monagon was screaming for help from the front porch. They had to stop her from going back into the burning house for the fourth woman, Beverly Maze, who was in her 70s.

“Oh, God, oh, God,” Monagon can be heard saying on police body camera video. “I have to get her.”

“She’s not well,” Monagon tells them. “She have a wheelchair.”

Police officers tried to enter the house through a side door, getting about 15 feet before the smoke and heat beat them back.

Maze was rescued by firefighters, who pulled her through a bedroom window. One officer called it “a miracle.”

Maze had soot around her nose and mouth; the fire marshal wrote he could not see if she had burns. She was transported to Thomas Jefferson University Hospital in Philadelphia, which has a burn center, while the other residents went to a nearby hospital.

Maze died about 10 weeks later. It’s unclear if the fire played a part in her death. Official reports do not indicate any fatality resulting from the blaze that destroyed the home.

The fire was ruled an accident. Fire officials believe it was started by a cigarette discarded near the deck, or by the smoker’s outpost, which may have ignited nearby bushes. Monagon doesn’t smoke, but the worker she replaced had been smoking outside.

An Allies official told police that Monagon was working alone “due to staff shortages as a result of call outs.”

Allies did not return calls, emails or a certified letter request for comment.

The state investigated, and Allies was required to develop a policy on fire prevention, create a “flow chart of expectations” on communication when filling shifts, and put in “tighter procedures for call outs and finding fill-in staff,” said Hester, the state spokesperson.

A year later, Monagon was fired for neglect — a charge she disputes. When she asked for more information, Allies wrote that “the agency does not send out any documentation concerning investigations.”

Impacts of understaffing

Understaffing can also lead to delayed medical care, or limit a resident’s ability to leave the house.

A direct support professional at Allies said that when there weren’t enough staffers to take a resident to the doctor, aides would reschedule and tell guardians it was the doctors who had changed the appointments.

A caregiver said the staff at Spectrum for Living would prioritize the medical appointments for residents who had involved family, as opposed to people with state guardians.

Brian Ross, a 25-year-old man with autism, would miss his day program “three out of five days because they didn’t have people to transport him” at Community Options, remembers his guardian, Laurie Densen. He would also often miss his Sunday social skills program at a community center because the only available staff would be taking his housemate to church in Newark.

“It’s not fair they decide who gets to go and who doesn’t,” Densen said.

Community Options Executive Vice President Svetlana Repic-Qira wrote in a statement that the agency maintains “a robust internal auditing system,” which includes reviews of staffing ratios.

A housemate of Jacquelyn Kaminski bit her finger and arms, and hit her on her head and back, the staff told her mother, Liz Filipovsky. When she sent an email to Broadway Group Home leaders, the house manager apologized for the attack.

“It was supposed to be three staff on shift last night but for whatever reason it was two staff on shift,” he wrote.

RHA Health Services, which bought Broadway in 2023, wrote in a statement, “We are committed to providing high quality services in safe and healthy environments for the people we serve.”

Zhanna Basina, the CEO at the time of the sale, did not respond to a certified letter request for comment.

When Lisa Rollins called an APluscare care group home to check on her son, Kai, the staffer who answered “was crying because she needed to go home. She was there for two days, and no one else showed up for work.”

NorthJersey.com called, emailed and sent a certified letter to APluscare asking for an interview.

A director said privacy law prevents the company from speaking about residents. “We can however confirm that the allegations described in your letter are simply not true,” said Anndrea Yetter, senior compliance director.

Caregivers have told state regulators they are fatigued.

“Staff doesn’t feel comfortable being the only staff working,” one state inspector wrote in a surprise visit report to Elwyn.

“The staff member feels as if she is getting burnt out,” wrote another. “She said with the staff shortage she is working a lot of hours.”

Elwyn directed NorthJersey.com to the New Jersey Association of Community Providers to speak on the agency’s behalf.

A pregnant worker was told by her supervisor that she had to stay at a Spectrum for Living group home for a third shift in a row. She clocked in at 7 a.m. and had already worked until 11 p.m. — and was then asked to do an overnight shift.

“It would happen quite often: ‘Could you stay ‘til this time, just until someone else comes?’” the worker said. “That would happen almost every day for my shift at Spectrum.”

Spectrum for Living declined to comment.

A year ago, the state sent out a memo reminding providers that DSPs are not allowed to be “regularly scheduled” to work more than 16 consecutive hours in a day.

Group homes had 425 confirmed cases of staff shortages last year, according to data reported to the state.

It’s also not uncommon for workers to juggle jobs across multiple companies to make ends meet. One worker estimates she would log 80 hours a week filling shifts for Community Access Unlimited, The Arc of Essex County and Our House.

“If the staff was working a bunch of shifts, of course they’re not at their best,” she said. “They’re tired, they want to go home.”

Seth Carr suffered a panic attack last May after no one arrived to relieve him at the Community Options group home for hours. He called the Deptford police and was taken to the hospital.

“I didn’t feel safe there by myself with the guys because I have anxiety and I’m overwhelmed, and obviously that’s why I called the police,” Carr said. “The person before me was on a shift for 20 hours.”

The group home was supposed to have three people on shift, according to a staffing schedule for the house on file with the state. Yet Carr was working alone.

The Deptford police sergeant decided units would take turns sitting at the group home since the four residents “can’t care for themselves,” he wrote in a police report. Carr hadn’t given the residents their evening medications, and police found two of the four residents lying in feces and urine.

Community Options can’t comment on specific individuals or employees, Repic-Qira said. In a statement, she wrote, “Ultimately, Community Options is committed to the dignity of every person, and to the health and well-being of all who have been entrusted to our care.”

Police step in

Police are called on to fill in where workers cannot, NorthJersey.com found after reading thousands of police reports at hundreds of group homes across the state.

Aides ask law enforcement to follow or find residents who ran away because the sole worker on shift couldn’t leave the other residents alone. Concerned neighbors call for help when they find residents wandering the streets alone.

For example, the sole Delta staff member on shift called police after a resident ran away three times in one day, state documents show.

People with disabilities called 911 because they were left alone in their group homes or felt lonely or mistreated by staff.

A Willingboro resident at a Community Options house called police saying a new employee was watching television too loudly and was being disrespectful toward him. He “confirmed that he only called the non-emergency number to have someone to talk to,” police wrote.

A Friends of Cyrus resident in Kendall Park also called police because he “wanted to talk to someone.”

“He is depressed,” police wrote. “Just seeking advice.”

Other times, workers called police from locked rooms, asking for help to calm residents throwing objects or feces, exposing their genitals, breaking furniture or threatening to kill staff. Aides say they aren’t properly trained to handle such situations or lack the support of behaviorists and other professionals.

New Jersey recently started tracking attacks on staff. In 2024, group homes confirmed 28 instances where workers were hurt and needed more than basic first aid to treat their injuries, according to state data.

A female employee left alone with four male residents at a Community Options group home in Cherry Hill called the police — the fifth time that week — after a new male resident spit on her, threatened to kill her and pulled the fire alarm. She told police she was alone because “other employees are refusing to go to work because of [the resident’s] conduct.”

Broadway Group Home workers called Monroe police about one resident at least 23 times in a little over a year. The resident pulled an aide’s hair out of her head, pushed and shoved staff, threw chairs, shattered a van’s window and yelled out racial slurs.

“I spoke in length to several of the staff members in person and on the telephone that the amount of times that the police are being called for [the resident] is alarming,” an officer wrote in a report. “I informed them that if they are unable to safely control him then they need to transfer him to another facility that can do this.”

‘Thrown to the wolves’

Many staff members said they are left to learn resident behaviors and decipher complex — and sometimes outdated — service plans on their own.

Training felt rushed, said one caregiver: “They’re kind of shoving the information down your throat.”

Another described the start of their job as being “thrown to the wolves.”

“This client, at night he’ll smear feces all over the bathroom. Nobody told me that. Or this client, he has seizures back-to-back, nobody told me that. I just had to figure it out,” the caregiver said.

When one manager started working at a new house, she learned her staff hadn’t taken orientation training or received training about the specific needs of the individuals in the house.

“I even asked the staff, ‘When you came in, if you didn’t get trained, did you even read about the client?’ And they said ‘No,’” said James, the former manager at Community Options.

Her staff didn’t know about two residents’ specialized diets; she had to show them the menu book.

“This is their first time hearing about this,” she said.

Workers are supposed to read a service plan or a behavior plan, and take classes on control techniques to use in response to aggressive behaviors, said Sellers, with the New Jersey Association of Community Providers. When told workers don’t feel prepared, Sellers said she didn’t know how else DSPs could learn about residents.

“There are a lot of people that go into their first group home and are shocked by behaviors; they weren’t expecting to go into a home where they might have feces thrown at them or be hit,” Sellers said. “I don’t know what to say when the DSP says it’s too much for them, and I’m certainly not trying to appear to be callous, but then this isn’t the right field, because it’s a part of the job.”

A former DSP said her supervisors demanded she change an individual’s colostomy bag without training her how to safely handle the pouches that collect waste.

“I didn’t know how to clean it or anything, so if it got infected, like, that’s her life, basically,” she said. “I’m reporting this and nobody’s doing anything about it.”

Another worker said companies have tried to train staff over the phone about how to give insulin injections.

“Training for insulin over the phone is…what the [expletive]. Sorry for my language, but like, you don’t mess with that,” the worker said.

On the flip side, comprehensive training run by a professional can make a huge difference.

Workers at New Concepts for Living, for example, describe a completely different process from simply reading a service plan. A behaviorist trains staff on each individual they will care for. The expert explains the residents’ triggers for outbursts and how to de-escalate them, how their equipment works, and what they can eat.

“They prepared us for what we’re actually going to do,” one manager at New Concepts for Living said.

Another worker explained the gulf between two companies’ training on how to thicken liquids used for residents with swallowing disorders. At one company, the worker was handed a flyer. At another, the worker’s manager “stood and watched me make it until I got it to the right consistency. That should be the standard,” the staff member said.

New Jersey requires DSPs and supervisors to take a series of about 30 courses. Some need to be completed before they start working, others up to six months out.

Most are standardized classes that workers take online, including preventing abuse and neglect, life-threatening emergencies and reporting incidents. A couple incorporate onsite competency assessments, including medication training required only for workers who administer medications.

“Yes, I think there is adequate training, absolutely,” Sellers said. “You’re telling me somebody goes through 60 hours of training and they don’t think that they’ve gotten enough training? I don’t know how that could be.”

One worker said colleagues would “just speed through” the online courses or “be on the phone while the video is playing in the background.”

“And when it comes time to take the quiz, it gives you infinite times to retake it, so they just keep retaking it, and it’ll tell you what your wrong answers are,” the worker said. “They’ll take photos of the right answers and they’ll give that to their friends that work in the company.”

Other training is developed by the group home companies themselves, such as the organization’s mission and policies, backgrounds on the residents and their diet, medical and care needs, and safety procedures for the house.

Many workers noted it was these specific group home training sessions — or the lack of them — that left the workers feeling unprepared.

And state inspection reports show workers are not always trained as the state requires, or that companies don’t have the paperwork to prove their employees took the required courses or assessments. For example:

• At seven of 12 sites run by Universal Institute, staff hadn’t signed documents required to show they had completed training on topics such as adaptive equipment or medical diets.

• At Allies homes, the state found a “pattern of failure” to assure that staff took required orientation and specialized training.

• Community Options received 14 licensing punishments in 2023; in nine homes, inspectors noted “substantial noncompliance” and the company’s “failure to assure that all staff persons are trained” in the residents’ needs, behavior plans or other topics, such as evacuation procedures.

Building a career ladder

Unlike a nurse, or home health aide, group home workers are not required to have professional certifications or licenses.

Building a career ladder helps retain skilled workers, Macbeth said.

The National Alliance for Direct Support Professionals, the organization he heads, offers a certification program for three levels of DSPs, where users earn badges as they prove they have gained specific skills such as crisis prevention, documentation or building relationships.

And as DSPs earn credentials, their wages should increase, Macbeth said. Pennsylvania, for example, launched a program to increase payments to providers that credential a percentage of their staff. The agencies must attest that a portion of new funding will pay staff increases or bonuses.

“If I can make more money by showing you how good I am, I’ll show you how good I am,” Macbeth said.

Some companies are trying to attract workers by offering support for continuing education.

Devereux Advanced Behavioral Health launched a “career accelerator program” that offers tuition reimbursement, career coaching and loan redemption. In the year or so the program has been offered, Devereux has seen recruitment numbers up, turnover and vacancy rates down, and disciplinary reports decrease nationally. In New Jersey, more than 40 DSPs are participating.

Currently in New Jersey, the base requirements to be hired as a DSP are few: A person must be at least 18 years old and have a high school diploma or equivalent, according to state rules. If driving is required for the job, they must have a driver’s license and a good driving record.

Competent DSPs can be quickly promoted to management, having to learn a new oversight role on the fly. The state does not require managerial training, though full-time DSPs and their supervisors must complete 12 hours of “professional development.”

And they may be forced back into their old roles when there is understaffing, filling shifts themselves.

“They’re spending enormous amounts of their time trying to get shifts filled and get new people on board, so then they have less time to support, guide and direct, which is what a supervisor is supposed to do,” said Hewitt, of the Institute on Community Integration at the University of Minnesota.

A mother with a son in a Benchmark Human Services group home in South Jersey said, “There have been times with good management, it was so sparkling clean you could eat off the floor. Then we go through periods where nobody seems to give a shit.”

Mike McCarthy said his son’s Broadway group home in Wayne suffered from high turnover in managers, one of its biggest problems.

“They either leave because they’re not competent, or they’re not getting the proper resources,” McCarthy said. “Then another manager would come in, and it’s like we’re starting from scratch again.”

When Alexandra Troncone was hospitalized with “severe protein-calorie malnutrition,” weakness and a kidney infection last spring, her support coordinator — essentially a caseworker — submitted a report alleging neglect, which was investigated and substantiated by the state.

The incident report noted that since Alexandra had been placed in the group home run by Keystone Community Resources, the agency “had constant turnover of both managers and staff. This has resulted in the staff being uninformed about Ms. Troncone’s dietary needs.”

Alexandra was down 26 pounds, to 89 pounds, hospital records show. The staff had not properly monitored her weight or addressed the loss. And she had not seen an endocrinologist for more than two years for her thyroid condition. A state investigative report indicated that the staff pointed to turnover in management when asked about the lapse.

The provider cannot comment on individual cases, said Lisa Coscia, president of Beacon Specialized Living, an affiliate of Keystone.

James, the a former manager at Community Options, put it bluntly: “All the managers were overworked, tired, and it’s like we don’t get a break.”

Relaxed standards

The more desperate agencies are for workers, the more standards are relaxed.

“People with a criminal record are encouraged to apply” appeared in advertisements for group home staff by Beacon Specialized Living, formerly called Enable, Inc.

“We only hire applicants who have been cleared by the Department of Human Services,” Coscia wrote in a statement.

Group homes cannot employ anyone who has a record of abuse or endangerment of a person with a disability, or other violent crimes such as murder, assault, terroristic threats, sexual assault or robbery.

Someone with a criminal background still has a chance to be hired if they show they have taken steps toward rehabilitation, such as counseling or showing good conduct in prison or the community.

One group home supervisor, for example, has an arrest for stealing from a previous employer, according to documents from the Hackettstown Police Department and the Warren County Prosecutor’s Office.

Another agency hired a man with a lengthy arrest record that included assaults and racketeering. He later threatened a colleague with a knife after being confronted about having sex with a woman he brought to the group home while working the night shift, and was charged with making terroristic threats, said a Hopewell police report and court records.

The Hopewell officer wrote in his report, “It should be noted that [he] has an extensive criminal history with numerous assault charges and an attempted murder charge, which is still pending.”

Group home companies are supposed to run a host of background and drug checks before staff can start working with residents with disabilities — and periodically after — but licensing records show they are not always done. For example:

• The state found a “pattern of failure” that Elwyn didn’t have required personnel clearances, paperwork and training in a 2021 inspection — a repeat offense.

• The state requires companies to conduct background checks on their employees every two years. 21 Plus didn’t have results of two-year background checks for 36 staffers in a 2023 inspection.

• Universal Institute didn’t have records that the company ran criminal background checks for six employees within 10 days of hiring them in 2018 — one worker was hired in 2014, and his fingerprints were not run until 2017.

The Department of Human Services supports a bill that would suspend resident admissions and then fine group homes that don’t conduct required background and drug checks on employers.

Parents have learned staff members ignored residents, entertained friends and drank alcohol or smoked pot on their shifts. Police have been called, records show, when fights between employees turn physical.

A worker’s arm was bruised and swollen after another employee struck her with a bag that had a metal water bottle inside. An aide twice threatened to beat up her coworker, who was 27 weeks pregnant. Two employees threatened to beat up their manager after being placed on unpaid administrative leave. A male worker said he would punch his female coworker in the face if she continued to talk.

Families find staff sleeping on the job — one parent showed a video of workers snoring in the daytime.

“It’s just flat-out ridiculous; just do your freaking job,” said the parent, who has caught multiple workers sleeping at her son’s group home run by Friends of Cyrus. “You are not here to go to sleep. These are the people that are taking care of my son.”

Tommy Schiavone, a 21-year-old man with autism, noticed that his caretaker at Beacon Specialized Living was wobbling and slurring his speech. The aide was acting strangely when he drove Tommy to Wawa that day. And later, the aide ran out of the supervised apartment, leaving the four residents alone. His bag was on the counter. Inside were mini-size bottles of 99 proof mango-flavored schnapps, a photo shows.

Tommy’s mother received a bare-bones letter from Beacon three months later that said “no neglect found on multiple allegations.”

In New Jersey, group homes largely police themselves, investigating the majority of allegations.

“I have called the police multiple times for my own safety,” Tommy said, such as when a housemate acted aggressively. “If I wasn’t at the apartment at the time of the alcohol situation, it would have never been noticed or recognized.”

Tommy said workers “call me retarded, a liar, non-trustworthy.”

“They try to make me feel bad,” Tommy said.

In March, Beacon substantiated an allegation of verbal abuse. Tommy recalled that a worker said “I was the reason why nobody liked to work here, I’m the reason why people get fired.”

Beacon wrote that “appropriate actions were taken.”

When Tommy’s mother asked for an investigation report, Beacon did not respond, she said.

“While we cannot comment on individual cases, the examples brought to our attention show we reported and/or investigated incidents of concern and took appropriate action on substantiated matters,” Coscia, the president, wrote in a statement.

“In 2024, our New Jersey facilities verified five allegations of physical misconduct and six verbal misconduct allegations,” Coscia wrote. “While this rate is low, even one incident is too many.”

Beacon did not substantiate eight other allegations of physical abuse and seven other allegations of verbal abuse in 2024, state data show.

Other times, staff members reach out to families with concerns.

Debra Flagg said that a few years back she was warned by a former worker about conditions at her son Adam Morris’ P.I.L.O.T. Services group home, and how staff would “verbally abuse Adam,” calling him “retarded” and other names.

“Adam has been abused for a very long time by that staff,” a worker said in a recording made by Flagg, “and they never, they never did nothing about it. I know so much stuff.”

She said when another resident broke Adam’s nose at a day program, the attack was provoked by the staff.

“They knew that guy was going to punch Adam,” she explained. “They set that up.”

The worker said staffers “cover for each other,” have people in the house who don’t work there, drink, get high, and sleep on the job and use money meant for residents to buy their own groceries.

“They don’t do anything to keep the good ones,” Flagg said. “And they’re not, you know, from what I’m hearing, they’re not doing anything to bring in the best people, and then the good people you do have get disgusted after a while.”

P.I.L.O.T. Services Executive Director Allen Samuels declined to comment on specific cases.

Many families and workers described how staff stole food, money, clothes, medication and electronics that belonged to clients — a common complaint. And some workers say their colleagues use money meant to buy residents food and other items for their own needs such as groceries and gas.

Iris Mayfield said she reported former colleagues at Allies who she said would take home duffel bags of name-brand food meant for residents, replacing the stolen food with supplies they picked up from a food bank.

Advancing Opportunities reported to police that more than $5,400 was stolen from two residents’ accounts in a group home in Byram in 2022.

Community Options contacted South Brunswick police in 2023 after realizing two residents’ accounts were short a total of $18,221. The company found purchases for clothing that were not the resident’s size and receipts for purchases made at locations far from the group home, in Maryland and Yonkers, New York.

The group home suspended the program manager in charge of the funds. Three months later, the manager mailed two $8,500 cashier’s checks back to the residents. The residents were still missing more than $1,200.

“Staff who deviate from accepted protocol or break the law are subject to suspension and potential termination pending the outcome of an investigation, and Community Options cooperates fully with regulatory and legal authorities,” wrote Repic-Qira at Community Options.

Keeping bad players out of the system

It’s unclear if this worker was added to the state’s Central Registry of Offenders — a list of caregivers found to have exploited, abused or neglected someone with intellectual or developmental disabilities. Those on the registry are banned from working with this population in state-overseen programs.

Yet members of the public, and even family members of group home residents, can’t view the confidential database or learn the circumstances behind why a name was added — it’s for employers who serve people with disabilities.

Group home companies are required to check the list each time someone new is added to the registry, or before they hire someone. But licensing records show companies skip these checks or lack proof they were done.

The threshold to be added to the no-hire list is high. The state must find that the person not only committed a serious act against a vulnerable person, but acted “intentionally,” “recklessly” or “negligently,” or showed a pattern of alarming behavior.

That means many people who harmed group home residents with disabilities don’t make the list. Over the course of six years, state investigators substantiated 412 cases of neglect, 267 cases of abuse and 111 cases of exploitation, according to data covering mid-2018 through 2024 obtained by NorthJersey.com through a public records request. And only a small fraction of accusations make it to this level; in most cases, the state leaves group homes to investigate themselves.

About 490 people have made it on the list since 2011, or about an average of 35 people a year.

Workers can also get removed from the list, appealing the placement or later petitioning the commissioner to show they have learned from their mistakes. Twelve have been successfully removed through the end of 2024.

Central registries are a “great start,” said Macbeth, from the National Alliance for Direct Support Professionals. But states need to do more to ensure someone can’t get a job in another state, or in another caregiving field, such as a nursing home, he said.

If a name isn’t on the registry, there isn’t a way for providers to trade information about problematic staffers without fear of being sued.

The group home industry needs its own version of the “Cullen Act,” said Sellers, of the New Jersey Association of Community Providers.

The New Jersey law protects health care facilities from legal liability. It was enacted after nurse Charles Cullen — who later confessed to killing dozens of patients — was able to hop between various New Jersey and Pennsylvania hospitals despite concerns raised by past employers.

“They can leave one agency and wreak havoc and go to another agency,” Sellers said. “You need to keep the bad players out of the system, and we’re not.”

This article originally appeared on NorthJersey.com: NJ group home understaffing, overworking harm residents