ESTATE OF JOSEPH GAMMA VS. CEDAR HILL HEALTHCARE CENTER(L-0199-11, ESSEX COUNTY AND STATEWIDE) <strong></strong>, A-3544-13T4

Joseph Gamma, a Cedar Hill nursing-home resident, was found on the floor on Jan. 8, 2009; he told staff he rolled/fell out of bed. He later suffered complications and died on Mar. 12, 2009.
Plaintiffs (wife and Estate) sued claiming the fall resulted from a bed without rails and asserted causes including violations of the New Jersey Nursing Home Responsibilities and Residents' Rights Act (the Act) and negligence.
Pretrial: the motion court dismissed many claims but denied summary judgment on negligence and Act claims and admitted Joseph’s out-of-court statement under the medical-treatment hearsay exception.
At trial: the court directed a verdict for defendants on the Act-based counts; the jury returned a no-cause verdict on negligence. Plaintiffs appealed; defendants cross-appealed on hearsay rulings.
Appellate outcome: Court affirmed the directed verdict on the Act claims and the admissibility of Joseph’s statement, but reversed and remanded for a new trial because the trial court failed to follow the Supreme Court’s Administrative Directive requiring at least three open-ended voir dire questions to each juror.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether failure to ask open-ended voir dire questions (Administrative Directive) requires reversal	Judge must ask the Directive’s three open-ended questions; failure prevented meaningful assessment of juror bias	No reversible error; overall voir dire and counsel follow-up sufficed	Reversed and remanded: trial court abused discretion by not following Directive; error not harmless
Whether violations of state/federal regulations constitute private causes of action under the Act	Any violation of a statute/regulation by a nursing home gives rise to an Act claim (N.J.S.A. 30:13-3(h))	Act limits private causes to enumerated resident rights; responsibilities do not create an unrestricted private cause	Affirmed: Act does not create a private cause to enforce general nursing-home responsibilities; directed verdict proper
Whether Joseph’s statement to nursing-home staff was inadmissible hearsay	Plaintiffs: statement admissible under medical-diagnosis/treatment hearsay exception	Defendants: statement is hearsay and should have been excluded; without it plaintiffs’ case fails	Affirmed: statement admissible under N.J.R.E. 803(c)(4); motion court did not abuse discretion
Whether the motion court should have granted summary judgment excluding Joseph’s statement	N/A (plaintiffs rely on statement)	Motion court erred in admitting statement at summary judgment stage	Rejected: appellate court upheld admission and denial of summary judgment

Ptaszynski v. Atl. Health Sys., Inc., 440 N.J. Super. 24 (App. Div. 2015) (limits private causes of action under the Nursing Home Responsibilities and Residents' Rights Act)
State v. Morales, 390 N.J. Super. 470 (App. Div. 2007) (administrative directives from the Supreme Court are binding on trial courts)
Gonzalez v. Silver, 407 N.J. Super. 576 (App. Div. 2009) (purpose of Directive is to empanel a jury without bias; voir dire obligations)
Greenfarb v. Arre, 62 N.J. Super. 420 (App. Div.) (hearsay exception for statements relevant to diagnosis/treatment may include statements about cause when sufficiently trustworthy)
R.S. v. Knighton, 125 N.J. 79 (1991) (explains the treatment-motive rationale underlying the medical hearsay exception)