Long-term care providers took a legal blow when a New York state Supreme Court judge struck down a legal challenge to the state’s staffing mandate law, and now providers could be days away from incurring heavy fines.
State officials have signaled they are ready to start doling out long-delayed fines of up to $2,000 per day for noncompliant nursing homes “within days,” James Clyne, president and CEO of LeadingAge New York, told McKnight’s Friday.
The 2022 mandate, signed into law by previous New York Gov. Andrew Cuomo (D), set high standards for nursing homes — requiring a total of 3.5 hours per resident per day from care workers. LeadingAge NY filed suit to stop the law, arguing that it places unreasonable burdens on the state’s facilities.
There is some room for cautious optimism for providers, according to Stephen Hanse, president and CEO of the New York State Health Facilities Association. Both Gov. Kathy Hochul (D) and the Department of Health have acknowledged a severe workforce crisis across the state and gave the sector a reprieve of more than a year on any fines from noncompliance with the mandate. State Medicaid reimbursements were also increased by 7.5% in 2023.
The fine reprieve appears to be coming to an end, however, as health officials confirmed that the initial batch of fines were being assessed for enforcement last week.
“We obviously think the judge got it wrong,” Clyne told McKnight’s Friday. “The impact is that, without some judicial help, it looks like New York nursing homes could be penalized even though the state recognizes that there is a health workforce shortage, which doesn’t seem to make any sense to us at all.”
Struggles, slow progress
While facilities may not have to pay the full $2,000 if they can demonstrate their efforts to increase staffing to the government, the potential recurring fines raise worries that facilities already struggling to find workers and resources will now be even more burdened, both leaders confirmed.
“It’s just money you’re taking away from resident care,” Clyne said.
New York facilities are already struggling to fill their staffing needs, and are reliant on the state’s Medicare and Medicaid reimbursement policies for funding. Absorbing the new requirements will be an additional challenge for such facilities.
“It’s unreasonable at best,” Hanse said. “Right now, there are a little over 600 nursing homes in the state of New York. Three-quarters of them cannot meet the 3.5 [hours per resident per day] staffing mandate…. Every nursing home in the state of New York would welcome the opportunity to staff at 3.5. The workers are not there.”
The state’s 7.5% Medicaid reimbursement increase in 2023 hit a historically high mark, according to Hanse, but it has not been enough to meet the financial needs described by sector leaders.
Early in 2023, long-term care groups in New York requested a 20% Medicaid reimbursement rate increase to cover rising costs, years of cuts and the recent pressure of high inflation. Even this would fall short of the 40% increase Hanse estimated would be needed to fully compensate for 15 years of funding cuts for New York nursing homes under previous administrations.
LeadingAge NY is still weighing whether to appeal the judge’s decision, Clyne told McKnight’s Friday. He explained that the decision will become clearer once the expected fines begin to be released and after Gov. Hochul’s budget is announced this week.