A stethoscope on top of a pile of money

Budget season has kicked off in state legislatures, and nursing home providers and advocates are at the front of the line desperately asking for increases in Medicaid rates. 

The temperature is rising in numerous states around the country. In New York, for example, Gov. Kathy Hochul (D) has scheduled a budget with a 5% increase in Medicaid, well below the 20% the sector and labor groups want. More than 20 members of the state’s General Assembly and Senate have called for long-term investments and no new cuts to the industry. 

“New York State has underinvested in Medicaid for years and must increase its spending to match the increasing need,” stated a letter signed by Sen. Gustavo Rivera, (D-33rd District), chair of the Senate Health Committee, and Sen. Cordell Cleare (D-30th District), chair of the Senate Aging Committee. A copy was provided to McKnights Long Term Care News Thursday.

In January 2020, New York dropped its Medicaid rate by 1.5%, which was later reversed. Hochul’s executive budget summary estimates the 5% hike for fiscal year 2024 would cost the state $379 million — nursing homes would get $157.5 million.

“While we are grateful for the increase, it’s not enough to stop the long-term care industry’s free fall,” said Stuart B. Almer, president and CEO of Gurwin Healthcare System, in a statement to McKnight’s. He added that the budget proposal does not address recalculating Medicaid rates, which have not changed in 15 years.

New York, like other states, received additional federal aid from pandemic-related legislative packages. Those funds along with any COVID-19 waivers are slated to end in about three months with President Joe Biden’s recent announcement setting May 11 as the end of the public health emergency. Nursing homes advocates across the country are lobbying hard for more Medicaid reimbursements to help contend with labor shortages and increases to operational costs. 

A tale of two state budgets

In South Dakota, Gov. Kristi Noem (R) proposed an approximate  21% increase in rates for fiscal 2024, which the leading nursing home advocate in the state called a “huge step in the right direction.” Later this month, the state Legislature’s Joint Committee on Appropriations will hear the revenue projections for the next fiscal year, which will ultimately drive the final rate hike. 

“I’m hopeful,” said Mark Deak, executive director of the South Dakota Health Care Association. “Gov. Noem has really championed long-term care, and that’s needed now more than ever.”

McKnights reported Thursday that five nursing homes closed in the state last year. Another two facilities announced last month they intend to shutter, Deak said.

Nursing home advocates in New Hampshire are similarly seeking a significant increase with the head of that state’s largest providers’ group telling McKnights that “out-of-state staffing agencies are bleeding facilities dry,” while some long-term care facilities have wait lists of more than 100 people.

“One need not be an expert in causation to understand why the latest AARP dashboard shows our nursing homes experiencing the nation’s second-worst staffing shortage,” said Brendan Williams, president and CEO of the New Hampshire Health Care Association. “We can’t responsibly serve the demand for nursing home care within our staffing constraints.”

During a hearing this week before the state Senate’s Health and Human Services Committee, the administrator of Mt. Carmel Rehabilitation and Nursing Center in Manchester told lawmakers they have 30 open positions but have spent $1.2 million on agency staffing, reported New Hampshire Public Radio.