Empty nursing home bed and wheelchair
Credit: byryo/Getty Images Plus


Bed reduction rule lowering patient access

MASSACHUSETTS — Four nursing homes in the same county announced they would close by June, chased out of the state by a “reconfiguring” reform meant to improve the quality of care.

The Northeast Health Group said in February that it planned to shutter four facilities in the western part of the state, according to the Department of Public Health. Twenty-five nursing homes in the state have closed since the start of the pandemic, with at least half shutting down over the last 12 months, said Tara Gregorio, president of the Massachusetts Senior Care Association.

Northeast pinned its reason on a 2021 state rule prohibiting more than two residents per room. It took effect in May 2022. Limiting beds per room has reduced revenue, even as some facilities are limiting admissions due to staff shortages.

“Government leaders must prioritize nursing facility care by increasing funding for this vital service, while simultaneously investing in proven workforce development initiatives and adopting smart immigration policies that further expand the number of available workers,” Gregorio said.

The Northeast Health Group unsuccessfully applied for a waiver to exempt it from the two-bed rule. Meanwhile, a Suffolk Superior County judge in January kept alive a lawsuit from 31 providers looking to block the capacity mandate. 

Long-term care workers lobbying for $25 minimum wage

CONNECTICUT — Nursing home workers and labor advocates in February began a public push for hourly wage adjustments that would bring their minimum pay to $25 hourly by 2025.

Workers represented by SEIU 1199NE made their arguments during an event hosted by Sen. Richard Blumenthal (D) promoting the federal Better Care Better Jobs Act. While that bill largely focuses on home and community services, it also would make states eligible for a 10% Medicaid increase if they meet certain pay and benefit standards.

“All of these goals that we are talking about, they are all achievable, they are all real,” said union president Rob Baril. “This is a real conversation. People are going to tell us that we are crazy. I don’t believe that the idea of ending poverty for long-term care workers is crazy.”

Desired raises and related benefits would cost about $700 million, but union leaders pointed to a state surplus of more than $3 billion. Lawmakers hadn’t proposed a budget at press time, but the funding was not expected to be in Gov. Ned Lamont’s (D) spending plan.


Bills address hospital backlogs with SNF pay

WASHINGTON — Nursing homes in Washington state in February were awaiting a reprieve from a labor crisis that is stranding potential residents in hospitals.

Companion bills introduced in the state Senate and House would update Medicaid funding for skilled nursing facilities every year and create an inflation adjustment.

Washington nursing homes were underpaid by $620 million over the last five years, according to the Department of Social and Health Services, which, combined with labor shortages have resulted in facilities closing units or halting admissions. Worsening hospital logjams led the Washington State Hospital Association to make post-acute funding a 2023 legislative priority.


Bill would double nursing home inspections

ARIZONA — Legislation moving through the state senate would privatize nursing home surveys and double the number required annually, a shift sector advocates said would hike costs without improving quality.

“You cannot punish facilities into good behavior,” Dave Voepel, CEO of the Arizona Health Care Association testified. “If you want to truly improve quality, you must examine the very nature of the current regulations and create new standards of care.”

The legislation stems from a 2019 audit of the state Department of Health Service that found neither inspections nor follow-ups on complaints were happening. It alleged the department failed to conduct onsite investigations within a required 10 days for 73% of 156 high-priority complaints and “inappropriately” shifted 98% of high-priority complaints to a lower status.

Nursing home advocates warned that third-party inspectors won’t resolve these problems and would double provider work and state costs.

Bill would eliminate predatory agency fees

COLORADO — Lawmakers are poised to prohibit staffing agencies from collecting damages when a facility wants to permanently hire a worker.

Doug Farmer, president and CEO of the Colorado Health Care Association, told the State of Reform website that contract restrictions put in place by agencies create a major barrier in bringing workers on board at a reasonable cost. One of the bill’s sponsors called it a “ransom fee.”

“There’s a separation fee that must be paid contractually and it is often $5-7,000 in average cost” Farmer told State of Reform. “But the challenge is really less about the one-time costs than it is about the fact that it’s not a guarantee.” 

Workers might still leave the nursing home for a competitor, or another job, and the facilities are still out the buyout fee. Under the bill, any agency that charges damages would be subject to a monetary penalty up to $5,000.