In a creative new reward plan being heralded nationwide by many providers, California will pay bonuses to all nursing homes that hire additional staff, reduce turnover, or improve the quality of care — regardless of the facility’s federal star rating.
Higher-scoring facilities will earn larger bonuses but any facility that meets the new metrics will be eligible for some of the $280 million in the program, reported Kaiser Health Network, noting that the amount is “just a fraction” of the more than $6 billion SNFs receive through Medi-Cal annually. The amount in the bonus program is “comparable” to temporary funding available during the pandemic for nursing homes, the report added.
A spokesman for the California Association of Health Facilities told McKnights Long Term Care News Friday that there remains a “significant shortfall” between the base payment rates for SNFs and the costs of care. That means for many facilities, the bonus funds will be a vital supplement payment.
“If SNFs do not have the opportunity to access additional funds as soon as possible, it will be challenging for them to operate, much less innovate to improve quality,” Corey Egel said.
The association supports the goals of improving care but said “consistent access to adequate financial resources” is a better approach than bonus payments. Many nursing homes are facing significant financial challenges due to a myriad of issues, including increased labor costs, the high cost of agency nurses needed to meet the state staffing minimums, and delayed Medi-Cal payments that do not reflect recent cost hikes.
Still more is needed said Craig Cornett, CEO of the California Association of Health Facilities,
“This is not going to move the needle fundamentally as long as the state continues to disinvest so badly into nursing homes,” Cornett said in the KHN article. “Facilities desperately want more staff. They want to hire more staff, but they are paid so poorly through Medi-Cal that that’s virtually impossible.”
At least one consumer advocate claimed there is underlying unfairness in the staffing bonus program.
“The overwhelming majority of the money goes to facilities regardless of what their quality looks like,” said Tony Chicotel, an attorney with California Advocates for Nursing Reform, a nonprofit that represents long-term care residents. “The worst performers will still get paid about the same as the best performers.”
