New York state nursing home advocates want a 20% Medicaid boost to pay rates, a demand struggling for traction while the governor’s budget framework puts money into home-based care instead. 

The demand was delivered officially to Gov. Kathy Hochul (D) Friday in a letter signed by the heads of five organizations representing nursing home providers and healthcare workers. Her budget proposal is scheduled to be released Wednesday. Without changes, more beds will be taken out of service and some facilities could close, providers warned.

“New York has underfunded nursing home care for the last 15 years,” said Stephen B. Hanse, president and CEO of New York State Health Facilities Association/New York State Center for Assisted Living, adding that New York was the only state to cut Medicaid to nursing homes during the pandemic.

Hanse’s organization represents 400 skilled nursing providers whose more than 60,000 employees care for more than 65,000 nursing home residents and assisted living clients. 

The statewide average Medicaid reimbursement is $211 per resident per day, Hanse said. Divide that by the 24-hour care that is required and it equates to the state paying providers $8.79 per hour to care for each resident, he noted in an email to McKnights Long-Term Care News.

“This is unacceptable … and is a driving factor why New York has a long-term care staffing crisis as nursing homes cannot compete in the labor market for desperately needed workers,” he explained. 

In addition to Hanse’s group, the letter was signed by: LeadingAge New York; Greater New York Health Care Facilities Association; 1199 SEIU, United Healthcare Workers East; and Southern New York Association Inc., which represents more than 60 nursing homes encompassing 16,000 beds in southern New York, Westchester, and Long Island.

New York requires nursing homes to provide a minimum of 3.5 hours of care per resident per day. Facilities are also required to spend at least 70% of revenue on resident care with 40% of that amount patient facing. 

In 2021, New York gave a Medicaid boost of 1%, but operating costs have surged 42%, according to the Alliance for Senior Care. A letter to the editor in the Rochester Beacon from the seven members of that group said that more than 6,700 beds in the state are “off-line” and coalition members in western New York are limiting admissions due to staffing challenges. The head of Gurwin Healthcare System told Spectrum News that its two nursing homes, which operate a total of 580 beds on Long Island, are similarly limiting admissions and “temporarily closing beds.”

Hochul’s budget priorities released earlier this month did not include any mention of a Medicaid increase for long-term care, instead making investments into teams that would care for low-income adults in their homes, reported WSHU. A Hochul spokesman said the governor is “committed to ensuring that all New Yorkers can age with dignity and independence in the community of their choosing.” 

Hanse and other nursing home advocates will be ready to scour the budget to see what kind of legislative fight they will have on their hands.

“Home-based care is not an alternative to skilled nursing care, given the fact that residents of nursing homes are unable to be cared for in the community given their acuity levels and co-morbidities,” Hanse said.