A boost for immigrants and nursing homes
Deal caps profits, requires more spending on patients
A budget deal reached Tuesday by state legislative leaders and Gov. Andrew M. Cuomo funnels millions of dollars into New York’s hard-hit nursing home industry to beef up staffing and requires operators to spend more money on patient care.
The deal — a response to pandemicrelated concerns over how nursing homes were spending their money —
““I don’t know that absent the pandemic — absent the pain and suffering of our elders, their loved ones and workers in this industry — that the kind of reform we need would have been enacted. And, in fact, even with the pandemic we still have a ways to go and that’s very sobering news.”
Milly Silva, an executive vice president with 1199SEIU United Healthcare Workers East
includes a new requirement that nursing homes spend at least 70 percent of their revenues on direct resident care, including at least 40 percent on staff who deal with residents. The union representing the state’s nursing home workers estimates this change will lead to an extra $500 million being spent on resident care.
Notably, the agreement also caps the profits that nursing home operators can make at 5 percent and requires them to redirect any excess funds into the state’s nursing home quality pool, which was established a decade ago to reward nursing homes that provide high-quality care to residents.
The reforms, which take effect Jan. 1, 2022, seek to address the chronic understaffing that has plagued the nursing home industry for years, but which became increasingly apparent during the pandemic.
“We have taken a huge step forward, but there is more to be done,” said Milly Silva, an executive vice president with 1199SEIU United Healthcare Workers East. “So we’re in this moment of breathing and of recognizing how this is bittersweet because the reform is so necessary but we also know that there are seniors and workers who are not here to see it and that makes it hard.”
Nursing home workers and their union representatives have staged numerous rallies in recent months to call for increased investment in resident care and an end to chronic understaffing. While workers had protested around these issues prior to the pandemic, calls for reform intensified this past year as the pandemic’s devastating toll on nursing home residents became clear and controversies swirled around the Cuomo administration’s handling of the crisis.
A state attorney general’s report published in January found the administration had publicly undercounted nursing home deaths by 50 percent by excluding those who died in hospitals.
The finding spurred the administration to finally release the number who died in hospitals.
To date, more than 13,000 nursing home residents are known to have died from coronavirus infections.
The report also found a correlation between poorly staffed homes and increased COVID deaths, and condemned the forprofit nursing home industry for bolstering their profits while leaving homes understaffed.
“I don’t know that absent the pandemic — absent the pain and suffering of our elders, their loved ones and workers in this industry — that the kind of reform we need would have been enacted,” Silva said. “And, in fact, even with the pandemic we still have a ways to go and that’s very sobering news for anybody that cares about what’s happening in our nursing homes.”
One reform Silva and others are pushing for would set a threshold for the minimum hours of care that must be provided to each resident each day. New York is one of only 12 states that has not set such thresholds.
Industry responds
Organizations representing the state’s nursing home operators had mixed reactions to the budget deal reached Tuesday.
While they were grateful for additional funding earmarked for homes by the state — $128 million over two years — some felt it wasn’t enough and many conveyed disappointment with the new mandates around spending.
Stephen Hanse, president and CEO of the New York State Health Facilities Association, which represents for-profit and other nursing homes, said the new spending mandates don’t take into account the differing needs of nursing homes around the state.
“Instead of implementing specific policies to recruit and retain new workers and reverse years of nursing home disinvestment, the state implemented a one-size-fits-all law dictating how all nursing homes are to allocate their financial resources, ignoring the unique nature and resident needs of each nursing home,” he said.
Operators also contend the new money for nursing homes doesn’t come close to touching years of “under-investment” by the state. Michael Balboni, executive director of the Greater New York Health Care Facilities Association, pointed specifically to the low Medicaid reimbursement rates New York pays out compared to other states.
“Without increasing the revenues to make up for the deficit and just saying, ‘You have to spend the money differently,’ it’s really like propping up an already dysfunctional system, an underinvested system and rearranging the deck chairs on the Titanic,” he said.
Balboni was also critical of the deal for what he said is a failure to incorporate lessons learned during the pandemic or mechanisms that would help nursing homes prepare for the next pandemic.
“We didn’t step up for the residents because we failed to imagine this happening ahead of time,” he said. “I’ve been involved in planning on pandemics for years and yet we’ve not done anything ... to truly prepare for pandemics. This should have been the moment with this amount of money where we could have institutionalized that forward-looking perspective.”