NY nursing homes face Medicaid funding gap, ask for relief - Catholic Courier
The outside of a nursing home.

St. Ann’s Community is seen May 23, 2023. (Courier file photo)

NY nursing homes face Medicaid funding gap, ask for relief

IRONDEQUOIT — The 2024-25 New York state budget proposed by Gov. Kathy Hochul is bad news for the state’s nursing homes and the 97,000 citizens that reside in them, according to Michael McRae, chief executive officer at St. Ann’s Community.

Hochul’s executive budget proposes massive cuts to Medicaid funding for nursing homes at a time when the facilities already are facing an enormous gap between the funds nursing homes receive to care for Medicaid-eligible residents and the actual costs of caring for those residents, McRae said. McRae and his counterparts at four other not-for-profit nursing homes in the greater Rochester community — which together with St. Ann’s Community form the long-standing Alliance for Senior Care — are encouraging New Yorkers to ask their local elected officials to push back against Hochul’s proposed budget, and to do it quickly.

“The budget is supposed to be in place by April 1, so we have the remainder of this month to convince our elected officials that our seniors are worth it,” McRae told the Catholic Courier March 8. “You and I are enjoying the community which we have because of all those that came before us, and the least we can do is provide funding that covers the cost of care.”

Nursing homes face gap between costs of care, Medicaid reimbursement rates

Medicaid is the payment source for more than 70 percent of the state’s 97,000 nursing home residents, McRae said, noting that at St. Ann’s Community, that figure is actually just over 80 percent. Medicaid provides St. Ann’s with $10.13 per hour, per resident, but this amount only covers 50 percent to 60 percent of nursing homes’ actual costs, especially when minimum wage in New York state is $15 per hour, McRae said.

“Nobody here earns less than $15 an hour,” he said. “Study after study has shown that Medicaid does not even come close to covering the bare cost of care. There’s a huge gap, and that’s the crux of the issue. Most facilities lose almost $100 per Medicaid-eligible resident per day.”

The formula the state has been using to determine the amount of Medicaid funding nursing homes will receive is based on costs and statistics from 2007, yet St. Ann’s expenses have gone up 43 percent since 2007, McRae said.

“At St. Ann’s, we’ve had a 35 percent increase in clinical wages, since 2018,” he added.

While the outdated Medicaid rate is “appalling,” McRae said, Hochul’s 2024-25 budget would freeze this rate, he noted. The proposed executive budget also includes more than $500 million in cuts to nursing home funding, he said.

Legislators, citizens asked to push for increased Medicaid reimbursement rate

The state Senate and Assembly are expected to release their versions of the 2024-25 budget in mid-March, and the five members of Rochester’s Alliance for Senior Care — St. Ann’s Community, Episcopal SeniorLife Communities, Jewish Senior Life, St. John’s and Friendly Senior Living — are hopeful that these budget bills will address the funding crisis facing nursing homes, McRae said. The members of the alliance are asking elected officials to fight for a 16 percent increase in the Medicaid reimbursement rate to nursing homes.

While a 16 percent increase is not enough to cover the funding gap, alliance members maintain that it would be a good bridge to a fair reimbursement, McRae said.

“Our expenses overall since 2007 have gone up 43 percent. We’re asking for 16. That’s less than half,” he said.

Alliance members would like all New York citizens to contact their elected officials and ask them to push for the increased Medicaid reimbursement rate. To help facilitate this effort, the alliance has drafted an electronic letter that may be customized and emailed to legislators.

Nursing homes’ Medicaid funding crisis affects hospitals

The funding crisis facing nursing homes affects all New Yorkers, whether or not they or their loved ones are nursing-home residents, McRae said. When nursing homes don’t receive the Medicaid reimbursement they need to care for residents, they are unable to hire more staff, which means there are fewer beds available in skilled-nursing facilities.

When these facilities are full, hospitals become backed up with patients who cannot be discharged because they have nowhere to go, and this in turn leads to adverse effects on emergency rooms, McRae said.

“It’s all of us that are affected,” he said.

Tags: Health, NY Catholics
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