NEBRASKA – COVID costs, wage pressures, low Medicaid rates combine to force closures and there’s no permanent fix in sight
Staffing pressures and Medicaid reimbursement issues being felt around the nation pushed several Nebraska nursing homes to their ends in late 2021.
Leaders of six facilities told families and staff that they would shut down or close at least one service line by 2022, reported Jalene Carpenter, president and CEO of Nebraska’s Health Care Association. The closures include three buildings operated by The Evangelical Lutheran Good Samaritan Society, the nation’s largest nonprofit senior care provider as ranked by nursing home beds, according to LeadingAge/Ziegler 200. The end-of-year struggles show no operator, regardless of size, is immune from the unrelenting labor crisis combined with stagnant Medicaid rates.
“This model is not sustainable,” said Good Samaritan President and CEO Nate Schema. “These challenges, combined with the stress caused by the pandemic, have forced us to make difficult decisions about how and where we provide services.”
MIDWEST
New group seeks SNF staffing fixes
MICHIGAN — Gov. Gretchen Whitmer established a Nursing Home Workforce Stabilization Council in December to develop policies, legislation and other solutions to improve long-term care in the state.
It will be composed of health and labor department directors, nursing home residents, and nursing home workers and employers. Among the appointees will be representatives of a not-for-profit nursing home, a for-profit nursing home employer, and a county-run nursing home.
Among their chief goals: increasing staffing levels; improving retention; developing career pathways; prioritizing living wages and benefits; ensuring quality of care; and promoting transparency and accountability.
SEIU Healthcare Michigan praised the group’s formation and workers’ inclusion when it was announced in December.
“Workers know this industry best and we know what’s needed to improve care, raise standards, and retain and attract workers to meet the needs of our communities,” said Martha Nichols, a licensed nurse practitioner and executive board member with SEIU Healthcare Michigan.
NORTHEAST
Operators get 30-day pause of funding law
NEW YORK — Gov. Kathy Hochul (D) delayed a new state law that requires nursing homes to spend minimum amounts on direct patient care and staffing. She issued a 30-day stay the day before it was to go into effect, and just after 250 nursing home operators filed a lawsuit seeking to overturn it. It had been set to go into effect on Jan. 1. At press time, the law, which requires 70% of revenues to go toward direct care, was set to go into effect Feb. 1.
“This law completely ignores the fact that nursing homes are on the front lines battling the COVID-19 pandemic while facing a nursing home staffing shortage crisis,” said Stephen B. Hanse, president and CEO of the New York State Health Facilities Association/New York State Center for Assisted Living. “The law as written violates the Constitution and disregards quality and seizes funds from providers.”
The measure also directs the state’s Department of Health to confiscate any profits or surplus that exceed 5%, regardless of the quality of care or its historic financial performance.
Providers seek delay of staffing minimum
RHODE ISLAND — The state’s top provider organizations in late December pleaded with officials to pause for one year a minimum staffing law set to start January 1, 2022.
“With an unprecedented staffing crisis due to a decade of drastic cuts to nursing home reimbursements, the prolonged COVID-19 pandemic, and employee burn-out, it will be impossible for our homes to meet these new requirements,” said John E. Gage, president of the Rhode Island Health Care Association. “The applicants simply do not currently exist to meet these new requirements.”
Without a moratorium, the association and LeadingAge Rhode Island predicted nursing homes would have to further reduce or limit admissions to avoid “crippling” fines.
In mid-December, the state’s 80 nursing homes had 1,920 job vacancies, or an 18.3% rate. Under the minimum staffing rules, those facilities would have to fill those jobs and add another 475 positions.
WEST
Lawmakers may connect pay, performance
CALIFORNIA — Gov. Gavin Newsom’s administration was drafting a proposal to tie state funding to performance, giving those who meet new quality standards a larger share of state funding. Lawmakers will likely debate specifics during budget negotiations, but details like minimum staffing levels and turnover penalties are likely to be opposed by the nursing home industry.
Rethinking Medicaid allocations made to the state’s nearly 1,200 nursing homes follows two years of COVID deaths, but also national leadership on vaccination efforts with nearly 95% of workers vaccinated.
Craig Cornett, CEO of the California Association of Health Facilities, said blaming nursing homes for high COVID infections early in the pandemic is unfair given residents’ vulnerabilities. He argued providers actually need more money to support innovations and address the staffing crisis.
From the January/February 2022 Issue of McKnight's Long-Term Care News
