A member of the New York State Assembly is calling for more funding to nursing homes through Medicaid reimbursement payments.

“We’re cutting aid to long-term care in the midst of a pandemic that disproportionately affects high-risk elderly,” Assemblyman Josh Jensen said. “It’s like what planet are we living on.”

Despite the implementation of COVID-19 testing, vaccination and visitation restrictions, it’s no secret that many in the industry say the underlying problem plaguing nursing and longterm care facilities in New York existed long before the COVID-19 pandemic began.

“For years, New York state is not given the proper amount of financial support to our state's nursing homes that they deserve,” Jensen said.

Jensen is calling on Gov. Kathy Hochul to immediately address this.

“So, unfortunately, in New York state, the Medicaid reimbursement for long-term care for nursing home care doesn't cover the cost of their care,” Jensen said. “It's only a percentage.” 

Jensen wants the governor to restore $168 million in funding he said former Gov. Andrew Cuomo cut from nursing homes during the pandemic. The New York State Health Department disputes that number — saying that in 2020, nursing home Medicaid reimbursement decreased by $17 million, not $168 million, and the following year increased it. There is, however, little dispute from the nursing home community that Medicaid just isn’t cutting it.

“Staffing is a challenge all around on nursing homes and acute care facilities alike,” Monroe Community Hospital Executive Health Director Alyssa Tallo said. “I think the one piece that really is hurting nursing homes right now is our reimbursement. We, you know, typically lose money every day, that we have a patient here that is funded through Medicaid. And if you look at the longterm care population, the majority of them are funded by Medicaid as a primary payer, and that hurts nursing homes because we were struggling to make ends meet. We're struggling to stay current with staffing and regulation. And it's really part of what is leading to a lot of the inability of nursing homes to function at capacity.”

Tallo has welcomed the National Guard’s help, as MCH opens its doors to patients from area hospitals.

“So it is great to have the need be recognized and to have the National Guard members here,” Tallo said. “But it is not a longterm solution. It's not going to correct the problems that are plaguing our system, such as reimbursement issues, such as staffing issues.” 

Jensen wants the governor to make the move before the end of this year, with the expectation the funds will kick off a domino effect, allowing for the hiring of properly paid nursing home staff, welcoming more residents, freeing up beds in hospitals, clearing emergency department backlog and addressing COVID-19 and health care needs of the community without long waits or cancellations of surgeries.

“If we can address the staffing shortages in nursing homes, through proper funding to allow them to recruit and retain frontline health care workers that will do a world of difference in helping address the public health issues we're currently facing,” Jensen said.

Jensen said tackling this problem will solve many others as he said more than 70% of all nursing home residents in New York are covered by Medicaid.

A spokesperson for the New York State Department of Health released a statement in response to Jensen:

“The total annual Medicaid reimbursement to nursing homes is approximately $6.5B.  We have been working with nursing homes across the state to identify where these National Guard medical teams will have the most impact on regional health systems.  In addition, we taken several steps to help with staffing shortages and bed capacity.  As stated in the final guidance Dear Administrator Letter issued Dec. 3, DOH retains the discretion to require any facility to limit non-essential elective procedures and/or implement other actions to coordinate services, as determined by DOH as necessary to protect public health.  As more arrangements are made, we will share more information."