Nursing Homes On The Verge Of Collapse

SARATOGA SPRINGS — Assemblywoman Carrie Woerner (D-Round Lake) is calling for a 20% increase to Medicaid reimbursement rates in the 2023-24 state budget to support upstate nursing homes. 

“Our upstate nursing homes are on the verge of collapse,” said Woerner, during a press conference held this week. “They have hundreds of beds that can’t be filled due to staffing shortages caused by lack of funds. While I am grateful that the Assembly’s one-house budget doubled the executive’s proposed paltry increase of only 5%, the need for a full 20% increase remains. Without that increase, many homes supporting the elders in our communities will be forced to shut their doors, and we cannot allow this to happen.” 

A systemic rebasing strategy, one that is based on current costs, is also critically needed if the rate is to keep up with the cost of providing care, Woerner added. 

Medicaid reimbursements rates — the amounts Medicaid provides to cover patient health care costs — for upstate nursing homes have not increased in 15 years in New York. Nursing homes’ operating costs have meanwhile increased around 40% over the last several years, leading to shortfalls in what the nursing homes charge for service and what they receive.  

Medicaid pays for care for many nursing home residents across the state. At The Wesley Community, 75% of residents are paid for by Medicaid, yet it only covers part of the actual costs of care, according to J. Brian Nealon, CEO of The Wesley Community in Saratoga Springs. 

“With every Medicaid resident we care for, Wesley loses $106 per day. Annually, this means underfunding of $8,500,000,” Nealon wrote in an editorial published Feb. 16 in Saratoga TODAY.  

Prior to the COVID-19 pandemic, Wesley was able to approach breakeven in some years through alternative revenue streams and donations from the community. 

“That is no longer the case. Due to this shortfall, community-focused, nonprofit nursing homes statewide are closing or being sold to private ‘for-profit’ operators at an alarming rate. In Saratoga County alone, the number of nursing home beds has dropped by 55% in the last decade,” said Nealon, adding that 26 other states have increased their Medicaid funding during the pandemic, whereas New York reduced its reimbursement rates during that time. 

The result of the underfunding by the state has forced many nursing homes, including Wesley, to limit admissions, and without available beds, hospitals cannot discharge patients who would have traditionally gone to a nursing home for rehabilitation. 

“The governor’s recently released Executive Budget, with a proposed 5% increase, is a start, but still falls short of what is needed after years of underfunding,” Nealon said.  

Assemblywoman Woerner said that a 20% increase will shore up the finances of upstate nursing homes and allow them to operate and provide care to the people who need it most.