New York State’s Long Term Care Crisis
by Ray Sweeney, Dan Heim & Robert J. Murphy

Imagine trying to explain to your 93-year-old mother that she needs to move to a new long term care facility where she won’t recognize her surroundings or any of her caregivers.

Or try telling a child that his father – recovering from major injuries after a car accident – must spend the next three months of rehabilitation at a nursing facility an hour or more away from home.

These situations will become more and more common if Albany fails to reform New York State’s nursing home reimbursement system this year.

Since 2003, nearly 30 nursing homes in New York State have closed their doors – and more than 80% are losing money caring for Medicaid patients. Nursing homes are literally fighting for survival.

And unless a long overdue reform package is adopted – like the one passed by the state Senate and Assembly but then vetoed – more facilities will close and more families will have to scramble for adequate care for their loved ones.

Even though the Governor vetoed the Legislature’s proposal, he has recognized that reform of the payment system must occur. New Yorkers need all parties to reach agreement on a reform package like that passed by the Legislature. Because when Medicaid under pays, it affects us all. Facilities must find a way to make up the shortfall – by shifting costs to private pay and insured residents, or finding ways to save in other areas.

It is wrong to subject families to more pain – particularly when the solution is so near. Improving health care for the elderly and injured must be a top priority.

Three factors are driving the financial crisis in New York’s nursing homes:

• Oldest system: New York State bases Medicaid reimbursement on costs determined in 1983 – more than two decades ago! This is the oldest base year being used in the country.
  
• Skyrocketing costs: From labor to liability insurance, utilities to prescription drugs, nursing homes are facing skyrocketing costs and Medicaid payments are simply not keeping up.
  
• Extreme labor shortage: At the same time, New York State has suffered widespread shortages of nurses, aides and other patient workers, forcing nursing homes to raise wages or pay expensive temporary nursing agencies to fill the gap.
  

It is time to modernize and streamline long term care processes, free caregivers from unnecessary paperwork, ensure our reimbursement system never again becomes so out-of-date and – most importantly – ensure access to quality nursing home care for all New Yorkers.

The comprehensive Medicaid reimbursement reform legislation passed by both houses of the Legislature will solidify New York State’s long term care system for decades to come.

This legislation is not some political whim – it is based on two years of work by a Joint Association Task Force on Nursing Home Reimbursement, comprised of clinical, regulatory and financial experts. The task force and our respective associations talked to national experts, hundreds of facilities across the state and other stakeholders to arrive at recommended changes to the system.

Each year, more than 300,000 New York State residents require long term care services – one day, it will be someone in your family. Let’s make sure nursing homes in our communities are able to continue providing the quality care our families need – and deserve.

Please contact your state representatives today and thank them for passing legislation to secure New York State’s collapsing long term care system – and urge them to override the vetoes so your local nursing home will be there when you and your loved ones need it.

Visit www.nysl.nysed.gov/ils/legislature/legis.html for contact information for your state representatives.

Ray Sweeney is Executive Vice President, Hospital Association of New York State. Dan Heim is Vice President for Public Policy, New York Association of Homes and Services for the Aging. Robert J. Murphy is Executive Vice President, Governmental Affairs, New York State Health Facilities Association. Together, HANYS, NYAHSA and NYSHFA represent more than 85% of New York State’s long term care facilities.