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Gov. Hochul faces Thursday deadline to lift pause on nursing home staffing rules

 New York Governor Kathy Hochul speaking at the University at Buffalo Aug. 31, 2021
WAMC screenshot
New York Governor Kathy Hochul speaking at the University at Buffalo Aug. 31, 2021

New York Governor Kathy Hochul has until the end of Thursday to decide whether to let a law take effect that would significantly increase the number of workers at the state’s nursing homes. Hochul paused the law’s January start date when nursing home operators said they could not meet the new standards, but workers are saying it’s time to let the measure take effect.

The law would, among other things, require that nursing home residents get at least 3.5 hours per day of direct nursing care.

George Gresham is president of the health care workers union SEIU 1199 and the son of a retired health care worker. He says when nursing homes were hit hard during the pandemic, workers suffered greatly. Many became ill themselves, and double and triple shifts were common.

Gresham says it’s past time for their needs to be addressed.

“We’re talking about people that really commit their lives to saving lives for all of us,” he said.

Gresham was joined by New York Attorney General Tish James, who is urging Hochul to end the delay on that law, along with another measure. It would require nursing homes to put at least 70% of their revenue toward patient care, with at least 40% going toward paying staff.

“It’s time to lift the pause on both of those bills,” James said in an event held earlier this month. “And put in staffing ratios. Put in place a law that was deemed to address where the profits of some of these owners should be placed. And that is back into the nursing homes.”

In January 2021, James issued a report on the nursing home industry. It found that former Governor Andrew Cuomo and his aides undercounted by 50% the number of nursing home deaths in the state during the height of the pandemic in the spring of 2020. The report also documented weaknesses in the system, including inadequate preparation for infectious disease outbreaks and severe lack of adequate staffing at many facilities.

But nursing home owners say they need the start date delayed even longer than the current March 31 date, or repealed altogether, because they can’t find the employees needed to be in compliance.

Jim Clyne is with LeadingAge New York, a statewide association of nonprofit and public providers of long-term care services, including county-run nursing homes. He says based on payroll data filed with the federal government, the homes estimated that the law would require the homes to immediately hire thousands of new nurses and health care aides.

“And it shows that if we were going to comply with this requirement of 3.5 hours residents per day that we would need 12,000 workers,” Clyne said.

He says even if nursing homes had the money to pay for them, that number of readily qualified employees just doesn’t exist.

Clyne says a major obstacle that nursing homes face is low Medicaid reimbursement rates. He says 75% of long-term care patients rely on Medicaid to pay for their care, and New York has not raised rates in 14 years. At the same time, he says costs have gone up by almost a third.

“The Medicaid rate in New York state is the worst in the country, when you compare the cost of providing care with the amount of revenue the state is providing,” Clyne said. “New York Medicaid is the single worst payer in the country as far as any Medicaid rate and that’s from an independent accounting firm that did this study.”

Clyne credits Governor Hochul for restoring in her budget plan the cuts made to nursing homes during the depths of the pandemic, and for including a 1% reimbursement rate increase. But he says that’s not enough to remedy the problem.

He says half of the nursing homes in his group are either temporarily suspending admissions or closing off wings due to lack of adequate staffing, even without the new requirements.

For-profit nursing homes have filed a lawsuit against the law that mandates a redistribution of profits, saying it represents a “taking” of their private property.

AG James, who is representing the state in the lawsuit, says she also supports proposals in the Legislature’s budget plans that include pay raises for nursing home workers. She says she hopes Hochul, a fellow Democrat, agrees to the salary increases in the final spending plan.

Karen DeWitt is Capitol Bureau chief for New York State Public Radio, a network of public radio stations in New York state. She has covered state government and politics for the network since 1990.