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

Some nursing home operators say they can't meet new standards in New York state.
Some nursing home operators say they can't meet new standards in New York state.

Gov. 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 of direct nursing care per day.

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

Gresham said 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 at an event held earlier this month.

In January 2021, James issued a report on the nursing home industry. It found that former Gov. 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But nursing home owners say they need the start date delayed even longer than the current March 31 date -- or repealed altogether -- because they can’t find the employees needed to be in compliance.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 said based on payroll data filed with the federal government, the homes estimate 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 per resident, per day, that we would need 12,000 workers,” Clyne said.

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

Clyne said a major obstacle that nursing homes face is low Medicaid reimbursement rates. He said 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 said 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.”

Clyne credits 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 said that’s not enough to remedy the problem.

He said 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.

James, who is representing the state in the lawsuit, said she supports proposals in the Legislature’s budget plans that include pay raises for nursing home workers. She said she hopes Hochul 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 10 public radio stations in New York State. She has covered state government and politics for the network since 1990.