As a non-profit provider dedicated to the well-being of our nursing home residents and older adults statewide, we want to shed light on a critical issue affecting us all: the severe underfunding of nursing homes in New York and its impact on nursing home staffing and access to health care for all New Yorkers.

Background: The Nursing Home Financial Crisis

Every day, approximately 97,000 older adults in New York receive care in nursing homes, making organizations like The Brothers of Mercy a cornerstone of our healthcare system.  Despite the importance of nursing home care to so many, New York’s Medicaid program refuses to pay rates that cover the cost of providing care.  Nursing home Medicaid rates are based on 2007 operating costs, creating a staggering $1.6 billion gap between the cost of care and Medicaid reimbursement annually. 

Medicaid reimbursement is critical to the financial health of nursing homes – Medicaid pays for 75% of nursing home days in New York.  As a result, in 2022, 70% of nursing homes in New York operated at a financial loss.

Inadequate funding has led to the closure of eleven nursing homes in New York State since 2020 and 5,600 nursing home beds taken out of operation since 2019.   This is creating an access to care crisis for older adults and patients seeking either short- or long-term nursing home care statewide.  Too often, older adults and their families are unable to find nursing home care close to home and must resort to distant facilities. 

Nursing Home Staffing Challenges Contribute to Hospital Gridlock 

Chronic underfunding combined with health care workforce shortages make it difficult for nursing homes to attract the staff necessary  to operate at optimal capacity.  When nursing homes do not have enough staff, they limit admissions and cannot accept all of patients from hospitals who need their care.   This leads to prolonged stays for hospital patients who are ready for discharge and, in turn, a shortage hospital beds for patients who need acute care.  It also exacerbates overcrowding in emergency departments because there are no beds for the emergency patients who need to be admitted.  

A recent Times Union article highlights the growing wait times in New York’s emergency departments, with average wait times of 3 hours and 22 minutes – the sixth highest in the nation. The article points out that lack of available nursing home beds is a major cause of prolonged hospital stays. 

Nursing home staffing shortages and associated reductions in nursing home admissions are creating significant access to care consequences for consumers of all ages. 

The Solution: Medicaid Reimbursement that Covers Costs!

Nursing homes are an integral part of the healthcare system. They provide essential rehabilitation and long-term care for older adults and others with complex conditions.  The availability of nursing home care is also essential to ensuring  access to acute care in hospitals.  

To improve access to quality care and reduce hospital wait times for all New Yorkers, the State should update Medicaid rates for nursing homes to align reimbursement with costs.  This would enable high-quality homes like ours to hire more staff, reopen closed beds, and admit more residents. 

As residents, families, and community members of The Brothers of Mercy Wellness Campus, it is critical that you understand the nursing home staffing and funding dynamics impacting access to quality care. By updating and increasing nursing home Medicaid funding, New York has the power to ensure that older adults have access to quality care close to home, while also reducing hospital wait times.