Newly proposed legislation would increase nursing home Medicaid reimbursement rates by 5%. Advocates say it’s not enough.
The bill, sponsored by Nashua Democrat Rep. Cindy Rosenwald, aims to rectify an error in the budgeting process that inadvertently failed to increase reimbursement rates, despite widespread support for the allocation.
“The pandemic increased their costs for staff for PPE and so they were really struggling and some had closed,” Rosenwald said. “We thought there was a risk of more private nursing homes closing.”
This session’s legislation moved through the Senate without opposition and Rosenwald said she is confident it will have bipartisan support going forward.
Shortages of staff in nursing homes have long been a problem in New Hampshire. Low Medicaid reimbursement rates in the state make it difficult for facilities to keep their salaries competitive. New Hampshire has one of the lowest Medicaid reimbursement rates in New England.
On average, New Hampshire nursing homes have only about three-fourths of their available beds filled with residents, Williams said. This is not because people don’t need long-term care but because the facilities can’t find licensed workers to staff many of their beds, taking a large portion of their spots offline.
Shortages of staff in nursing homes have long been a problem in New Hampshire. Low Medicaid reimbursement rates in the state make it difficult for facilities to keep their salaries competitive.
Legislation like Rosenwald’s is a step in the right direction, but not nearly enough to address the crisis long-term care facilities now face, he said.
Between Mar. 2020 and Dec. 2021, 4425 nursing assistants allowed their licenses to lapse while only 4,003 new licenses were issued, ultimately creating a loss of 422 LNAs, according to data from the NH Commission on Aging.
We just can’t grow this front-line workforce fast enough,” Williams said
This number doesn’t account for nurses that leave their positions at nursing homes for traveling agencies, which sometimes charge the facilities exorbitant amounts to hire their employees back.
Williams said immediate action, like a stipend program for licensed nurses, is needed to keep the homes afloat.
“You can’t continue to operate at an occupancy that averages 75% you just have too many fixed costs,” Williams said. “If that continues to be the case, I don’t see a way forward absent significant state assistance”.
New Hampshire established the Long Term Stabilization program in 2020, which granted $300 weekly stipends to full-time frontline health care workers and $150 to part-time workers. The program was established to incentivize frontline workers to continue working even as COVID-19 spread through the homes.
However, the program ended a couple of months later, due to a lack of federal support for the state’s budget, according to a statement from Gov. Chris Sununu’s office. Ben Vihstadt, a spokesperson for the Governor, said at the end of last year, the state created the COVID Impact LTC program which has provided over $7,500,000 to nursing homes based on Medicaid patients. He said nursing homes have had the flexibility was to use the funding to pay employees.
The Senate Health and Human Services Committee will hear another bill, SB 332, aimed at helping long-term care facilities next week. Like the stabilization program from 2020, the bill would use funds from the American Rescue Plan Act to pay stipends to full-time and part-time frontline long-term care workers.
“The consequences of this pandemic are not the state’s fault but at the same time, we need the state’s assistance in order to address these consequences,” Williams said.