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The Wayne County Nursing Homes dilemma

by WayneTimes.com
April 9, 2022

On Friday (4/1) New York Governor Kathy Hochul  stated she will begin enforcing a 2021 state law, approved by former Gov. Andrew Cuomo.

The law established minimum staffing levels for New York nursing homes, 

Hochul had cited pandemic-related staffing shortages  when she previously delayed enforcement of the law, which was initially to take effect on Jan. 1.

The statement by the Governor came after NY Attorney General Letitia James and members of the 1199 SEIU Healthcare Workers East Union called on the Democratic governor to implement the law now that COVID restrictions have been relaxed.

Labor union 1199SEIU United Healthcare Workers East and consumer advocates on Friday expressed gratitude to Hochul for putting the minimums into effect.

The law requires the state’s more than 600 nursing homes provide 3.5 hours of care per resident per day. Of the 3.5 hours, no less than 2.2 hours of care must be provided by a certified nursing assistant (CNA) or nurse aide. At least 1.1 hours of care must be given by a registered nurse (RN) or licensed practical nurse (LPN).

This standard will change again on January 1, 2023, after which the law will require a certified nursing aide to provide at least 2.2 hours of care per resident per day.

Before the law even went into effect, of the 611 nursing homes in the state 383 (63%) were considered below 3.5 hours per resident day staffing requirements.

More than 200 nursing homes statewide sued the state in federal court in December to block the regulations on nursing home spending. That lawsuit is pending.

To meet the new staffing requirements, it would take an additional 5,610 additional staff for New York facilities, according to a report compiled by professional services firm CliftonLarsonAllen (CLA) as part of a partnership with the NYS Health Facilities Association.

The CLA report found that it would cost anywhere from $250,000 to $1.6 million in annual costs per facility that is below the newly imposed staffing requirements.

The law stipulates that 70% of a nursing home’s revenue is to be spent on direct resident care and at least 40% spent on staffing. It also states that nursing home operators in the state are required to return all profits in excess of 5% to the state, regardless of the quality of care or whether the operator sustained losses in prior years.

In a prior interview, Stephen Hanse, New York State Health Facilities Association president and CEO, said the laws do not reflect the current reality of New York’s long-term care landscape, calling it “unworkable.”

Milly Silva, the union’s executive vice president, said nursing home leadership needs to find effective ways to retain its workers, which will result in better recruiting success.

“If employers actually invest and agree that they are going to do everything they can to retain those committed workers, they won’t lose them,” she said during a virtual news conference on Friday. “It means that you have to confront issues around wages, issues around benefits, issues around working conditions and what it means to have a safe working environment for the caregivers.”

Helen Schaub, the union’s policy and legislative director, said during the virtual news conference that the health department will view payroll based journal (PBJ) data to ensure nursing homes are complying with the laws.

Fines for noncompliance could be up to $2,000 a day, she said. According to County Administrator Rick House, so far the State Department of Health has not pushed local nursing homes the new requirements, but as of Friday (4/8) Governor Hochul has refused to consider any more delays. The Department of Health didn’t immediately respond Friday to questions about the agency’s plans for enforcing the staffing minimum law.

In a statement provided to Skilled Nursing News, the state Department of Health said, “at this time, nursing homes should appropriately document their efforts to comply with the law. Mitigating factors can be considered by the department when assessing penalties for non-compliance at a later date.”

The law was first introduced by former Gov. Andrew Cuomo in 2021 as a way to improve nursing home transparency and hold bad actors accountable.

The mandate comes at a time when the Biden administration has set its sights on a federal nursing home staffing minimum.

There is no question the new law will affect the County Nursing Homes along with private homes in the county.

On Monday (4/4) Nursing Home Administrator Jeffrey Stalker updated the Health & Medical County Committee on the State’s staffing mandate that went into effect April 1st.

The County will need to adjust their Nursing Home census depending on staffing, or be fined, according to the new mandate. Mr. Stalker said, with current staff levels, the Facility should be able to house around 155 residents.

Currently, the Wayne County Nursing home has 166 residents, but attrition of both residential and in-patient rehabilitation admissions will bring that number down to the maximum number. The County Nursing Home is a 192 bed facility. In doing so, rehabilitation patients may have to leave after receiving services for appointments. There is no plan to remove individuals from the Nursing Home, however, there will be no new admissions from hospitals, or families.

“Is this good for Wayne County residents? Absolutely not!,” said House. He admits that the new state regulations will eventually increase costs across the board for Medicaid and private pay residents. With the reduced nursing home population being decreased to match the new requirements, the county will still have to cover staff and other overhead costs.

The Wayne County Nursing Home has been financially stable for the past several years due to overall management practices, according to House. He added this may not be the case for some private homes on the edge.

Jeff Stalker said the proposed county stipend (See story on front page) will especially help the newer CNAs (Certified Nursing Assistance) that start at $16 per hour.

The nursing home has been successfully with recruitment, but is not allowed give bonuses that private nursing homes can use as incentives. He added that staff members initially left for cash incentives and bonuses, some of those employees are now returning finding the working conditions are more receptive.

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