NY nursing homes are in financial crisis. Our seniors deserve better (Guest Opinion)
Published: Jan. 06, 2023, 8:15 a.m. 

By Janet Dauley Altwarg & Jack Pease

Janet Dauley Altwarg, director of the Long Term Care Executive Council of Central New York (L TCEC of CNY), and Jack Pease, chair of the L TCEC and administrator at Loretto, write on behalf of the council's members listed at the end of this commentary.

Nursing homes across New York State need your help.  There are approximately 614 nursing homes in New York State.  We say approximately because nursing homes have been closing at an increasing rate.   If not closing, these facilities are forced to take vital beds offline.  If you, your loved ones, or family members depend upon nursing home care in your community, this statistic should scare you. 

The end of 2022 marks a new milestone that most people are unaware of - but should take notice.  It marks 15 years since NYS raised the daily Medicaid rate paid to nursing homes to account for inflation.  Except for a meager 1 percent increase this year, it has been 15 years since the last ‘trend factor’ was provided in 2008.  Meanwhile, the inflationary costs that we all feel have risen by 42%.  With Medicaid being the predominant payer for care (about 75% of all resident days are paid by Medicaid), is it any wonder nursing homes are on the verge of financial collapse?

Our seniors deserve better. The financial hardships faced by nursing homes directly impact nursing home residents who depend on us for custodial care (e.g., bathing, dressing, eating) and skilled care.  This crisis has resulted in a reduction of nursing home beds and the inability of hospitals to discharge to nursing homes.

This alarm has been sounding for several years with legislators and governors – as failing to reimburse the actual cost of care is not sustainable.  Today, the shortfall between what it costs to provide care for one day to one resident and what we are paid by NYS exceeds $110.  Action to increase Medicaid rates must be taken in 2023.

Unfortunately, New York has distinguished itself as being dead last, or at best second to last, in what it reimburses nursing homes compared to actual costs, according to studies comparing nursing home rates across states.  It’s one of very few states that does not update its rate regularly, even though the law requires periodic updates. When most states increased Medicaid nursing home rates to respond to the pandemic, New York reduced the rate not once, but twice (cuts that were thankfully restored in the 2022 budget).  The political will to prioritize care for our most vulnerably older adults is simply missing.

Adding insult to the financial injuries is the ongoing staffing crisis declared months ago impacting all sectors in the healthcare delivery system.  While this is impacting services at all levels, nursing homes are unable to compete for the quality workforce we all aspire to.  The result is very real if you’re in need of nursing home care.  Due to staffing limitations, many nursing homes in Central New York, including members of the Long Term Care Executive Council of Central New York (LTCEC), which consists of members from six CNY counties: Onondaga, Oswego, Cayuga, Madison, Cortland and Oneida, and represents a total of 4,665 skilled nursing beds are, for the first time in their history, leaving beds vacant. Statewide, over 6,700 beds are off-line for the same reason.  This has a direct impact on hospital capacity -- when hospitals cannot discharge patients who need nursing home services, there are no hospital beds for patients who truly need hospital care.

The people we serve deserve better from NYS.  The outstanding employees who work in these settings deserve better.  The family members who rely on us today, and the community who will look to us in the future deserve better, too. 

Nursing homes from across the state are asking every legislator and the Governor to take notice of the damage caused by financial neglect and prioritize long term care in the next state budget by providing a 20 percent increase in the nursing home rate – still less than half the increase in costs we have absorbed over the past 15 years. 


Members of the Long Term Care Executive Council of Central New York (LTCEC of CNY):

Bishop Rehabilitation & Nursing Center                    Centers at St. Camillus

Central Park Rehab & Nursing Center                       The Cottages at Garden Grove

Elderwood at Liverpool                                              Iroquois Nursing Home

Jewish Health & Rehab Center                                   Loretto Health & Rehab Center

The Nottingham                                                          Onondaga Center for Rehab

Sunnyside Care Center                                               Syracuse Home Association

Van Duyn Center for Rehab & Nursing                     The Manor at Seneca Hill

Morningstar Care Center                                            Pontiac Care & Rehab Center

St. Luke Health Services                                            Auburn Rehab & Nursing Center

The Commons on St. Anthony                                   Finger Lakes Center for Living

Crouse Community Center                                         Cortland Park Rehab & Nursing Center

Crown Park Rehab & Nursing Center                        Oneida Health Rehab & Extended Care

Rome Health                                                               Sunset Nursing & Rehab

Waterville Residential Care Center