Rhode Island’s nursing home industry has been ravaged during the COVID-19 pandemic, but some financial help appears to be on the way.
The state budget proposal approved by the House on June 16 earmarked $30 million of Rhode Island’s American Rescue Plan Act funds to help bail out the state’s 80 nursing homes, which have been grappling with the coronavirus crisis, escalating health care costs and a shrinking pool of workers.
The proposed budget also contains a 3% bump in Medicaid reimbursement rates that nursing homes insisted was desperately needed to cover the rising cost of care for nursing home residents, most of whom are in the state and federal insurance program.
Even before the $13.6 billion state budget for fiscal 2023 was approved by the Senate and signed by Gov. Daniel J. McKee, industry advocates were already breathing a sigh of relief after the House vote.
“The industry desperately needs this infusion of funds,” said James Nyberg, director of LeadingAge Rhode Island, which represents 14 nonprofit nursing homes in the state.
Nyberg said the ARPA money and increase in Medicaid reimbursements will help nursing homes meet inflationary costs, as well as boost wages and pay bonuses to attract more workers.
Five nursing homes have closed since the start of the pandemic more than two years ago, and the remaining facilities say they’ve struggled to fill about 2,000 job openings.
“Our goal is to get the $30 million to providers as soon as possible,” Nyberg said. “As soon as the budget passes, we hope to work with state officials to get it out in an efficient way.”
Patrick Quinn, executive vice president for the Service Employees International Union 1199NE, which represents nursing home workers, said he hopes to see the money invested to improve staffing conditions and help with recruitment and retention.
“Thirty million dollars of one-time money is not going to fix a whole system that’s broken, but they’ve already committed to spending that money for staffing,” Quinn said.
What remains uncertain is the nursing home industry’s effort to delay the implementation of a more-stringent staffing law passed last year, which requires an average of at least 3.58 hours of direct nursing care per resident per day in 2022 starting in April and 3.81 hours in 2023 starting in January. As part of the new staffing mandate, the state is scheduled to bump up Medicaid rates by 1% in October, on top of the 3% increase included in the state budget.
It appears that two House bills that would have put a moratorium on enforcing the staffing requirements – one until July and the other until next January – will die in committee this session.
Nursing homes found noncompliant with the new mandates could be fined by the R.I. Department of Health. A RIDOH spokesperson said the agency is still finalizing the penalty provisions.
Still, industry advocates seem hopeful that the $30 million infusion of ARPA money and insurance reimbursement boost may ease the labor shortage and allow them to meet the staff requirements.
“There’ll be a lot of nursing homes not in compliance,” Nyberg said. “It will take time for them to recruit the workers. But the ARPA funds and rate increase will help.”
For some, the minimum staffing requirement is necessary to guarantee better working conditions and care.
“It should be enforced,” Quinn said. “The industry was arguing there wasn’t enough money, now they have an additional $30 million. They should comply with the standard.”
While saying the industry still needs financial help, Nyberg said the state’s actions are a “strong step forward.”
“We need to keep the attention on the challenges facing nursing homes and the need to support residents and staff,” Nyberg said.