The New York State Department of Health (DOH) is pressing ahead with implementing a severe $352 million Medicaid cut that will threaten care for thousands of nursing home residents across the state. This drastic cut, to be implemented on Nov. 6, 2019 and made retroactive to July 1, 2019, is the result of a change to the way that DOH calculates case-mix index (CMI) adjustments, which ensure that nursing home Medicaid reimbursement rates match the level of need of the residents they serve.
Most nursing homes in the state, over 100,000 residents, and the frontline staff that care for those residents are at risk in the face of this cut. On average, the cut will reduce facility payments by nearly $11.50 per resident day. In an environment in which nursing homes have seen no Medicaid inflation adjustment in over 10 years, while the costs of care delivery have risen steadily, many facilities will be put at risk of having to sell or close, while most others will be under pressure to curtail programs and reduce staffing. Ultimately, access to high-quality care for vulnerable New Yorkers who rely on our long term care system will suffer greatly.