PHHPC Discusses Nursing Home Staffing Penalties, Nursing Home Finances
(April 22, 2025) At its April 10th meeting, NY's Public Health and Health Planning Council (PHHPC) questioned Health Commissioner McDonald about the looming imposition of penalties on nursing homes for non-compliance with staffing mandates and criticized inadequate Medicaid rates that force facilities to sell or close their doors.
Referencing LeadingAge NY's letters to the Commissioner and the Council, a PHHPC member asked the Commissioner about his recent determination that there was no shortage of nurses or certified nurse aides in most of the state in the second half of 2023. As previously reported, this determination generally cuts off the ability of nursing homes to seek a reduction in the statutory penalties of up to $2,000 per day for violations of the State's nurse and aide hours-per-resident-day requirements. The Commissioner indicated that he had read the letters and that he was enforcing a state law, unfortunately overlooking the absence of any statutory provisions governing the methodology for measuring a staffing shortage. He indicated that the Department of Health retains some ability to mitigate penalties, notwithstanding the absence of a declared staffing shortage. LeadingAge NY is following up with the Department to determine whether that discretion is limited to the incremental penalties set forth in the Department's Frequently Asked Questions on the staffing requirements.
The PHHPC engaged in a heated discussion of nursing home financing and transfers of ownership in connection with three applications to transfer ownership from not-for-profit or county operators to for-profit entities, none of which mustered sufficient votes to secure PHHPC approval. PHHPC members raised the unsustainability of nursing home Medicaid rates, especially for small facilities like those under consideration. They also expressed concerns about the character and competence review process for transfers of ownership. They noted the strategy pursued by some purchasers of selecting related individuals who have no health care experience to serve as applicants, in order to avoid disqualification based on substandard compliance or quality records. One PHHPC member noted that the Council was faced with two bad choices (i.e., approve inexperienced operators who will not be reimbursed at a level that enables adequate staffing, or disapprove the applications and force the facilities to close, displacing their residents and compromising access to care). PHHPC members called for the Legislature to address the funding crisis. One member expressed the fear that the State's current path will bring about "the destruction of long-term care" in NY. The Council will be convening an ad hoc committee on character and competence and financial feasibility.
The meeting was so unusual that it received attention from the news media. Media reports on the meeting are available here and here. A recording of the meeting is available here.
Contact: Karen Lipson, klipson@leadingageny.org