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Governor Hochul Deploys National Guard to Nursing Homes and Implements Surge and Flex Strategies

As members have surely been reading in the news, current staffing shortages and concerns about hospital capacity have prompted Governor Hochul to take steps to help ensure that the health care system can respond. Specifically, non-essential procedures at certain hospitals are being restricted.

By way of background, on Nov. 26th, the Governor issued Executive Order (EO) 11 declaring a state of emergency through Jan. 15, 2022. This proclamation triggered the implementation of the State’s Surge and Flex Health Care Coordination System regulations, which allow the Commissioner of Health a variety of flexibilities. While the regulations speak largely to hospitals and nursing homes, the regulations do include adult care facilities (ACFs) as well. The flexibilities include the ability to increase bed capacity, restrict or postpone non-essential procedures, and allow for a statewide coordination of facilities, including the discharge, transfer, and receipt of patients. The regulations also direct facilities to establish plans to ensure enhanced staffing capacity and require minimum levels of supplies and personal protective equipment (PPE) (consistent with regulatory requirements for nursing homes). Click here for more information on these flexibilities.

This guidance from the Department of Health (DOH), directed to hospitals, outlines the framework when facilities must limit non-essential elective procedures and/or implement other actions to coordinate services, as determined by DOH as necessary to protect public health. According to news reports, DOH has identified 32 hospitals that meet the criteria, which will apply to procedures scheduled to occur on or after Dec. 9th. It should be noted that the plan does not apply to single specialty facilities (e.g., cancer treatment facility), non-hospital-owned ambulatory surgery centers, office-based surgery practices, or free-standing diagnostic and treatment centers. The assessment outlined in the guidance will be used on a weekly basis to determine the Impacted Facilities List. The hospitals must participate in weekly regional coordination meetings and daily Health Emergency Response Data System (HERDS) reporting to inform the decision-making process.

While there are obvious implications for members regarding the staffing challenges in your communities and access to needed care, in addition to your own challenges, this also gives members an indication of the types of pressures they are likely to face in helping to decant the hospitals. It gives a sense of the flow of post-acute care services that may or may not be needed as certain elective procedures are canceled. This may affect the rehabilitative services that nursing homes and certified home health agencies (CHHAs) offer.

The Governor has also deployed the National Guard to certain nursing homes in the state to assist with staffing shortages. Approximately 120 medically trained individuals, described as medics, are being sent to nursing homes with the intention of reducing the number of hospital patients waiting to be discharged to nursing homes. Some nursing homes have been contacted by DOH directly regarding this resource; however, the Department has not disclosed the specific metric by which a nursing home may qualify for it.

LeadingAge NY has been very vocal about our members’ needs. While we appreciate assistance and attention to the matter, the deployment of the National Guard is unlikely to be a true solution to the current capacity issues and is certainly not a solution to the larger issues that must be addressed to ensure sustainability. We are very concerned that the small numbers of staff being deployed, the limitations on their abilities, and the unknown timeframe for which they are committed will not allow nursing homes to staff at levels that allow them to accept new admissions. In other words, receiving National Guard staff is unlikely to allow nursing homes to further relieve hospitals. Further, this strategy does not address the long-term workforce needs in long term care and aging services.

LeadingAge NY continues to advocate for an immediate Medicaid rate increase for nursing homes to enable them to recruit and retain staff. This provides a pathway for a more permanent solution that helps to ensure consistent quality of care to nursing home residents and assist hospitals in managing their capacity to ensure availability for those in need of acute care. In addition, we are advocating for investments in all long term care and aging services providers across the continuum in the State Budget process, as well as various other strategies to bolster the workforce.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828