HARTFORD, CT — How much did Democratic lawmakers know about changes in nursing home rates before they approved it as part of the state budget?
That’s the central question at the moment as nursing homes and the association that represents them are calling for a special session to address the issue.
Last month the Department of Social Services announced rate reductions based on a new vacancy calculation that could cost nine nursing homes $5.3 million. The nursing homes are located in Bristol, Fairfield, Hamden, Shelton, Simsbury, South Windsor, Torrington, Wallingford, Waterbury and Wolcott.
Gov. Ned Lamont’s administration is trying to assure lawmakers there’s a process for the nine nursing homes to appeal the rate reduction if they think it was unfairly applied. The governor, in a letter to Democratic lawmakers, also rejected any argument that the nursing homes didn’t know this “rebasing” of rates was coming.
The budget approved with only Democratic votes essentially eliminated the rate protection for homes with low occupancy rates to keep up with the trend of more residents preferring to receive nursing care in their homes.
“While the new rates will apply retroactive to July 1, 2019, DSS does not expect that there will be any immediate change in the status of the impacted homes, and there is sufficient flexibility to allow homes time to evaluate opportunities to adjust their business models as needed,” Lamont wrote in a letter to lawmakers. “DSS and/or the Office of Policy and Management (OPM) has and will continue to meet with impacted nursing homes to support and assist with this process.”
Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, disagreed with the assertion that the legislature gave “full and fair” notice of these cuts.
“State legislators and nursing home representatives were not made of what facilities and the areas they serve were affected until 8-14-19 in a meeting with OPM and DSS, over two months after the measure was adopted. We surmise it would have been impossible for the state legislature to have fully evaluated the impact without this information. Nursing home operators also disagree that they had earlier notice of the occupancy penalty policy and should have reduced licensed bed capacity previously,” Barrett said.
Lamont said the proposal was in his budget and the proposed Human Services implementer, which received a public hearing.
Barrett said nursing home operators are also concerned about the opportunity to prevail in a rate appeal, also offered by the administration, because the adopted legislation effectively eliminates the stop loss for certain nursing homes with occupancy under 70%.
Nursing home operators dispute claims they are being paid above their costs.
Lamont told lawmakers that all of the 213 nursing homes in Connecticut have received an increase in their reimbursement rates of 2%, for the purpose of enhancing wages and benefits for staff, retroactive to July 1. And 204 of those homes are seeing their rates increase overall, some of whom are also receiving fair rent increases.
Senate Republican Leader Len Fasano said Tuesday that the Connecticut Association of Health Care Facilities wasn’t doing enough to advocate for their members.
“Instead of calling on the Democrat lawmakers who developed and approved this Medicaid cut to reverse this devastating policy, your memo suggests Democrats are not accountable or responsible for this cut and suggests that the responsibility lies solely on the Department of Social Services,” Fasano wrote in a response to Barrett’s memo. “Those assertions are false, and actually weaken the nursing homes’ position in fighting against this damaging policy passed in the Democrat state budget.”
Fasano emphasized that restoring this funding and reversing the policy change legislatively is simple if Democrat leaders agree to do so. However, “If Democrats are given a pass by the nursing homes to claim they are not responsible for this cut, you have lost your leverage,” Fasano wrote.
Senate President Martin Looney, D-New Haven, said last week that Republicans chose to sit on the sidelines in the budget debate and have no right to criticize what was passed because they didn’t offer an alternative.
“We appreciate the Republicans’ new interest in funding Medicaid for nursing homes after failing to offer a budget during the 2019 session. Offering an alternative budget would have provided them with an opportunity to forthrightly state their spending priorities in comparison with the adopted budget,” Looney said.
Meanwhile, lawmakers in the House have vowed to keep a close eye on the situation.
“We have been monitoring this situation closely and my office has been in touch with both the administration and representatives of the nursing homes,” House Speaker Joe Aresimowicz, D-Berlin, said Tuesday. “I know the Governor’s office is discussing potential options, and we hope this can be resolved in a way that achieves the overall goal without impacting seniors or their care providers.”