Nursing Home Budget Request
LeadingAge NY is urging NYS to reform and rationalize the nursing home Medicaid reimbursement methodology in the State Fiscal Year (SFY) 2025-26 budget, to ensure that Medicaid payments keep pace with rising costs and ensure access to quality care for those who need it.
THE PROBLEM
- On average, NYS's nursing home Medicaid rates cover only 75 percent of the cost of care.
- There is a $1.6 billion Medicaid funding gap for the nursing home care provided in NYS.
- The foundation of NYS's nursing home Medicaid reimbursement is based on 2007 costs.
- NYS's nursing home Medicaid reimbursement is among the worst in the country, according to an independent federal MACPAC report.
- Inadequate Medicaid reimbursement significantly hinders provider ability to compete for, hire, and retain staff.
- Lack of staff directly impacts access to skilled nursing services for those who need them.
THE SOLUTION
NYS must reform and rationalize nursing home reimbursement by:
- Increasing nursing home Medicaid rates by 20% (to combat over 50% cost growth since 2007),
- Restoring recent cuts to reimbursement for capital improvement projects, and
- Reforming the Medicaid rate methodology to ensure rates match current costs & incentivize quality.
Click here to learn more about rebasing nursing home Medicaid rates.
Contact: Sarah Daly, sdaly@leadingageny.org