LeadingAge NY Joins HANYS and Nine Associations to Address Hospital Discharge Delays

LeadingAge NY joined the Healthcare Association of NYS (HANYS) and nine other associations to develop a series of recommendations to support discharges of hospital patients with complex health care needs and to strengthen the network of providers that often serve as discharge destinations for these patients. The recommendations are included in a report entitled "No more waiting: Recommendations to begin addressing care delays for New Yorkers with Complex Needs." The associations will continue to collaborate on solutions and hope to partner with policymakers and additional stakeholders to promote more person-centered and equitable health care and social care systems for individuals with complex care needs.

The recommendations arose from a series of work group meetings convened by HANYS in 2023, after an analysis of hospital length-of-stay data in 2022 showed prolonged stays of over one month for patients with complex needs who were ready for discharge.

At a high level, the resulting report focused on:

• creating and sustaining adequate care options;
• eliminating payment obstacles; and
• advancing ways for patients and providers to navigate multi-agency services more easily.

Of particular note for LeadingAge NY members are the following, more specific recommendations:

• Provide a multi-year commitment to close the Medicaid payment gap for nursing homes.
• Invest in the expansion of specialized units in skilled nursing facilities (SNFs) and/or in specialized training and access to specialty consultation services for SNFs (with or without specialty designations), such as services for residents who present with challenging behaviors, mental illness, substance use disorders, and/or neurological conditions, and advanced expertise in managing infectious disease (e.g., Candida auris).
• Invest in the Special Needs Assisted Living Residence voucher program to increase the number of people who can be served by the program and allow vouchers to be used in Enhanced Assisted Living Residence units to allow special populations (e.g., those with traumatic brain injuries, bariatric equipment needs, others) to qualify.
• Expand Special Needs Certified Home Health Agencies.
• Allow nursing homes to establish on-site dialysis dens for residents without obtaining an independent health equity impact assessment of the service.
• Authorize certified medication aides to administer routine and prefilled medications in residential health care facilities (A.8299).
• Partner with high schools and higher education programs to encourage entry into geriatric medicine, such as The New Jewish Home’s SkillSpring program.
• Allow and reimburse for telehealth services in all settings as appropriate (e.g., SNFs, home care, adult care facilities, Office for People with Developmental Disabilities programs). For example, update Department of Health guidance (i.e., DACF 23-27, DHCBS 23-04, DNH 23-19).
• Reinstate the full Medicaid payment for SNF residents who are temporarily hospitalized (for up to 14 days).
• Allow hours worked by registered nurses and licensed practical nurses in SNFs to count toward aide hours for purposes of the nursing home minimum staffing requirements, in order to support care for medically complex residents who may require more nurse hours.

The report is available here, and the press release is here.

Contact: Karen Lipson, klipson@leadingageny.org