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Nursing homes under threat – Fears swirl around possible cutbacks and closures

By Aaron Short

Hundreds of nursing homes and other long-term health care facilities throughout the New York region are facing the grim reality that the state will cut over $800 million from their budget over the next three years. “Next week will be a pivotal week for this legislation,” said Scott Amrhein, president of the Continuing Care Leadership Coalition (CCLC), a nonprofit consortium of long-term health care facilities and certified home health agencies in New York State, at CCLC’s 3rd Annual Brooklyn Town Hall Forum on Long-Term Care. “It is a myth that administrative and general costs is overhead. It’s cutting to the bone. We know that we are on the cusp of an important week in the state legislature.” The coming weeks are pivotal for health care lobbyists as they visit state legislators as they debate the budget in their communities, including recently at the Brooklyn town hall forum, held at Kingsbrook Jewish Medical Center (585 Schenectady Avenue). About 40 long-term health care professionals met on March 6 with CCLC staff members and several elected officials to discuss the proposed cuts in long-term health care services in the proposed 2008-2009 New York State budget. “When we report to our conference about the impact of the cuts to long-term health care, we are going to go with one agenda and one agenda only: That is to restore those cuts that the governor is calling for,” State Senator John L. Sampson said. Most of the health care professionals in attendance represented facilities that are members of the CCLC, which has been holding forums in each borough this past week to give its members the opportunity to voice their specific concerns with the proposed budget to state legislators as well as explain how they have had to make cuts within their own health facilities based on prior budget allocations. “If you cut those long-term health care services, then you will increase the number of people visiting hospitals,” said a representative from the Norwegian Christian Home and Health Center, a nonprofit nursing facility, 1270 67th Street, Bay Ridge. “Do you want to spend $2,000 a day on a hospital or $200 a day on a long-term health care? This will put more people in the hospital, and will cost jobs. What we need now are more jobs.” The proposed executive budget would eliminate $826.9 million in funds over a three-year period, $87 million in Brooklyn alone. Nursing homes in New York City are also expected to receive cuts upwards of $200 million. By 2009, funding for the Workforce Investment, funding for staff wages, benefits and training, would be eliminated, and 52 percent of total losses of workforce cuts would occur in Kings County. Also in 2009, the Case Mix Index, a factor that determines the overall level of payment to nursing homes, would receive a cut of $190.8 million, with Brooklyn receiving a CMI reduction of $21.8 million next year. These cuts come on top of losses that the long-term health care industry has sustained in the past year, where losses topped $177 million in 2006, and many facilities are operating at or below the margin of profitability. Nearly one out of two nursing homes in Brooklyn loses money on operations, and the operating margin is a negative 1.7 percent. The brunt of the losses have been felt in operations and administrative overhead, with long-term health facilities scrambling to prevent further layoffs and the closing of whole departments. “We will have to lay off 120 people or fund cost savings measures elsewhere,” said Monica Mahaffey, a representative from Visiting Nurse Regional Homecare Services. “The flu clinics, diabetes screenings and other respiratory screenings which help prevent problems down the road may have to be reduced or cut out entirely. We are people caring for people, but what cannot be replaced are nurses and therapists.” Over the next thirty years, the over-65 population in New York City is expected to grow by 60 percent, from 2.5 million to 3.9 million, and the population most likely to require long-term care is expected to double, from 311,000 to 621,000. Home health care providers stated that they have noticed the trend of patients asking to be moved from nursing homes and treated at home with their families, in the communities, even though the cost for these services is considerably higher. Last month, Amrhein testified on behalf of CCLC before the New York State Senate Finance and Assembly Ways and Means Committees, where he recommended several solutions to the proposed budget cuts. CCLC recommended that the state legislature restore the cuts in Home Health Care and expand home and community-based care options. Amrhein highlighted the Partnership Plan, which enables patients to buy a private long-term health care policy and still be eligible for Medicaid without spending through savings, but pointed to a disturbing trend. “At the same time the state is promoting the Partnership Plan, they’re taking away all the options,” Amrhein said. “If you buy a Partnership Plan, where are you going to go to get long-term health care services?” For more information on the Continuing Care Leadership Coalition, go to www.cclcny.org/ or call 212-258-5330.