News10NBC Investigates: Hospitals sending patients to nursing homes hundreds of miles away

News10NBC Investigates: Nursing home crisis

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ROCHESTER, N.Y. — Imagine: Your loved one survives a life-or-death situation and as they improve, the hospital sends them to a nursing home more than 100 miles away. That is what is happening to families in our community as overcrowded hospitals desperately try to free up space. 

Liz and Ski Dombkowski have been married for more than 50 years, they’ve never spent a birthday apart.  But instead of waking up next to Ski on the day he turns 75, Liz had to drive two hours away to see him. 

Around Thanksgiving, Ski had complications following heart surgery. After three months at Highland Hospital, he was told it was time to go to a nursing home to continue his rehabilitation. But, the closest available long-term Medicaid bed for Ski was in Horseheads in Chemung County —120 miles away from his home in Spencerport. 

Instead of visiting him every day, Liz is lucky to see her husband once every few weeks, and every visit is emotional. News10NBC Investigative Reporter Jennifer Lewke recently took the trip with Liz to visit Ski.

Jennifer Lewke, News10NBC: “The thought of you being in Horseheads… How did that settle with you initially?”

Ski Domkowski: “Not good. Not good at all. I actually fought it and I said, ‘I’m not going.’ I said, ‘Come on, all the nursing homes and places that are in Rochester?’”

Sally Rousseau is the Director of Social Work at Highland Hospital.

“We are a community in crisis,” she says.

Rousseau and her team are tasked with finding nursing home beds for hospital patients who need them. To say those beds are in high demand would be an understatement.

“Nursing homes receive upwards to 400 referrals a day from our local hospitals, vying for those available beds,” she tells News10NBC.

Rousseau says initially a hospital will try to find nursing home placement for a patient in the county in which they live. But after a week, they send the referral further out to include counties across the state.

“We have had to place patients as far away as New York City, Lake Placid, and other parts further away,” she adds. 

Jennifer Lewke: “Sally, is it fair to say that if I have $200,000-$300,0000 in the bank and I need a nursing home, I have a much better chance at getting one closer to home than someone who’s on Medicaid or is on their way to Medicaid?”

Sally Rousseau, Highland Hospital: “Absolutely, and it’s understandable. Nursing homes have to be paid for their services and they need that case payer mix also.”

Most local nursing homes say the Medicaid reimbursement rate doesn’t come close to covering the actual cost of care. So, the nursing homes have to limit how many people on Medicaid they take.

“I think this is the tip of the iceberg of this issue, it’s not going to go away,” Rousseau says. 

It has real-life consequences for people who will need care for the rest of their lives and for those like Ski, who are trying to get well enough to get home, “Thanksgiving, Christmas, New Year’s, our 54th wedding anniversary, and now my birthday, it’s just, I can’t believe I’ve been gone from home so long,” Ski says through tears. 

Patient advocates and nursing home trade organizations have been pushing state lawmakers to increase the Medicaid reimbursement rate in hopes of generating enough revenue to open more beds.

“Especially with long-term care, we’re in greater crisis than other parts of the state because of our low staffing numbers,” says Assembly Member Josh Jensen.

In the last five years, more than 1,200 beds in the Finger Lakes Region have disappeared because nursing homes can’t afford to staff them. The new state budget may help but it’s complicated.

“We don’t have the money,” Jensen says, “So, what was included in the budget was essentially a legalized form of federal money laundering.”

Here’s how it would work, the State would tax insurance companies, and then,

“We’ll have the federal government match it, give the money back to the managed care organizations, and then use the matched money for Medicaid increases for nursing homes, hospitals, and assisted living facilities,” explains Jensen.

It could work but it still needs approval from the feds. 

Assemblyman Jensen: “New York won’t have its answer on whether or not we’ll be able to use this scheme until October.”

Jennifer Lewke: “But in the meantime, it’s business as usual until then?”

Assemblyman Jensen: “Correct.”

Jennifer Lewke: “And so, we are nowhere near an end to this crisis?”

Assemblymen Jensen: “Unfortunately not.”

To search for available nursing homes in the region: