In-Depth: Nursing home owners not happy with reforms on the horizon

Jennifer Lewke
Created: March 26, 2021 06:14 PM

ROCHESTER, N.Y. (WHEC) — Nursing homes have been at the epicenter of the COVID-19 pandemic in New York State. More than 15,000 nursing home residents have died during the pandemic, how their care was handled and the conditions inside the facilities in which they lived, has become a topic of political debate.

The NYS Senate and Assembly are now advancing long-talked-about legislation to make sweeping changes.    

Some of the reforms on the table are:

  • A requirement that for-profit nursing homes use 70% of revenues for direct care.
  • Set staff to resident ratios
  • Increased public access to all inspection/regulation records
  • Increased fines/penalties for violations.  

Bob Hurlbut owns 13 local nursing homes that employ 2,000 people, “COVID is still bad but it's not the unknown anymore…we've become smarter I think that there are different ways to handle COVID residents medically that we didn't know before,” he told News10NBC.

Hurlbut offered up two of his nursing homes in the fall when COVID rates in the Finger Lakes were sky-rocketing to try and help local hospitals.

“If we were so bad then why did I get two waivers from the State Health Department and the Governor himself to take COVID-positive residents out of the hospital?” he said.

That’s why he gets frustrated when he hears Gov. Andrew Cuomo saying this, “I don't want for-profit nursing homes squeezing profits out of the nursing home and maximizing profit and minimizing the quality of care.”

Hurlbut says forcing a private company to use its revenues for pre-approved expenses poses a real risk for his long-term viability.

“Seventy percent toward RN's and LPNs and direct care staff. That actually doesn't even include dietary or housekeeping or activities or social work so, my point is instead of doing these bills, if you want to talk about nursing home reform why don't you do it after the budget and set-up a commission,” he said.

When it comes to staffing ratios, a recent study commissioned by the New York State Department of Health and conducted by Cornell showed a major shortage of qualified employees to meet them.

“We are 35,000 people short between RNs and LPNs and nurses aids so, even if they did the staff ratio you couldn't do it,” Hurlbut said.

Why not pay people more to get them into the business?

“We haven't had a Medicaid rate increase since 2007 and yet we've had minimum-wage gone up at four times so we're doing more with less,” Hurlbut said.

According to the New York State Health Facilities Association, almost 80% of New York’s nursing home resident care is reimbursed by Medicaid. The average cost of providing 24-hour nursing home care in New York is $266 per resident per day, but the State pays an average of $211 per resident per day – or $8.79 per hour.

Hurlbut says he’d be open to increased inspections and more transparency around the results of those inspections. He also would be willing to accept reforms around increased penalties when nursing homes have egregious violations but he believes nursing home owners should have a seat at the table when it comes to determining the best way forward.

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