Governor Andrew M. Cuomo has announced sweeping nursing home reform legislation to increase transparency, hold nursing home operators accountable for misconduct and help ensure facilities are prioritizing patient care over profits as part of the 30-day amendments. The COVID-19 pandemic exacerbated existing health equity and access to care issues among all communities, however, the State’s minority communities and older adults have been disproportionately affected. These reforms would make permanent the lessons learned from the COVID-19 pandemic to improve the health and safety of nursing home residents, as well as the quality of services in nursing home facilities.
“Every day, families across the state entrust the safety and health of their loved ones to nursing homes and as this unprecedented public health crisis has shown, some performed admirably, but some did not,” Governor Cuomo said. “Facilities have put profits over care for far too long and as we look forward, we must learn from the past and prepare for the future. These facilities must be transparent and we have to have the tools necessary for holding bad actors accountable – that is the only way families will have peace of mind and I won’t sign a budget that doesn’t include these common-sense reforms.”
1199SEIU United Healthcare Workers East President George Gresham said, “Governor Cuomo has introduced a strong proposal that will significantly increase the accountability of nursing home owners and require them to invest their revenues in providing quality resident care rather than diverting taxpayer dollars to excessive profits, including those hidden in transactions with related corporations. We are very glad that nursing home reform will be part of the upcoming budget negotiations and look forward to working with the Governor and the Legislature to see it enacted.”
This legislation aims to improve the safety and quality of New York’s nursing homes through a series of reforms that increase transparency around nursing home staffing, expenditures and ownership; hold operators accountable for violations of the Public Health Law and other misconduct; and ensure nursing home facilities are prioritizing patient care and safety over profits and adequate funding is spent on direct patient care and resident staffing.
Increasing Transparency
These reforms aim to increase transparency by:
- Requiring nursing homes to post their rates for each payer source on a public website, updated annually;
- Requiring the posting of all facility owners;
- Requiring the posting of a list of all contracts or other agreements entered into for provision of goods or services for which any portion of Medicaid or Medicare funds are used by the facility within 30 days of execution of the agreement; and
- Requiring information regarding staff be included in an application to establish a nursing home.
Holding Operators Accountable for Misconduct
These reforms aim to hold operators accountable for misconduct by:
- Increasing civil monetary penalties to $25,000 for violations of the Public Health Law, including increasing penalties for willful violations of Public Health Law or regulation;
- Removing the requirement to provide adult care facilities a 30-day period to rectify violations prior to imposition of a penalty; and
- Building off legislation signed by the Governor in 2019, requiring any nursing home with a repeat
- Infection Control Deficiency to work with the Quality Improvement Organization, or a state designated independent quality monitor, at the nursing home’s own expense, to assess and resolve the facility’s infection control deficiencies.
- Streamlining process to appoint a receiver to protect patient health and safety.
Prioritizing Patient Care Over Profit
These reforms aim to ensure nursing home facilities are prioritizing patient care over profits by:
- Requiring that nursing homes spend a minimum of 70 percent of revenue on direct patient care and a minimum of 40 percent of revenue on resident staffing; and
- Establishing a nursing home profit cap and limiting certain unscrupulous transactions, including but not limited to related party transactions over fair market value and payment of compensation for employees who are not actively engaged in or providing services at the nursing home.
- Limiting the overall proportion of management salaries and setting a cap by regulation, dependent on the size of the facility, for managers and executives.
