Nursing home caregivers and all the staff who support quality care -- activities professionals, dietary, housekeeping, and maintenance workers -- are there for us, but Medicaid funding cannot keep pace with the biggest wage increases of any health care sector. A December 2023 report found that nursing homes led all health care sectors with wage increases of 24.9% between February 2020 and September 2023 .
Most nursing home residents in New Hampshire have their care paid for by Medicaid, and delays in the completion of Medicaid application documentation or processing can result in a nursing home provider carrying hundreds of thousands of dollars in unpaid bills.
There is no margin to play this waiting game. Nationally, the all-payer margin for freestanding nursing homes fell in 2022 to negative 1.4 percent.
Care providers are very grateful for what legislators and Gov. Sununu did to bolster care funding in the current two-year state budget.
Yet, in the absence of any federal help (indeed, with the federal government poised to impose new unfunded expectations), nursing home care could use additional state assistance.
The health care workforce crisis has not spared any providers in New Hampshire. And that includes the state's own facilities.
Consider the fact that the state itself, which can afford to pay more than private or county-run nursing homes, recently raised the value of its temporary staff contracts at the New Hampshire Hospital and Glencliff Home from $3,770,000 to $11,500,000. Of the sixteen staffing agencies contracted with, only two are based in New Hampshire.
If even the amount of that staffing agency increase for just two facilities was given to nursing home care it could make a huge difference for over 70 nursing homes.
At a minimum, state law should be changed to allow, as occurs in other states, Medicaid payments to be made when Medicaid applications go past 90 days in processing.
Time remaining until next state budget takes effect on July 1, 2025.
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