Jan. 1 cuts severely impacted many nursing facilities
We thank Gov. Kelly Ayotte and policymakers who have tried to stand by nursing home care
Nursing home caregivers and all the staff who support quality care -- activities professionals, dietary, housekeeping, and maintenance workers -- are everyday heroes. Gov. Kelly Ayotte and legislators have tried to maintain progress for nursing home care, and added funding to better process Medicaid long-term care applications.
When a funding shortfall threatened Jan. 1 cuts, funds were shifted to mitigate the cuts. This effort, supported by Gov. Ayotte and her Department of Health & Human Services, the Executive Council, and the legislative Fiscal Committee, is much appreciated. However, many facilities are still hard-hit. Work must occur in the 2026 legislative session to further bolster care funding, or a number of facilities will close and access to care will be further restricted in our aging state.
Nursing home care finances are precarious, with no margin for cuts
Most nursing home residents have their care paid for by Medicaid. New Hampshire has the nation's second-oldest population, and facilities are already turning away residents because they cannot find enough staff. Most Medicaid care costs are wages and benefits. At a minimum, Medicaid cuts will prevent nursing homes from being able to pay the higher wages they have given the staff they already have, quite apart from restricting their ability to hire new staff and pay other rising costs associated with care of our most frail and vulnerable Granite Staters.
NH care funding has long been shortchanged
Sister Jacqueline is among an estimated 3,517 New Hampshire residents on Medicaid in nursing homes. She worked as a school principal, including in Derry and Franklin, for as little as $1 a day in keeping with her vow of poverty. Her Manchester facility experienced a severe care cut on January 1, taking 11.74% of its Medicaid funding, or $31.74 a day, away from the care of Sister Jacqueline and her fellow residents.
But that's not all. Even when a facility's' care funding isn't cut, in New Hampshire it still does not receive what the state acknowledges to be the fair payment rate.
That's because a "Budget Adjustment Factor" reduces the state's rate to whatever legislators have appropriated. This longstanding practice of effectively balancing the state budget on the backs of seniors by ignoring state-recognized care costs is increasingly unsustainable. And cuts on top are unbearable.