Spending

Care homes sue over minimum staffing and mandatory spending levels

Credit: Kong Ding Chek/Getty Images

New York City’s nonprofit nursing homes are taking action against the state in an effort to overturn “illegal and unconstitutional” policies that establish minimum staffing requirements and spending mandates for providers.

LeadingAge New York, leading a group of 80 nonprofit and public retirement homes, filed a lawsuit against the state on Monday over the two laws enacted during the COVID-19 public health emergency. 19.

“The combination of poor policies, lack of funding and an insufficient workforce has resulted in a perfect storm of circumstances that leaves us with no recourse but to seek the intercession of the courts,” said James Clyne Jr., Chairman. and CEO of LeadingAge New York, said in a statement Monday.

Challenge to Minimum Endowment Law

Former New York Governor Andrew Cuomo (D) signed the minimum staffing law in June 2021. Implementation was delayed until current Governor Kathy Hochul (D) refused to extend the term end of March. The regulation obliges establishments to provide a daily average of 3.5 hours of care per resident by a nurse or nursing assistant. At least 2.2 hours of care must be provided by a certified practical nurse and at least 1.1 hours of care must be provided by a registered nurse.

Providers estimated affected care homes would need to spend an additional $325 million to meet the requirement. Penalties for non-compliance can reach $2,000 per day. The federal government is also pursuing a minimum staffing requirement for nursing homes.

LeadingAge NY alleged that the staffing law creates an arbitrary, one-size-fits-all standard that is impossible to meet in the context of a declared staffing emergency and is inconsistent with the state’s prior legislation on staffing ratios. endowment.

The group said in court documents that a previous study by the state Department of Health found that “staffing mandates were not compatible with the flexible, team-based approach of the modern medicine it needs to address the needs of nursing home residents”.

“The Staffing Act directs the DOH and its commission to penalize nursing homes up to $2,000 per day for failing to meet these arbitrary and irrational goals,” the lawsuit states. “There are simply not enough nurses and nursing aides to meet the requirements of the staffing level laws, and the law will only serve to financially penalize petitions and other nursing homes. not for profit, regardless of residents’ needs or the quality of care provided, depleting them of funds needed to recruit and retain staff.

Spending Warrant Challenge

The new state spending mandate for nursing homes also requires providers to spend at least 70% of their revenue on direct patient care, including at least 40% for direct care staffing. This had also been delayed from implementation until Hochul let it expire in March.

Providers in court documents allege that the Expenses Act omits capital costs of direct resident care expenses, but “inexplicably” includes all capital reimbursements for most facilities in the calculation of income, which will discourage facilities to make capital improvements that support infection control efforts.

They also argued that the law directs the state to recover, or confiscate, any annual operating income that exceeds 105% of annual operating and non-operating expenses.

“If a non-profit retirement home has a good year financially, for example through investment income generated by reserves, [the state] will also seize these funds,” the lawsuit states. “The establishment will not be permitted to save them in the event of a financial crisis or extraordinary expenses, or to otherwise protect the financial situation of the establishment.”

The group is seeking a preliminary and permanent statewide injunction prohibiting the penalties imposed on nursing homes and wants the regulations declared unconstitutional and illegal.