Long-term care industry hurt by proposed budget cuts

Governor David Paterson’s proposed budget for the coming fiscal year has long-term care providers in Queens scrambling, with anticipated funding cuts that would squeeze $840 million, according to a State Health Department (DOH) report, out of an industry that insiders claim is already struggling.
With the state’s budget deadline less than three months away, a group of aggrieved long-term care providers and residents gathered with local legislators on Friday, January 9 at Parker Jewish Institute for Health Care and Rehabilitation to lay out their concerns and work toward a plan to minimize the impact of any slashes to their state-issued funds.
According to the DOH’s Budgetary Impact Analysis and Joint Task Force on Nursing Home Reimbursement, the Governor’s proposed actions would amount to over $117 million in cuts to long-term care providers in Queens alone.
Meanwhile, Scott Amrhein, the President of the Continuing Care Leadership Coalition (CCLC), which represents 110 non-profit nursing homes and long-term care facilities in southern New York State, told the crowd at the CCLC Queens Town Hall Forum, “There’s not much room for even a haircut without affecting patient care.”
Indeed, even if Paterson’s budget is revised, the CCLC and its members are bracing for more than just a trim, a daunting realization for an industry groomed to “perfectionism,” in the words of Parker President and CEO Michael Rosenblut. “To have that quality there’s a cost,” Rosenblut emphasized.
Amrhein cited a 2007 American Health Care Association survey, which found that New York facilities had the lowest nursing staff turnover in the nation, as evidence of the high quality of care in New York - a level of care that would surely diminish in the face of such harsh cutbacks, he said.
In fact, nursing homes like Parker, as well as The Silvercrest Center, Margaret Tietz and Bishop Charles Waldo MacLean - which were all represented at the meeting - figure they will lose 10 percent of their revenue under Paterson’s plan.
“Ten percent cuts means longer time to respond to that call bell going off,” said Gerald Hart, Margaret Tietz’s Executive Director. “You’re wounding nursing homes so they’re bleeding,” he said of the cuts, prompting a fellow health care professional to worry aloud that Paterson’s actions would do to long-term care beneficiaries what Governor Hugh Carey’s budget cuts did to the mentally ill. The implication was that residents would end up on the street.
“It’s Darwinian,” the woman called out.
In light of the dire news - “With much more modest cuts over the past few years, over 24 centers have closed,” Amrhein said - the CCLC would have to think outside the box, to devise a survival plan, of sorts.
Aside from rejecting all “extreme direct cuts” - the organization’s top priority among its 2009 Budget Priorities - Rosenblut advocated for more relaxed regulations, such as a cap on expenses like Con Ed - “a dollar a day for natural gas” - and medical malpractice reform, which would increase the bottom line without affecting patient care, he said.
For their part, the politicians in attendance - both Assemblymembers Rory Lancman and Michelle Schimel come from health care backgrounds - were eager to lend their support.
Lancman, noting that there are five nursing homes in his district, said automakers are to Detroit what long-term care facilities are to Central Queens.
“You and the people you take care of have got the bull’s-eye on your back,” he said, eliciting nods around the room.
Assemblymember Mark Weprin said that while “The governor is not overestimating anything” in his budget, all cuts have to be fair and “they can’t overburden.”
However, care providers and advocates believe one provision in Paterson’s plan, the Medicaid-Only Case Mix, would have grim consequences. They say the provision - which was initially proposed in the 2007-2008 budget and would take effect in April, 2009 under the current plan - would prevent centers from caring for as many Medicare patients as they currently do and would cut an additional $300 million in funding from the long-term care community. Cuts like these, providers argue, would directly affect people like Bishop Charles Waldo resident Bob Rosenberg, inarguably the star of the symposium.
“You’re slicing off a part of me,” Rosenberg, 56, said of the proposed cuts. “If [Bishop Charles Waldo] closed, I’d like to know which legislator in here would take me in?” he asked.