Home Health Care Administrator: Nursing Homes Deserve Funding Too!

CANTON – For the past 15 years skilled nursing facilities across New York State have not seen an increase in their Medicaid reimbursement rates, leading to the creation of a coalition that is bringing the fight to Albany with the intent of receiving a 20% increase in the state’s 2023-2024 budget.

Local media coverage of the coalition and its efforts recently prompted newly elected Assemblyman Scott Gray (R-Watertown) to state he would like to see the state’s efforts focused on home health care, and allowing people to “age in place.”

Northern Lights Home Health Care Vice President of Operations Katherine A. Race said that while home health care is important, it’s not for everyone, making skilled nursing care an important part of the health care continuum.

“In order to be signed on for home health care there are federal guidelines you have to meet,” she said. 

One of those guidelines is you have to be able to exit your home safely.

“A lot of times we will meet with people seeking home health care, but they can’t be home alone for any period of time. That will disqualify them from qualifying for our services,” she said.

Another issue Ms. Race said is insurance policies which will not pay for home health care, but will cover skilled nursing care.

“There are a lot of people who do not qualify for Medicaid, but cannot afford to pay for home health services out of pocket if their insurance will not cover them,” she said. “These people need a place to go where they can receive the care they need and deserve.”

A shift to home health care for more people also assumes there are enough providers to give that care – something that Ms. Race says is not the case.

“Like hospitals and nursing homes, we too are facing staffing difficulties,” she said. “It takes a special kind of person to work in home health care. We are going into people’s homes and working with whatever they have available. Many of these people don’t have lift chairs or hospital-style beds.”

That doesn’t even take into account precautionary measures, as a result of COVID-19, which is still active in the community, and something home health care providers are dealing with on a near daily basis.

“Our staff is doffing and donning PPE (personal protective equipment) on people’s porches, in hallways, or in some instances while standing outside of their vehicles,” she said. “It’s very hard to recruit people who are willing to do all of this.”

Ms. Race said she is pleased that Assemblyman Gray recognizes the importance of home health care, but she said their funding should not come at the expense of skilled nursing facilities.

“It’s great to see the state wanting to put money in the community, but at the end of the day these folks are going to age out and need a place to go. We need options,” she said.

Those wishing to support the coalition’s efforts may send an automatically generated message to Gov. Hochul by visiting https://p2a.co/Q2wLwJZ. People may also reach out to Mr. Gray, Assemblyman Ken Blankenbush, Senator Mark Walczyk, and Senator Dan Stec.

Mr. Gray, Mr. Blankenbusg, Mr. Walczyk, and Mr. Stec all represent portions of St. Lawrence County in the state legislature.

 

On the web:

https://www.nysenate.gov/senators/mark-walczyk

https://www.nysenate.gov/senators/daniel-g-stec

https://assembly.state.ny.us/mem/?ad=116 (Mr. Gray)

https://nyassembly.gov/mem/Ken-Blankenbush 

Caregivers: Home Health Care isn't for Everyone

OGDENSBURG – Following comments from newly elected Assemblyman Scott Gray (R-Watertown), that he would rather see the state focus its funding efforts on people “aging in place” than skilled nursing care, several people who served as caregivers for loved ones are speaking out to let him and the state’s other elected leaders know that home health care isn’t for everyone.

Janet Geddes served as a caregiver to her mother for 18 months. Sheree Trainham managed home care for her grandfather for two years, and Susan Denesha provided and managed care for both her father and stepmother for roughly two-and-a-half years.

Ms. Geddes said the 18 months she was providing care to her mother were easily the most difficult of her life. 

“I was providing 24/7 care for my mother,” she said. “I could barely sleep. The sleep deprivation took a big emotional toll on me.”

Ms. Geddes said she did have family who provided some relief, but she was hesitant to ask them for too much help, in case the time came when they would have to step in and take over the 24/7 care.

“I had to keep something in the reserves,” she said, explaining that her mother had dementia, which eventually lead to her mother not recognizing her as her daughter, but rather as her caregiver.

“I had enough savings that I could give up my work, but most people can’t do that,” she said. “I feel like my experience shows that not ever senior is appropriate for home care.”

Ms. Geddes said she doesn’t understand how someone could feel like home care is the only answer.

“It’s going to become an even bigger challenge with all the baby boomers,” she said. “There are already nursing shortages and CNA shortages, where do they think they’re going to find the staffing to care for everyone at a 1:1 ratio, and isn’t it going to cost more to do that? We already have a system in place to care for our seniors, starving it out just doesn’t make sense.”

Mrs. Trainham said the decision to transition from home care to skilled nursing care provided her family with a gift that allowed them to cherish their time with her grandfather, rather than constantly struggling to manage his care themselves.

Her grandfather had dementia, as well as several other health issues, which made each day a “safety nightmare and pharmaceutical adventure.”

“My strong, funny, loving Grandpa was at best sad, and more often in tears, because his body and mind were no longer working as they had before. He was aware of the decline and felt powerless,” she recalled. “I was at best sad, or more often on the verge of tears, because even with at home help, I was spending all of my time sorting through logistical and pharmacological chaos with little or no progress.”

Her grandfather’s frustrations soon became her frustrations, and they were eventually both feeling the same way – powerless.

“As I sought to organize and balance the demands of full-time at-home care for Grandpa, family emotional wellness, and a full-time professional career, I too was completely aware of our family’s decline and we all felt powerless,” she said. “It was truly not a matter of if, but when a scheduling error, a medication mix-up, or a fall injured the most vulnerable member of our family. We needed to act before a crisis occurred.”

So after two years of managing this process, the family decided to move their grandfather into a skilled nursing facility.

“Moving a loved one from home to a long-term living facility is difficult, but may be the very best solution for the emotional and physical health of the loved one and his or her family,” Mrs. Trainham said. “The move provided us with time to cherish our grandfather, and each other, to recall and relive great family moments, to make new memories, and to say thank you – to him, to each other, and to the people who supported us. The move allowed us to embrace our grandfather’s final days, not as an end, but as a loving transition.”

Mrs. Denesha also juggled a full-time career with providing home care for loved ones, though her family did contract with a home care agency who provided assistance four times per day, although she can recall signing a contract that stated if their paid provider was unable to make it that day, a family member or someone else who would fill-in in their place.

“I was always one phone call away from a very long night, before having to go to work again the next day,” she said.

Mrs. Denesha said she would wake up in the morning and go to her dad’s house before going to work and then return to her father’s house at the end of her work day, often time spending weekends there as well.

“That went on for two-and-a-half years. It was very difficult, but when you’re in the middle of it, you don’t realize it and you think you’re doing great,” she said.

Mrs. Denesha said her ah-ha moment came one day when her father walked outside to get the mail.

“The mailbox was on the same side of the road as their house, but I could tell by the look on his face when he turned around that he had forgotten where the house was,” she recalled.

It was at that moment she decided her parents needed more care than she was capable of providing at home.

“As soon as they were here (United Helpers Rehabilitation and Senior Care), we realized we weren’t doing as good of a job as we thought we were,” she said.

All three ladies said their intent in speaking out is not to bash home health care, but rather to remind policymakers that in the world of healthcare, there is no one-size-fits-all solution. Hospitals are important. Home health care is important, and skilled nursing facilities are important.

“Our loved ones deserve a place to go where they can receive quality care when they can no longer care for themselves or stay in their own homes,” Mrs. Denesha said. “I wouldn’t want to see anything happen to this place (United Helpers Rehabilitation and Senior Care).

Coalition Aiming to Inform Public of State's Neglect

OGDENSBURG – United Helpers COO Stacey Cannizzo is joining leaders from 25 other non-profit nursing homes across Upstate New York in sending strongly worded statements to media in their community to alert citizens of the on-going lack of response from the governor on senior care issues.

“The end of 2022 marks a troublesome new milestone that most people are unaware of,” Mrs. Cannizzo wrote. “It marks 15 years since the state has raised the daily Medicaid rate paid to nursing homes to account for inflation.”

Given that the last increase was awarded in 2008 this failure extends back prior to Gov. Kathy Hochul’s administration through Andrew Cuomo’s entire 11 year term and into the final years of David Paterson’s time as governor.

“New York has distinguished itself as being dead last, or at best second to last, in what it reimburses nursing homes compared to actual costs,” Mrs. Cannizzo wrote citing multiple studies which compare nursing home costs and reimbursement rates across the country.

Citing those same studies, Mrs. Cannizzo said many states responded to the COVID-19 pandemic by increasing the rates paid to nursing homes for care. At the same time, New York State cut those rates, not once, but twice, leading to a shortfall that exceeds $140 per resident, per day.

The lack of funding, she said is also making the staffing crisis faced by everyone in the medical community that much worse for nursing homes. 

“Nursing homes are unable to compete for the quality workforce we all aspire to. The result is very real if you’re in need of nursing care,” she wrote. “Due to staffing limitations, United Helpers is, for the first time in its history, leaving beds vacant.”

United Helpers is not alone, she said. Citing coalition data, Mrs. Cannizzo said there are more than 6,700 beds sitting empty for those same reasons, which is also negatively impacting hospital systems across the state. 

“When hospitals cannot discharge patients who need nursing home services, there are fewer, or in some cases no beds, for patients who truly need hospital care,” she wrote, adding this can also lead to patients sometimes being sent to facilities outside of the area, farther away from their families and loved ones.

In response to the past 15 years of neglect, Mrs. Cannizzo said the coalition is asking for a 20% increase in reimbursement rates to be included in the 2023-2024 budget.

“This is still less than half of the increase in costs we have absorbed over the past 15 years,” she wrote, noting the coalition has calculated that costs have risen by 42% over that same time.

“The people we serve deserve better from New York State. The outstanding employees who work in these settings deserve better. The family members who rely on us today, and the community who will look to us in the future deserve better too,” she said.

Those wishing to support the coalition’s efforts may send an automatically generated message to Gov. Hochul by visiting https://p2a.co/Q2wLwJZ. People may also reach out to Assemblyman Scott Gray, Assemblyman Ken Blankenbush, Senator Mark Walczyk, and Senator Dan Stec.

Mr. Gray, Mr. Blankenbusg, Mr. Walczyk, and Mr. Stec all represent portions of St. Lawrence County in the state legislature.

 

On the web:

https://www.nysenate.gov/senators/mark-walczyk

https://www.nysenate.gov/senators/daniel-g-stec

https://assembly.state.ny.us/mem/?ad=116 (Scott Gray)

https://nyassembly.gov/mem/Ken-Blankenbush

United Helpers Joins Coalition Fighting for Our Seniors

CANTON – United Helpers Rehabilitation and Senior Care in Canton is one of 26 non-profit skilled nursing facilities from across Upstate New York taking part in a coalition aimed at delivering the message to Albany that they can no longer continue to ignore senior citizens and their families who rely on these facilities for care.

As part of this effort the United Helpers Management Company Board of Directors, as well as the Society of the United Helpers Board is asking members of the public to reach out to Gov. Kathy Hochul through this link, which will generate a message on your behalf, https://p2a.co/Q2wLwJZ.

“Skilled nursing facilities all across New York have not seen an operating rate inflation adjustment in their Medicaid reimbursement rates for 15 years, going back to 2007,” said United Helpers Chief Operating Officer Stacey Cannizzo. “These stagnant rates have led to operating losses, not only for United Helpers, but for facilities all across the state.”

According to data compiled by the coalition, the 26 facilities have a census capacity of 4,631 beds with an average financial loss per bed of $25,384 per year.

Over the past several years these losses have led to the closure of more than a dozen senior care facilities in the region, including United Helpers Rehabilitation and Senior Care in Ogdensburg in 2021.

Using data provided by coalition members, there is a combined loss of $81.6 million for its 26 members in 2022. That’s an average of almost $3.14 million per facility.

“It’s almost as if the people responsible for making these funding decisions do not have parents, grandparents, or other loved ones who receive or could potentially one day receive skilled nursing care,” Mrs. Cannizzo said. “It’s disheartening to constantly read in the newspaper or see on TV about the tens or hundreds of thousands of dollars available to other types of health care providers, but when it comes to folks in facilities such as ours, there is seldom any money available.”

With nearly 80% of the people receiving care through United Helpers relying on Medicaid and/or Medicare to pay for the services they receive, Mrs. Cannizzo said reimbursement rates from the government only provide enough funds to pay for roughly 50% of that care.

“The bottom line is New York State needs to do better for our seniors,” she said. “Along those lines we are compelling the state to provide skilled nursing facilities with a 20% increase to their reimbursement rate. We recognize that a 20% increase may sound like a lot, but if the state had not gone 15 years without an increase, we would not be in the situation where their lack of action has led to the closure of facilities such as ours.”

Mrs. Cannizzo said she would like to reassure both United Helpers employees, as well as family members for those receiving care in Canton that United Helpers Rehabilitation and Senior Care is not in danger of closing at this time, but without some changes to the state’s funding structure each year that passes puts us closer to that point.

“For many of us our parents and grandparents are among the most important people in our lives. They deserve the same level of love and care in their golden years that they provided to us as children and young adults growing up” Mrs. Cannizzo said.

United Helpers Management Company Board of Directors President Dr. Galen Pletcher said the time for people to act is now.

“Skilled nursing facilities such as ours have been preaching this message for years, but it has continually fallen on deaf ears,” he said. “Perhaps if our representatives started hearing from the people they rely on for votes and campaign contributions, they will finally hear our message.”