Nursing homes warn of widespread job losses, facility closures in wake of state funding cuts

Article as it appeared in the Hartford Courant

After nine nursing homes received word that a new state law would cost them a collective $6 million in Medicaid funding, a Simsbury facility called a meeting to illustrate the on-the-ground impact, which union and executive leaders warn could lead to the shuttering of some nursing homes.

Union leaders and nursing home industry executives have sounded the alarm over the new law, warning that the cuts would lead to job losses and the closure of facilities. They also argue that the state’s calculations for occupancy, which it used to determine the cuts, are out of whack and that facility reductions will lead to a shortage of care down the road.

Union and executive leaders at Governor’s House, a skilled nursing facility on Firetown Road, held an informational session Thursday afternoon, where they encouraged residents and employees to share their stories.

Those stories focused primarily on the trauma to both residents and employees if Governor’s House were to shut its doors.

Ostensibly to prevent that, the leaders called on the legislature to revoke the new law and to reevaluate its methods for calculating occupancy.

The Medicaid cuts stem from a law passed by the state legislature this spring, which eliminated the so-called “stop loss” protections that guard Medicaid funding even when facilities are partially vacant.

The law targets nine nursing homes in the state, all of which have a vacancy rate of at least 30 percent.

Of those nine homes, five are owned by Pennsylvania-based Genesis Health Care, including Simsbury’s Governor’s House.

Though the law was passed months ago, union leaders and industry executives learned last week that their actual losses would be about $6 million per year. This has led to a renewed uproar.

Where would cuts be made?

Although the cuts are impending and significant, Nancy Slocum — the regional director of sales and marketing for Genesis Health Care, which owns Governor’s House — said that jobs and patient care would always be the last to suffer.

State officials have also noted that nursing homes never close overnight, and even an eventual closure would require state approval.

Instead of employee elimination, Slocum said, Governor’s House would likely find cost savings by sacrificing facility upgrades such as repainting walls and replacing furniture.

“Care is critical to us,” Slocum said. “We’re unwilling to compromise care” by cutting jobs.

Slocum also said that she couldn’t comment on where exactly cuts would be made, if the state law is implemented.

At Governor’s House, concerns are intensified by the home’s relatively small size — it has 48 residents and 125 employees.

And although employees’ livelihoods may not be on the immediate chopping block, facilities such as Governor’s House take issue with being targeted at all.

Slocum, as well as Genesis Regional Executive Director Marian Guadioso and Governor’s House Executive Director Teri Moriarty, all said that the state’s vacancy calculations are out of whack.
Guadioso said the state is counting beds that have been taken out of the daily mix and devoted to specialty services, such as dementia, respiratory, ventilator and hospice care.

Essentially, the nursing home industry employees say that the state is counting beds that have been intentionally sidelined or no longer even sit in the facility’s rooms.

State Sen. Kevin Kelly, R-Stratford, a member of the Committee on Aging and an elder law attorney, gave another example. He said that Carolton Convalescent Home in Fairfield — which is not part of the Genesis network — is considered by the state to have a 30 percent vacancy rate.

But the home has a waiting list.

“How can there be a wait if 30 percent of the beds are available?” Kelly said. “The point is, they are not available. This is where the Department of Social Services departs from reality.”

After realizing that these offline beds were being counted toward vacancy rates, Genesis offered to shed nearly 400 beds as a compromise — but state social service and budget officials have not accepted the offer.

Guadioso said that even if the state wants to decrease the number of beds in the state, that’s no reason to endanger the facilities themselves, particularly small facilities such as Governor’s House.

“The state feels that Connecticut is overbedded,” Guadioso said. “Let us give beds back … and keep the number of facilities.”

An incoming “senior tsunami”

Nursing home leaders, as well as legislators, have also labeled the law shortsighted, because it would shrink the nursing home industry before an expected surge of seniors.

Kelly said the state believes that, because Baby Boomers make up a third of the population, Connecticut won’t need these nursing homes over the next 10 to 15 years.

But executives and union leaders at the Thursday Governor’s House meeting talked about an incoming “senior surge” or “senior tsunami” that is expected in about 20 years.

Guadioso said that the state will need facilities in place and operational to meet that influx of need.

Kelly said that the state, while pulling back on facility-based funding, also hasn’t invested in community- and home-based care for seniors who want to “age in place.”

“You can achieve smaller nursing homes, but there has to be a corresponding investment in community care,” Kelly said.

Nearly 70 nursing homes, with 6,600 beds, have closed of their own accord in the state since 1995.

The state estimates there are currently at least 3,000 empty nursing home beds in Connecticut — a figure the industry disputes.

All nine of the homes affected by the cuts have filed appeals with the Department of Social Services. In addition, both Democrat and Republican legislators from the districts that house the homes have reached out to Lamont’s office in the hopes of delaying or reversing the law.