Massachusetts health officials have increased financial penalties for nursing homes with the state’s lowest staffing levels, implementing a new Medicaid payment policy that took effect Thursday.
Under the new MassHealth rules, nursing homes that fall below the state’s minimum staffing standard of 3.58 nursing hours per resident per day (HPRD) can face reduced Medicaid payments. The maximum penalty previously was 3%; the new rules establish an 8% payment cut for facilities staffing below 3.00 HPRD.
The change follows an investigation by a local news outlet, Bedford Light, that found about half of Massachusetts nursing homes were violating at least one of the state’s minimum staffing standards. Senior living resident advocates had argued that the previous 0.5% to 3% penalties were too small to discourage facilities from operating with inadequate staffing.
The new 8% penalty is expected to affect only a small number of facilities, however. Based on available payroll data, roughly five nursing homes would have faced the higher penalty earlier this year. A facility with 100 residents operating at 3.00 HPRD or less would have about 37 or fewer full-time nursing staff, compared with roughly 45 needed to meet the state standard, the news outlet noted.
Advocates welcomed the increase but said the state should impose even stronger penalties, and as much as 10% penalty for the most understaffed facilities.
The new rules do not increase penalties for facilities between 3.00 and 3.58 HPRD. Those homes remain subject to cuts of 0.5% to 3%.
MassHealth also created an incentive for better-staffed facilities. Nursing homes reaching 4.00 HPRD can be exempt from a separate requirement to spend at least 75% of revenue on direct-care costs. Resident advocates have raised concerns that the exemption could allow some facilities to shift money away from resident care.
The staffing rules are separate from pending Department of Public Health regulations aimed at strengthening broader oversight of nursing homes.
Companies featured in this article:
