Dr. Deidre S. Gifford, Commissioner of the Department of Social Services and Senior Advisor to Governor Lamont for Health and Human Services, today shared the department’s Report on Connecticut Nursing Home Rebalancing & Efficiency Plans with members of the Nursing Home Financial Advisory Committee, leadership of associations representing the state’s skilled nursing facilities, and additional colleagues in service to Connecticut’s older adults and persons with disabilities.
As Commissioner Gifford wrote, the document presents data and analysis of skilled nursing facility responses to the efficiency plan requirement included in one of the state’s financial support packages provided during the COVID-19 public health emergency.
Included in this support package was $85.8 million in 10% Medicaid rate increases (subsequently extended three additional months at a cost of $29.1 million through a combination of Medicaid and ARPA funding); $149.5 million to support 4.5% Medicaid rate increases for staff wage enhancements in each year of the biennium; $30.8 million in staff health and pension enhancements; and $90 million to support the three-year transition to Medicaid acuity-based reimbursement. In return, nursing homes were asked to submit an efficiency plan to the Department of Social Services by April 1, 2022. Specifically, facilities were asked to discuss and present ideas regarding ‘right-sizing’ and rebalancing efforts if a facility did not reach 85% occupancy by that date; has excess beds in its region; or determines that acuity-based reimbursement would adversely impact a facility’s financial conditions.
Connecticut, like other states, has been responding to major shifts in consumer demand by ‘rebalancing’ public expenditures on long-term services and supports (LTSS), while fostering alternatives in care to meet varying levels of need. In essence, rebalancing refers to reducing reliance on institutional care and expanding access to home and community-based services. A balanced LTSS system gives Medicaid members (and other consumers) greater choice in where they live and from whom they receive services, while increasing cost-effectiveness. A central part of this strategy is to encourage and assist nursing homes in diversifying their care and business models to help meet consumer preferences and strengthen high-quality nursing homes for those who need and choose that care setting.
While responses varied by facility and some included detailed information and transformative thinking about future sustainability and current consumer trends, it is disappointing that the vast majority of nursing homes (over 60%) with lower occupancy rates (53 of 83 homes) reported no action being taken. Similarly, the vast majority of nursing homes (over 70%) that identified excess beds in the area (76 of 103 homes) reported no action being taken.
At the same time, Commissioner Gifford emphasized that the main purpose of the report is to provide data and analysis on a statewide basis. That is the reason for not identifying individual facilities and regions. The report can be viewed as information and intelligence on the state of skilled nursing facilities, their commitment to innovation, and as a tool for further discussion and deliberation on how best to sustain necessary skilled nursing home care resources while rebalancing of the overall LTSS system continues.