Nursing homes
Massachusetts raises Medicaid penalties for the most understaffed nursing homes to 8%
New MassHealth rules cut Medicaid payments by 8% for nursing homes staffed below 3.00 nursing hours per resident per day, up from a 3% maximum, though only a handful of homes are expected to be affected.
Key facts
- Skilled Nursing News reported on October 6 that Massachusetts health officials put in place a new Medicaid payment policy that took effect that Thursday.
- Nursing homes below the state's minimum staffing standard of 3.58 nursing hours per resident per day can face reduced Medicaid payments.
- The maximum penalty was 3%; facilities below 3.00 hours now face an 8% cut.
What happened
Skilled Nursing News reported on October 6 that Massachusetts health officials put in place a new Medicaid payment policy that took effect that Thursday. Nursing homes below the state's minimum staffing standard of 3.58 nursing hours per resident per day can face reduced Medicaid payments. The maximum penalty was 3%; facilities below 3.00 hours now face an 8% cut.
The change followed a Bedford Light investigation that found about half of Massachusetts nursing homes were violating at least one minimum staffing standard. Based on payroll data, roughly five homes would have faced the higher penalty earlier this year. Homes between 3.00 and 3.58 hours still face 0.5% to 3% cuts, and homes reaching 4.00 hours can be exempt from a rule to spend 75% of revenue on direct care.
What it means for families
Staffing hours per resident is a number families can look up and compare. Penalties like this push the lowest-staffed homes to improve, but the best protection is still choosing and watching closely.
For example: a home with 100 residents at 3.00 hours would have about 37 or fewer full-time nursing staff, compared with roughly 45 needed to meet the Massachusetts standard.
What this means in New York: New York has its own minimum staffing law for nursing homes. You can compare staffing for New York homes on Medicare's Care Compare.
Quick answers
What is the new Massachusetts nursing home staffing penalty?
Skilled Nursing News reported on October 6 that Massachusetts health officials put in place a new Medicaid payment policy that took effect that Thursday. Nursing homes below the state's minimum staffing standard of 3.58 nursing hours per resident per day can face reduced Medicaid payments. The maximum penalty was 3%; facilities below 3.00 hours now face an 8% cut.
What to do this week
- Look up your relative's nursing home staffing hours per resident on Medicare's Care Compare.
- Ask the administrator how the home handles shifts when staff call out.
- If staffing seems short, document what you see and raise it with the home and the state health department.
Sources
More from Nursing homes
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