Last Thursday, the Baker Administration and the Executive Office of Health and Human Services (EOHHS) released the Nursing Facility Accountability and Supports Package 2.0 which includes up to $142 million for quality nursing home care, covering (1) a new integrated rate structure for the Rate Year 2021 rate and beyond, and (2) targeted COVID-19 Supplemental Funding. The EOHHS proposal builds upon prior Accountability and Supports programs designed to promote and ensure high quality nursing home care.
Beginning in October 2020, MassHealth will invest $82 million in new funding in order to establish a single integrated rate based on more current costs (2018 with a cost adjustment factor to calendar year 2020) that will then be adjusted based on facility-specific quality performance, occupancy, Medicaid usage and the number of residents requiring specialized
behavioral health services. The rate investment is linked to reforms centered on resident care and safety, as well as initiatives intended to strengthen the direct care workforce, including a minimum Hours Per Patient Per Day (HPPD) requirement beginning this winter and the establishment of a direct care cost quotient (DCC-Q) standard requiring no less than 75% of total nursing facility revenues be spent on direct care staff which will replace the current direct care add-on. Massachusetts Senior Care Association continues to work with EOHHS, the Executive Office of Labor and Workforce Development and other stakeholders both to increase the supply of staff available to work in nursing homes and to ensure validity and consistency in the DCC-Q measurement. For the purpose of infection control, the state will also require facilities to reconfigure in order to eliminate the 3rd and 4th beds in multi-bed rooms, with a glide path of over one year for planning purposes.
Massachusetts Senior Care Association believes the EOHHS proposal as a whole, which has been strongly endorsed by the MSCA Board of Directors, is consistent with the longstanding goals that MSCA has advocated for stabilizing the system and putting the sector on a path to long-term sustainability. In a recent Commonwealth Magazine article, Baker Unveils Nursing Home Aid Package, the article reports “the new nursing support package appears to be a recognition that the industry has been inadequately funded and overseen by the state for years. The package provides $82 million a year in additional funding through the rejiggering of Medicaid rates.”