2025/26 Budget Update

The Legislature released the agreed upon Health and Mental Health (HMH) Article VII State Budget bill overnight with voting set to begin mid-afternoon today, coming over a month after the April 1 deadline. The following is an initial brief summary of some of the provisions included in the FY 2025-26 State Budget affecting skilled nursing and assisted living providers.

SKILLED NURSING FACILITIES

Medicaid Rate Increase

The State Budget increases the Medicaid reimbursement rate for skilled nursing facilities by $445,000,000 (state and federal share) for the period of April 1, 2025 through March 31, 2026. Beginning on April 1, 2026 and thereafter, the nursing home Medicaid rate will be increased by an aggregate amount of $385,000,000 in addition to the $445,000,000. These increases are contingent upon available revenue derived from the managed care organization (MCO) tax.

These increases build upon the 7.5% increase for skilled nursing providers in FY 2023-24 and the $285,000,000 increase for skilled nursing providers in FY 2024-25.

Capital Rate for SNFs

The State Budget does not include a capital cut restoration.

Cash Receipts Assessment

The State Budget extends the 6% CRA program through March 31, 2029.

Rate Appeals

The State Budget extends the $80 million cap on nursing home capital appeals to April 1, 2029.

Trend Factor

The State Budget extends the 0% trend factor through March 31, 2029.

Notice of Material Transaction Requirements

The State Budget does not include language to amend the length of time that a healthcare entity must submit a notice to the Department before the closing date of the transaction.

ASSISTED LIVING PROGRAMS (ALPs)

Medicaid Rate Increase

The State Budget increases the Medicaid reimbursement rate for assisted living providers by $15,000,000 for the period of April 1, 2025 through March 31, 2026 and every year thereafter. These funds are contingent upon the available revenue derived from the managed care organization (MCO) tax.

These increases build upon the 6.5% increase for assisted living providers in FY 2023-24 and the $15,000,000 increase for assisted living providers in FY 2024-25.

EQUAL Program

The State Budget does not include funding for the EQUAL Program. 

State Supplemental Program (SSP)

The Health and Mental Hygiene Article VII Budget bill does not address the SSP rate for enhanced residential care as this is taken up in a separate budget bill. NYSHFA|NYSCAL is still awaiting final details on this. 

ALP Bed Need Methodology

The State Budget does not include a revised ALP bed need methodology. 

Temporary Operator Program

The State Budget does not include language to amend the temporary operator program for adult care facilities. 

ADDITIONAL PROVISIONS:

Certified Medication Aides

The State Budget does not include provisions to allow certified medication aides to work in SNFs.

NYSHFA | NYSCAL will continue to provide updates as further FY 2025-26 State Budget information becomes available.

NYSHFA | NYSCAL CONTACTS: 

Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x11

Kristin DeVries, MA, MPP
Director of Government Relations
518-462-4800 x14