Senate and Assembly One-House Budget Bills
The Senate and Assembly have advanced their One-House Budget bills and accompanying resolutions, setting forth their respective negotiating positions pertaining to the FY 2025-26 State Budget. The following is a preliminary summary of some of the provisions either included or excluded in both House’s proposals affecting skilled nursing and assisted living providers.
SKILLED NURSING FACILITIES
Medicaid Reimbursement Rate:
Senate: Increases in the total Medicaid reimbursement base rate, in the aggregate, by $600 million ($500 million in the total Medicaid rate; $100 million in the operating component of the rate; Governor’s proposal: $385 million).
Assembly: Increases the Medicaid reimbursement rate, in the aggregate, by $481.25 million.
Capital Rate for SNFs:
Senate: Restores the 10% capital rate cut as set forth in FY 2024-25 State Budget, beginning April 1, 2025.
Assembly: Restores the 5% capital rate cut previously enacted in 2020.
70/40 Staffing Rule:
Senate: Adds new language to amend the 70/40 staffing rule to clarify that any federal financial assistance would be excluded from the total operating revenue for accounting purposes.
Assembly: Does not address.
Rate Appeals:
Senate & Assembly: Both Houses amend the Governor’s sunset proposal and extend the $80 million cap on nursing home capital rate appeals to April 1, 2027.
Certified Medication Aides:
Senate & Assembly: Both Houses reject the Governor’s proposal to authorize certified medication aides to work in skilled nursing facilities.
Trend Factor:
Senate & Assembly: Both Houses extend the 0% trend factor through March 31, 2027.
Cash Receipts Assessment (CRA):
Senate & Assembly: Both Houses accept the Governor’s proposal to extend the 6% CRA program through March 31, 2029.
Notice of Material Transaction Requirements:
Senate & Assembly: Both Houses accept the Governor’s proposal to amend the length of time that a healthcare entity must submit a notice to the Department of Health, from 30 to 60 days, before the closing date of the transaction.
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ASSISTED LIVING PROGRAMS (ALPs)
Medicaid Reimbursement Rate:
Senate: Increases the Medicaid reimbursement rate, in the aggregate, by $30 million for FY 2025-26 and every year thereafter (to be included in the Medicaid base rate; Governor’s proposal: $15 million).
Assembly: Increases the Medicaid reimbursement rate, in the aggregate, by $18.75 million, for FY 2025-26 and every year thereafter (to be included in the Medicaid base rate).
State Supplemental Program (SSP):
Senate: Does not address.
Assembly: Includes an 8% increase to the SSP rate for enhanced residential care (Congregate Care Level 3).
ALP Bed Need Methodology:
Senate & Assembly: Rejects the Governor’s proposal to amend the ALP bed need methodology on a case-by-case basis beginning April 1, 2026.
EQUAL Program:
Senate & Assembly: Both Houses accept the Governor’s proposal to eliminate the EQUAL program.
Temporary Operator Program:
Senate: Accepts Governor’s proposal to amend the temporary operator program for adult care facilities, including an extension of the length and number of terms they may serve.
Assembly: Rejects the Governor’s proposal.
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ADDITIONAL PROVISIONS
Interstate Licensure Compact and Nurse Licensure Compact
Senate & Assembly: Both Houses reject the Governor’s proposal to expand the scope of practice for medical providers via both the ILC and NLC.
NYSHFA|NYSCAL will continue to provide updates as the FY 2025-26 State Budget negotiations progress.
NYSHFA | NYSCAL CONTACTS:
Stephen B. Hanse, Esq.
President & CEO
518-462-4800 x.11
Kristin DeVries, MA, MPP
Director of Government Relations
518-462-4800 x.14
Carl J. Pucci
Financial Consultant
518-462-4800 x.36
cpucci@nyshfa.org
