Nursing facility leaders say provider-tax limits and FMAP rollbacks would cut long-term care payments

Representatives of Nevada nursing facilities told the joint Health and Human Services committees that provider tax programs are central to sustaining nursing facility payments and that federal restrictions or reductions could reduce payments to skilled nursing facilities.

Brett Salmon, representing the Nevada Health Care Association, said about 60% of nursing-facility care in Nevada is provided to Medicaid residents and that the provider-tax model has been in place in Nevada for two decades. He said providers pay roughly $48 million in tax and receive roughly $80 million in federal match for the current program design. Salmon warned that reducing the allowable tax rate from 6% to 4% would meaningfully reduce supplemental payments to facilities and that a combined FMAP rollback would magnify the loss.

Weeks had told legislators earlier that a rollback of the enhanced 90% match for the expansion adult population would reduce federal funding that flows through supplemental payment programs; Salmon said that change could reduce payments to nursing facilities by tens of millions — his association provided an early estimate of about $95.5 million in reduced payments to skilled nursing facilities over the biennium under some scenarios, rising when coupled with FMAP changes.

Nursing facility leaders said cuts would pressure wages, staffing and the ability to provide behavioral or pediatric specialty rates that some facilities receive; they urged legislators to weigh statewide impacts and to coordinate with the governor and congressional delegation.

Ending: Nursing facility representatives asked for early notice of federal changes and for state support and legislative engagement to preserve care capacity for long-term care residents.