Senate committee hears pleas for $5 million and a rate review after nursing‑home Medicaid cuts

Sen. Cindy Rosenwald told the Senate Finance Committee she introduced SB 663 to address an "emergency in the nursing home sector" after substantial Medicaid reimbursement cuts earlier in the year. "Section 2 appropriates $5,000,000 of general funds for this fiscal year for the commissioner to pay out to nursing homes that experienced a rate cut of more than 5% on January 1," Rosenwald said, and she asked the committee to support the measure and convene a stakeholder working group to examine rate methodology.

Rosenwald said budget neutrality in the current rate methodology requires offsets that can force cuts for many facilities; she cited that 34 nursing homes — including 10 county facilities — faced substantial rate reductions on Jan. 1 and said Medicaid pays more than 60% of nursing home care in New Hampshire.

The state's Medicaid director told the committee DHHS had no objection to reviewing rate methodology but suggested the existing state, county and finance committee established in statute could be the appropriate public venue for such a review.

Administrators from multiple nursing homes and provider groups described the operating impact of the cuts. "The cut for Saint Francis was just over 9% or $24.43 per resident per day," said Brenda, administrator at Saint Francis Rehabilitation and Nursing Center in Laconia, testifying in support of the bill. She said higher wages and rising supply costs, paired with the Medicaid shortfall, had left facilities struggling to recruit and retain staff.

Brendan Williams, president and CEO of the New Hampshire Healthcare Association, said earlier fiscal committee fund shifts reduced initial projections of impacted facilities but that about 13 facilities still faced severe cuts "in excess of $10 per resident per day." He described SB 663 as a triage measure to help the most affected homes and supported establishing a working group to examine the rate methodology.

Witnesses offered facility‑level numbers: Rockingham County's cut was described as about $26.43 per day (roughly $67,000 per month shortfall for the facility described); Maple Leaf reported a cut a little over 9%; Alpine Healthcare described an 11.85% reduction equivalent to $34.49 per resident per day. Providers warned that shortfalls had placed beds offline and created cash‑flow challenges from pending Medicaid claims.

Committee action: public testimony was heard for SB 663 and the committee closed the public hearing; no final committee vote on the bill was recorded in the public transcript. Several senators asked that the item be held while staff and the fiscal committee review funding availability.

Next steps: Committee members signaled they would consider the fiscal implications and look for ways to structure aid or rate adjustments; SB 663 remains pending in Senate Finance.