‘Over my 30 years in the industry, I’ve seen challenges come and go, but this moment is unprecedented in its severity.’
By Joe Murabito
The care of our elderly is in crisis. As the managing partner of Elemental Management Group, overseeing several nursing homes in New York state, I’ve witnessed firsthand the financial turmoil caused by the state’s unsustainable policies.
Over my 30 years in the industry, I’ve seen challenges come and go, but this moment is unprecedented in its severity.
I’m left questioning whether elected officials lack a fundamental understanding of the nursing home industry or if they simply do not care.
Regardless, there is an opportunity to educate them — as well as the public — on why this issue matters so deeply.
New York state’s nursing homes are being squeezed by two crushing forces: retroactive demands for COVID-era funding — money already spent on mandated staffing and care — and Medicaid reimbursement rates that fall far short of covering the cost of care.
Together, these pressures are creating a perfect storm that threatens the future of elderly care in our state.
The Crisis at a Glance
Consider the following:
• Morningstar Residential Care Center (Oswego): This facility is being asked to repay more than $127,000 in COVID-era funding, despite operating with a Medicaid reimbursement rate less than $200 per day. Rising operational costs make this an impossible financial burden.
• Waterville Residential Care Center (Waterville): A fourth-generation, family-owned facility now facing a demand to repay $97,495 — funds used to meet state mandates for safe staffing and quality care. With Medicaid rates also less than $200 per day, the financial strain is overwhelming.
• Elcor Health Services (Horseheads): Managed by Elemental Management, Elcor has been notified it must repay more than $323,000. Like many facilities across New York, Elcor is grappling with severe financial instability fueled by unsustainable Medicaid rates and retroactive funding demands.
These stories are not isolated. They represent the experiences of nursing homes statewide. Hundreds of nursing homes run by operators that I consider colleagues and friends are facing similar challenges. This is a systemic problem that requires immediate attention.
Why This Matters
When nursing homes struggle, the ripple effects impact everyone:
1. Displaced Seniors: When facilities close, elderly residents are uprooted, causing emotional and physical distress. Families are left scrambling to find alternative care, often far from home.
2. Strained Hospitals: Nursing homes play a critical role in transitioning patients out of hospitals. Without them, hospitals face discharge gridlocks, exacerbating an already strained healthcare system. We have proudly partnered with and support our local hospitals, including Oswego Health, to ensure continuity of care and better outcomes for our communities.
3. Diminished Dignity for Seniors: The state’s actions send a clear message that elderly care is no longer a priority, undermining the dignity and respect our seniors deserve.
A Call to Action
New York’s nursing homes cannot survive without immediate relief. Policymakers must:
• Re-evaluate Repayment Demands: Retroactive claw backs of COVID-era funding are punitive and fail to consider the reality that these funds were spent to meet state-mandated requirements.
• Increase Medicaid Reimbursement Rates: The first step to solving the rate problem is to create better wage parity and reduce the gross disparity that exists today. Level the field by establishing base rate minimums for direct and indirect rate components. This will prevent further closures. From there, begin the process to develop a methodology that captures reasonable costs including capital improvements and that can effectively respond to market changes.
Prioritize Elderly Care: A comprehensive strategy is needed to address the growing crisis in long-term care.
The Bigger Picture
This issue is bigger than just numbers on a balance sheet. It’s about the dignity and care of our seniors, the stability of our communities and the future of healthcare in New York state. Facilities like Morningstar, Waterville and Elcor have served their communities for generations. Without intervention, their future — and the care of thousands of elderly residents — hangs in the balance.
To put it in perspective, a Medicaid reimbursement rate of less than $200 a day is unsustainable.
According to Nestment, the national average rate for a one-night stay in a hotel room is $206. Let’s remember, this is an overnight in a hotel and does not include food or entertainment. Nobody is responsible for exceptional care, nutritious meals and a meaningful quality of life for elderly residents. Yet, this is the reality faced by facilities across New York state.
I’ve spent my career advocating for quality care and the sustainability of our industry. But now, I’m calling on the state to do its part. Let’s work together to ensure that New York’s seniors receive the care they deserve and that the facilities entrusted with their care have the resources they need to succeed.
Joe Murabito is the managing partner at Elemental Management Group, which owns or operates several senior facilities in Upstate New York, including Morningstar Residential Care Center and The Gardens by Morningstar in Oswego.