Hartford, CT — Connecticut officials are asking lawmakers to rein in Medicaid payments to unionized nursing homes that employ relatives of facility owners at above-average salaries.
Under a proposal from the Department of Social Services (DSS), Medicaid reimbursement would be capped at the average wage for a given position when the employee is related to the owner. For example, if a relative working as a certified nursing aide earns significantly more than the standard rate, Medicaid would reimburse only up to the average pay for that role.
State officials say similar limits already apply at nonunion facilities. The new measure would extend that oversight to unionized nursing homes.
“The goal is straightforward,” DSS spokeswoman Christine Stuart said. “Medicaid should not pay more for a relative than it would for any other employee doing the same job under the same union contract.”
Relatives include anyone connected to an owner by blood or marriage. At least 51 of Connecticut’s 180 nursing homes have unionized staff.
Nursing home operators would still control salary decisions. The change would only affect how much Medicaid reimburses, a move DSS says would protect taxpayer dollars.
Mixed Reactions from Lawmakers and Industry
Sen. Jan Hochadel, co-chair of the Aging Committee, said she supports drafting legislation that reflects the proposal, calling it a matter of compliance with Medicaid rules.
Rep. Jane Garibay, also co-chair, argued the state cannot overlook inflated family salaries at a time when nursing homes face ongoing challenges.
Industry leaders, however, raised concerns. Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, warned that the plan could undermine negotiated collective bargaining agreements. He said salary costs in union contracts are typically recognized as reasonable because they result from formal negotiations.
Additional DSS Requests
Separately, DSS is seeking authority to require faster submission of nursing home health assessments used to calculate Medicaid rates. The department also wants flexibility to consider adding bed capacity in regions where occupancy exceeds 96% for two consecutive quarters.
Officials emphasized the request is not aimed at returning to three- or four-bed rooms. A 2024 law limits nursing home rooms to two residents beginning July 1.
Instead, DSS said it wants the option to address future capacity shortages through the state’s Certificate of Need process, if necessary.
