Heritage Ministries P-J file photo

Millions of dollars to help build a football stadium in Western New York.

A New York state mandate requiring staff of health care facilities to be fully vaccinated against COVID-19.

And a Medicaid reimbursement rate that hasn’t been raised in more than a decade.

All were noted by Lisa Haglund in a list of grievances she as president and chief executive officer of Heritage Ministries had regarding New York in an interview Wednesday. She said plans to provide the Buffalo Bills millions of dollars in public money for a new stadium is further proof the state has all the appearances of caring more about its pro sports teams than some residents.

“New York state is willing to invest in the Bills, the stadium, in arts and culture and sports, but not willing to invest in veterans and seniors,” Haglund said.

Her comments came as Gov. Kathy Hochul has been called on by state officials, nursing associations and unions to begin enforcing a law passed last year that established minimum staffing levels for nursing homes. Haglund said the law will compound staffing shortages made worse by the pandemic and will be the latest in a series of mandates and policies that are hurting nursing homes.

Specifically, Haglund noted that Heritage has yet to be reimbursed for the costs of testing staff for COVID-19. An executive order under then-Gov. Andrew Cuomo just months into the pandemic required twice weekly testing of all personnel in nursing homes.

In addition, Haglund said the rate Medicaid reimburses health care providers for their services has not increased in 14 years. A large number of nursing home residents are funded by Medicaid as a primary payer.

And then there’s the mandate that staff at health care facilities be fully vaccinated against the virus, which the Heritage president and CEO previously said resulted in the loss of 9% of its New York workforce.

Under the minimum staffing level law, passed in 2021 and delayed through an executive order by Hochul, facilities are required to provide a daily average of 3.5 hours of nursing care per resident and post information about staffing levels. Hochul again extended the order through today, and it wasn’t clear if she planned to let it expire or extend it further.

Haglund estimates Heritage will need to hire between 20 and 40 more employees to be in compliance of the law and avoid fines.

“We are here to support but now we’re talking about fines and vaccine mandates,” she said. “We’re calling on the county to rally behind us.”

Haglund said Heritage “budgets” to provide each resident 3.4 to 3.5 hours of care a day, though that number can fluctuate with staff call-outs and employees quitting as was the case when the vaccine mandate was enforced.

Tom Holt, president and CEO at Lutheran, said requiring “specific workforce numbers” at a time when employment rates in health care are “unstable” will be a challenge for many skilled nursing facilities in New York.

“Having said that, we’ve been extremely fortunate to maintain high levels of care despite our struggles through the pandemic,” Holt said in a statement Wednesday. “We’ve had one of lowest COVID-19 infection rates in (Western New York) and we are a five-star rated skilled nursing facility overall; both are a testament to our staff, their dedication to what they do, and their thoughtful decision-making day in and out. While this legislation may have good intentions, it just isn’t realistic without sufficient Medicaid support to back us up.”

He continued: “At Lutheran, we have always budgeted our staffing numbers above what these new staffing mandates would require. It was a challenge before COVID-19 and the pandemic has made it even harder as the gap between open positions and available workers continues to widen. I strongly believe that our preparedness and strong staffing practices have helped us find success at a time when small wins are few and far between. However, we do still need more help caring for others. We (skilled nursing facilities) all do.”

When it was proposed, Assembly member Aileen Gunther said the bill would be an important first step to getting a handle on the extent of understaffing at New York’s nursing homes. Gunther and other supporters — including unions representing nurses and other health care workers — said the pandemic had revealed the cycle of understaffing, overwhelmed workers and burnout at nursing homes in the state.

“I can tell you that by addressing these issues that we’ll see a lot less burnout,” Gunther, a Democrat, said at the time.