Nursing home operators who absorbed earlier cuts warn the latest decision could force them to postpone new projects and eliminate the jobs of caretakers, whom they view as critical to their operation.
"These further cuts will directly lead to more layoffs," said Jim Nyberg, director of the Rhode Island Association of Facilities and Services for the Aged. "The more staff, the more quality care you're able to provide."
While the cuts are unfortunate, they were necessary to balance a budget deficit equal to about 11 percent of expected state spending, said Ralph Racca, administrator for medical services in the state's Medicaid program.
"Everyone has to tighten their belt," Racca said. "It's not something we want to do. It's something we have to do."
Carcieri first proposed cuts for nursing homes in January as part of a revised budget for the fiscal year ending in June, then added back the money after Congress passed a federal stimulus package to aid state governments.
But lawmakers in the Democrat-dominated General Assembly went a different route in a budget passed earlier this month.
Carcieri criticized the plan, but he did not veto it.
It makes a 5 percent cut in a daily rate paid to nursing homes that care for Medicaid patients starting April 15. Separately, Carcieri's administration plans to reduce payments the nursing homes receive to compensate for staff costs.
Representative Eileen Naughton, a Democrat, faulted lawmakers for approving the cuts without first researching the effects on the elderly.
"The first thing we should practice is do no harm," she said. "We certainly shouldn't do things when we don't know what the consequences are."
The effects are already being felt at the Tockwotton Home in Providence, which cares for 66 people and employs 80, executive director Kevin McKay said.
He already laid off a licensed practical nurse and a certified nurse assistant to survive a drop in state funding last year. McKay said the current cuts are equal to the salaries of two more nurse assistants, although he has not decided what positions will be cut, if any.
Under the current plan, the state will reduce its payments for nursing home labor costs going back to last summer.
"That money is gone. I spent it," McKay said. "Now, I've got to figure out how to pay back the state."
