Vermont
Nursing home bailouts: Why Vermont has given millions to keep care centers afloat – The Boston Globe
For their part, state health officials say Vermont’s nursing homes are a vital piece of the eldercare landscape. Without extraordinary financial relief, they say, the state would have lost even more critical bedspace.
Efforts to address the upstream causes of the nursing homes’ financial crises, like the state’s reliance on traveling nurses, have received far less financial support.
Around half of the extraordinary financial requests from 2020 onward mention concerns with increased costs of staffing, particularly contract staffing. Staff and contract staff make up about 50 percent of total costs in nursing homes’ budgets, according to the state.
Vermont’s nursing homes depend on traveling staff more than those in any other state, according to federal data from the Centers for Medicare and Medicaid Services.
There are many reasons extraordinary financial relief is not a sustainable means to “plug the gap” for nursing homes, “but we needed something,” said Helen Labun, the Vermont Health Care Association’s executive director.
“We don’t want EFR to be a standard option,” Labun said. “It really is meant to be an extraordinary measure.”
An old program meets an urgent need
Despite existing for more than 20 years, Vermont’s extraordinary financial relief program started playing a recurring and sustaining role for the state’s nursing homes only since the COVID-19 pandemic.
The bureaucratic program routes through multiple departments nested within Vermont’s Agency of Human Services.
The Department of Vermont Health Access’ rate-setting division, which sets Medicaid reimbursement rates for nursing homes, reviews requests submitted by facilities. But the funds for extraordinary financial relief come from Medicaid dollars allocated through the Vermont Department of Disability, Aging, and Independent Living, according to the department’s commissioner, Jill Bowen.
Nursing homes, which receive extraordinary financial relief, provide the most intense level of care, serving people who wouldn’t have their needs met in an assisted living or residential care home, according to Labun. These facilities must serve patients on Medicaid to qualify for financial relief, she said.
There are 33 nursing homes in the state, with a total of about 2,847 beds as of July, a decline of nearly 900 beds in the last 20 years, according to the DAIL.
Bowen said the loss of beds in long-term care facilities is worrying given Vermont’s aging demographic, though she said the trend may partially stem from people seeking at-home care instead.
Angela Smith-Dieng, director of DAIL’s Adult Services Division, said the state does not want to lose options for its large elderly population, so extraordinary financial relief is “incredibly important as a tool to prevent nursing home closures.”
One factor leading to increased emergency funding requests, according to state leaders, is the “rebasing” of Medicaid reimbursements. Rebasing, which most recently occurred in 2025 and 2023, according to state leaders, changes Medicaid reimbursement rates based on cost data from earlier years. In 2023, the state altered reimbursement rates based on 2020 costs, which didn’t yet capture the new financial pressures brought on by the pandemic.
In July, the state again balanced reimbursement rates, this time using 2023 costs, which Bowen hopes will limit the need for extraordinary financial relief.
Working with the Legislature, the DAIL advocated for changing how much facilities are paid based on their occupancy, reducing penalties for not meeting high thresholds, according to Bowen.
In some instances, the state has advanced nursing facilities money through the bailout process or provided more money than a facility requested. The state may advance facilities funds if they will not be able to meet payroll for staff, Bowen said, but she added that the state was more likely to provide less — not more — than a company requested.
The state has recouped every advance or was in the process of recouping them, according to the department’s rate setting division.
As part of an extraordinary funding review, Jaime Mooney, the director of the rate setting division, said the state examines a company’s finances and whether facilities are in compliance with state and federal requirements.
After the rate setting division reviews the request, combing through the provided financial information such as past-due invoices and the amount of cash on hand, the division makes a recommendation to the DAIL.
The rate setting division also consults with DAIL regarding possible issues with the care provided by the requesting facility. But Mooney said she couldn’t recall ever denying a facility’s request due to the quality of care.
The state restricts grant use, and facilities cannot pay penalties or exorbitant owner-administrator fees with the funds, according to Mooney.
The facility must also meet reporting requirements, including providing updated financial information, she said.
According to Labun, nursing home owners need to demonstrate they don’t have money from other sources. That prevents companies that own many facilities from shifting their investments to out-of-state homes and then requesting bailouts from Vermont.
In the past, nursing homes had savings they could rely on when reimbursement rates weren’t covering expenses, Labun said. But, during the pandemic, nursing homes’ coffers ran dry, and extraordinary financial relief was retrofitted to respond to the emergency, Labun said.
Nursing homes typically used extraordinary financial relief in one-off cash flow emergencies to “fight financial storms that they might not otherwise have been able to weather,” according to Labun.
That’s now changed, and the cost of nursing is driving the crunch.
Contract staff tend to cost facilities at least twice as much as permanent staff, contributing to nursing homes’ financial distress, Labun said. The use of contract staff in Vermont has fallen slightly, according to Centers for Medicare and Medicaid Services data. But the state’s rate is still exceedingly high compared with the national average, Labun said.
While the nation saw heightened rates of contract staff at the onset of the pandemic, the rates have generally returned to the pre-pandemic norm, said Richard Mollot, executive director of the Long Term Care Community Coalition, a national nonprofit organization.
Vermont nursing homes had the highest rate of contract staff employment compared with those in other states in 2024, peaking at 31 percent in the first quarter of 2024, according to analysis of Medicaid data by the Long Term Care Community Coalition. The national average in the same period was 8 percent.
Mollot said nursing homes often use a larger number of contract staff when there is high attrition among permanent staff.
Staffing tends to be the highest expenditure for nursing homes, and oftentimes nursing homes that work with temporary staffing agencies are contractually obligated to pay contract staff more than permanent staff, said Kaili Kuiper, Vermont Legal Aid’s long-term care ombudsman. That means nursing homes spend much of their budget on filling the staffing gap.
This is a “difficult cycle to break, because there’s only so much money to go around,” Kuiper said. The cycle can also cause poor care, and Kuiper said her office has seen “a lot of issues that are related to there not being enough staffing to provide the care that’s needed,” including problems with response times and hygiene.
Vermont’s demographic challenges are driving the underlying problem of nursing homes’ high use of contract staff, Labun said.
So, in recent years, the Legislature has allocated some funds to rebuild the nursing workforce.
The state put half a million dollars toward attracting and keeping licensed nursing assistants in the current fiscal year budget. That investment was an attempt at addressing the upstream causes of nursing homes’ financial woes, according to state Senator Richard Westman, Republican of Lamoille, who sits on the Senate Appropriations Committee and serves on the board of a rural hospital.
The state plans to draw down federal funds for workforce development from the Civil Monetary Penalty Reinvestment Program that had previously been held up in between the President Joe Biden’s and President Trump’s administrations and during the federal shutdown, Labun said.
The legislative investment was far less than the money spent on extraordinary relief, but Westman argued that prioritization makes sense, given the financial weakness of some facilities. In the last two years, about two-thirds of nursing homes have requested extraordinary relief, he said in a May interview.
“I think one could make an argument that without that help, they probably would have gone out of business,” Westman said.
Staffing underlies the financial challenges, Westman said, echoing others. Investing in nurse recruitment and retention, as well as increasing reimbursement rates nursing homes receive, could prevent the facilities’ reliance on bailout money, he suggested.
Kuiper said that using temporary emergency staff is an important tool. As the state’s advocate for nursing home residents, Kuiper said employing contract staff is a better alternative than allowing a facility to be understaffed.
But in the long run, Kuiper said she would like to see “a stronger movement away from temporary staff,” and for the care community to prioritize strategies to curb the high use of contract staff as the “status quo.”
Former VTDigger reporter Peter D’Auria contributed reporting.
This story was originally published by VTDigger and distributed through a partnership with The Associated Press.
Two empty seats
The leaders of both the Vermont House and Senate will not be running for reelection. So who will fill their shoes?
Senate Majority Leader Kesha Ram Hinsdale, D-Chittenden Southeast, said she’s running for Senate president pro tempore.
Ram Hinsdale has served in the legislature for 14 years and is the first woman of color to serve in the Senate.
“I have seen so many types of leadership, so many tools in the toolbox that you can use to move people in the same direction,” she said.
While spending more than a decade in the Legislature, Ram Hinsdale said she’s lived through many crises and charted the state’s path through them. She was a lawmaker during the Great Recession, the Covid-19 pandemic and two years of record breaking floods.
With multiple long-serving legislators retiring this year, Ram Hinsdale said she thinks she will bring needed institutional knowledge and experience, along with a willingness to rally new people.
Along with Ram Hinsdale, lawmakers have eyed Sen. Andrew Perchlik, D/P-Washington, who currently chairs the Senate Appropriations Committee, as a future pro tem.
Perchlik said Friday that he’s considering running for the position, though he didn’t want to definitively say until after the primary election in August.
“I’ve been approached by many senators asking me to do it,” Perchlik said. And he said he thinks it makes sense, given his past leadership roles as the whip for the majority party in the Senate and his former role as chair of the Senate Transportation Committee.
Perchlik has chaired the appropriations committee for the last two years, receiving bills from every committee and managing the state’s funds. That role has allowed him to work with lawmakers across the chamber and different parts of the executive branch, he said.
“You get a really broad picture of the entire government,” Perchlik said.
Just a day after House Speaker Jill Krowinski, D-Burlington, surprisingly announced that she won’t seek reelection, a handful of likely Democrats to succeed her said they were mum on their plans to run for speaker.
House Majority Leader Rep. Lori Houghton, D-Essex Junction, said it’s too soon to say if she will run, though she didn’t rule out the possibility.
“She just announced yesterday,” Houghton said, adding that she’s trying to focus on finishing out the session.
Rep. Emilie Kornheiser, D-Brattleboro, who chairs the House Ways and Means Committee, similarly said she’s considering running, but right now she’s focused on finishing legislative work, too.
Rep. Charlie Kimbell, D-Woodstock, said, “I haven’t made up my mind about it.” Kimbell previously ran for speaker in 2020 before dropping out of the race to endorse Krowinski. He also ran for lieutenant governor in 2022 before losing in the primary.
Rep. Laura Sibilia, I-Dover, who challenged Krowinski for speaker at the beginning of 2025, said, “I have not ruled it out.”
In the know
At the eleventh hour, lawmakers let the law enforcement masking bill supported by immigrant rights activists, S.208, die.
“I’m very disappointed with what has happened to S.208,” said Sen. Nader Hashim, D-Windham, the bill’s lead sponsor, on the Senate floor Friday.
The decision comes after a committee of lawmakers from the House and Senate agreed on a version of the bill that would have largely banned all law enforcement operating in the state — including federal agents — from wearing masks or failing to visibly identify themselves.
Committee members decided to make that provision of the bill go into effect March 15, 2027, rather than upon passage, reasoning it would give the state time to see how similar laws in other states play out in the courts.
The bill the committee approved would have given the Vermont attorney general’s office the responsibility to enforce it, bringing a civil lawsuit if officers violated the law.
Upon passage, the bill also would have required a Vermont law enforcement board to create a statewide policy on masking and identification for local and state police.
All members of the conference committee signed on to support the newest version of the bill except the committee’s lone Republican appointee, Sen. Chris Mattos, R-Chittenden North. During a committee meeting Thursday, Mattos said he was unsure he could support the bill because the committee hadn’t heard from the attorney general’s office about whether it was on board to enforce the policy.
After the conference committee approved the bill, it sat on the House’s calendar Friday but was not taken up on the House floor.
For the bill to pass before adjournment, lawmakers would have needed three-quarters of the House to suspend legislative rules, which would allow lawmakers to speed up the legislative process. That would have required Republican support.
Lawmakers on the Senate floor decided to adjourn around 5:50 p.m., giving up on the idea of receiving the bill from the House.
“It was barely a year ago that I watched Mohsen Mahdawi be taken by masked men in unmarked vehicles,” said Sen. Becca White, D-Windsor, expressing her frustration that the bill didn’t pass.
— Charlotte Oliver
Lawmakers on the House floor Friday made a failed attempt to override the governor’s veto of a bill, H.727, that would have set strict guardrails for any future huge data centers in Vermont.
The bill contained provisions that would prevent any large data centers in Vermont from increasing electricity costs for average ratepayers. The bill also contained provisions that would restrict how data centers discharge chemicals and use water to stay cool in an attempt to limit environmental impacts.
Gov. Phil Scott vetoed the bill Thursday. In his letter to lawmakers, Scott said he believes Vermont’s existing regulations would prevent harmful impacts from data centers.
Lawmakers voted 83-52 in favor of overriding the veto, but they needed 90 votes to do so.
— Charlotte Oliver
On the move
Vermont’s House and Senate budget writers reached a deal Thursday night on a state spending package for the upcoming fiscal year, which starts in July.
Agreement on the budget bill, H.951, came with likely just a day left in this year’s legislative session. Overall, the joint House and Senate conference committee’s version of the budget totals $9.38 billion, close to the amount of spending Gov. Phil Scott proposed at the start of the session in January.
The bill was expected to get a final sign-off on the House floor Friday after weeks of both public and closed-door negotiations. The conference committee signed off on the bill around 11 p.m. Thursday.
Among the last pieces of the nearly 150-page legislation to get resolved in the committee was a controversial plan to take money out of a state-run college scholarship fund to help pay for a long-stalled athletic complex at the University of Vermont instead. The fund, called the Higher Education Endowment Trust Fund, saw a historic infusion of cash last year from Vermont’s tax on the estates of high-wealth individuals.
Read the full story here.
— Shaun Robinson
Say cheese
“A crime has been committed, and we do need justice by the end of the day.”
Rep. Conor Casey, D-Montpelier, told his colleagues on the floor Friday morning that he was set on getting to the bottom of a putrid predicament that has been vexing him and other members of the House Corrections and Institutions Committee for weeks.
As he told it: Casey walked into the committee room a couple of months ago to “a rancid smell.” After weeks of searching high and low, he realized that the desks making up the committee’s table had small drawers underneath that he had never noticed before. He opened his drawer, only to find “a moldy, disgusting, offensive glob of cheese,” with a note that read, “say cheese.”
Casey is well known around the Statehouse for pulling pranks on his colleagues, so the cheese may have been an effort to get back at him before he steps down from the House. He then pulled open the drawer of his seat-neighbor, Barre Town Republican Rep. Gina Galfetti, to find yet another glob of cheese.
“It was a bipartisan cheesing, Madam Speaker,” he exclaimed Friday.
If the person who lodged the offending dairy did not come forward by the end of the day, Casey said, he would subject his colleagues to a full recitation of James Joyce’s mammoth novel, “Ulysses,” on the floor. Coming from the man who recited part of a play he wrote during a floor session last year, that seemed far from an empty threat.
As of this newsletter’s deadline, at least, the mystery remained unsolved.
“The craven still hides in the shadows,” Casey wrote in a text. “But rest assured they will be brought to justice. The session may end, but my lust for vengeance will endure…”
— Shaun Robinson
Nearly 1,000 Vermont students will bring live jazz to downtown Burlington this June as part of the 2026 Discover Jazz Festival, with dozens of school ensembles scheduled to perform free concerts on Church Street.
According to a community announcement, 44 ensembles from 36 schools, representing 993 students from across Vermont, will take part in the festival’s 43rd year.
The student concerts are organized by The Flynn, which produces the Burlington Discover Jazz Festival and oversees its education and community programs. All student performances are free and open to the public.
Student performances highlight statewide participation
Participating schools span Vermont, including Chittenden, Franklin and Grand Isle counties, central Vermont, Addison County, Lamoille Valley, the Northeast Kingdom and southern Vermont, along with visiting ensembles from New York, according to the announcement.
Chittenden County schools listed include Burlington High School, Champlain Valley Union High School, Charlotte Central School, Colchester High School and Middle School, Edmunds Elementary and Middle schools, Essex High School and Middle School, South Burlington High School, Winooski Middle High School and Vermont Commons School, among others.
The student performances will take place during the Burlington Discover Jazz Festival, which runs June 3–7 and features free outdoor concerts alongside ticketed performances by internationally recognized artists curated by MacArthur fellow Jason Moran.
Featured collaboration includes Vermont Youth Orchestra musicians
A featured performance during the festival, “My Heart Sings: Jason Moran Plays Duke Ellington”, will include musicians from the Vermont Youth Orchestra Association jazz ensemble, according to the announcement.
The concert will also feature guest vocalist Rachel Ambaye, a South Burlington native studying with Moran at Berklee College of Music. Ambaye will join the student ensemble for a collaboration tied to one of the festival’s signature performances.
Flynn Executive Director Jay Wahl said in the announcement that bringing student musicians into the center of the festival highlights jazz as a living tradition shared across generations.
This story was created by Dave DeMille, ddemille@gannett.com, with the assistance of Artificial Intelligence (AI). Journalists were involved in every step of the information gathering, review, editing and publishing process. Learn more at cm.usatoday.com/ethical-conduct.
MONTPELIER, Vt. (WCAX) – Republican Gov. Phil Scott filed Thursday to seek a sixth term in office while the heads of both legislative chambers announced they will not run for reelection.
Thursday marked the deadline for candidates to get on the ballot for the August primary elections. For months, it has been unclear if Scott would run again.
“I don’t want to see anything move backwards; we need to keep pushing ahead,” Scott said.
Scott filed the necessary 500 signatures on Thursday. If he serves a sixth term, he would be the longest-serving consecutive governor in state history.
“It’s not easy work, it weighs on you, but at the end of the day, I feel the responsibility to stick this out,” Scott said.
The governor has won by larger margins each cycle. Potential Democratic challengers have waited to see whether Scott might step aside, providing a chance not to run against a popular incumbent.
Those who political observers speculated might be interested in the governor’s race included Democratic Attorney General Charity Clark and Treasurer Mike Pieciak. Both instead decided to seek reelection.
Pieciak told reporters he has experienced several personal tragedies this year and wants to continue with his office’s work. “It’s really been a year of reflection, and I think I’m excited about continuing this job that I enjoy,” Pieciak said.
Scott will face an opponent in November. Democrats Aly Richards and Amanda Janoo will face off in the August primary.
Three other Democrats, Molly Gray, Ryan McLaren, and Esther Charlestin, will face off for the Democratic nomination for lieutenant governor and the chance to challenge incumbent Republican John Rodgers in November.
House Speaker Jill Krowinski received a standing ovation from House lawmakers as she announced she will not seek reelection, joining Senate President Phil Baruth.
“The next group of leaders will do a great job continuing on with this work. I wouldn’t be leaving if I didn’t think that we had the right people in places to do this work,” Krowinski said.
That means there will be fresh leadership in the House and Senate next legislative session.
And there is competition in the race for Congress. Republicans Gerald Malloy and Mark Coester will face off in the GOP primary to determine who will face Congresswoman Becca Balint in November.
“To deliver results for Vermont. They are tired of the constant complaining and angry rhetoric,” Malloy said.
There are at least three dozen state House and Senate races that will see fresh faces as another large contingent of lawmakers steps back.
Copyright 2026 WCAX. All rights reserved.
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