This story is part of a series about how the 2025 Minnesota Legislative Session is affecting Jewish institutions and communal priorities. Stories will include views from Jewish lawmakers and coverage of how budget cuts might affect social services, elder care, and education.
Like many leaders of nursing homes and assisted living facilities, Jim Newbrough, CEO of the Jewish long-term care organization Sholom, is concerned about the future of his industry.
Projections show that one-fourth of Minnesotans will be age 65 or older by 2030.
The Jewish community is already close to that marker: 21% of Twin Cities Jews are over the age of 65, while almost a third are 50-64, according to a 2019 population study.
“We’ve got baby boomers that are turning 80 now,” Newbrough said. “There’s a huge need for our services and our care — at the same time, it’s being defunded.”
Long term care is facing a potentially crippling loss of funding from the state and federal governments.
Minnesota has a $6 billion projected deficit, and lawmakers are negotiating over cuts to balance the state budget. That includes a proposal from Gov. Tim Walz for a $300 million cut to Medicaid, the federal insurance program for people with low income.
In early May, both the Minnesota House and Senate passed bills with $300 million in cuts. But the bills make those cuts in different ways, leaving the end result under negotiation.
Newbrough prefers the House bill, as the Senate bill could cost Sholom an extra $2.3 million each year until 2030, he said. “The magnitude is so significant the damage to access to care will be done by then.”
The legislature has until May 19 to reconcile, finalize, and pass budget bills. If they don’t succeed, lawmakers will likely reconvene for a special session in June.
Minnesota could make deeper cuts if Congress, with the support of President Donald Trump, slashes billions of dollars in federal spending.
For the moment, though, state cuts are the focus, Newbrough said. Federal cuts are still more concepts of a plan than a concrete reality.
“We’re waiting to see what those are going to be,” he said.
Medicaid and mandates
Medicaid — renamed Medical Assistance in Minnesota — is a cornerstone program for long-term care organizations like Sholom (and social service providers).
When they care for people with Medicaid, the program reimburses organizations for that care, helping to cover the cost of staffing and services. Reimbursements take over a year, and sometimes over two years, to pay out.
Cuts to the program mean a loss in revenue for long-term care organizations. And as revenue goes down, organizations can’t care for as many people, leaving many families to shoulder the burden on their own.
The cuts also have a lasting effect. Even if Medicaid reimbursements go back up, it still takes months for providers to see increased funding.
“Over a four-year period of time, you’re talking several millions of dollars that this will impact us in decreased reimbursement,” Newbrough said.
“It’s going to be challenging, and not just for Sholom,” he said. “It’s going to be challenging for us as an industry across the state, in particular, in rural areas where people don’t have a lot of other resources.”
The loss of funding is yet another hit to an industry in crisis. Battered by the COVID-19 pandemic and inflation, many organizations are losing money and struggling with staffing.
According to a recent industry survey, there are 12,500 job openings in long-term care, and almost half of Minnesota nursing homes expect “negative financial performance” this year.
Sholom, together with industry organizations like LeadingAge Minnesota, has been advocating against the state cuts.
“Everybody’s going to take cuts,” Newbrough said. “We’re just trying to make sure that the cuts are not catastrophic…they could actually destabilize the state’s long-term care infrastructure.”
Another issue for Newbrough are a series of mandates from the Nursing Home Workforce Standards Board. The board was created in 2023 to make pay and benefit standards more enticing to long-term care workers.
It did so by mandating increased wages and setting 11 holidays for increased pay. But long-term care providers argue they don’t have the money to cover these mandates, and the board isn’t giving any funding for the extra expenses.
The mandates would cost Sholom $1.2 million per year, Newbrough said.
Currently, the Minnesota House human services budget bill has funding to cover those mandates. The Senate bill does not.
“We value our workers, and we want to give them adequate wages,” Newbrough said.
“[But] we’re saying, ‘OK, where does that money come from?’ Because it’s an additional expense for an industry that’s already financially challenged,” he said. “We don’t disagree with the concept, but how does it get paid for?”
An eye on the future
As Sholom prepares for cuts, so does the broader Jewish philanthropic community around Sholom, which has sustained the organization through hard times.
Donors are “keeping an eye on this as well, because they’ve invested a lot in this organization over the years,” Newbrough said. “We’re all working together on this, to try to come up with what the solution will be and what this will look like going forward.”
Meanwhile, there is some movement from the federal government. Even as President Trump and Republicans in Congress push for drastic cuts to Medicaid and Medicare (another federal insurance program that helps sustain long-term care organizations), behind the scenes they’re offering a fig leaf: Cutting regulations.
“If they were to remove some of the burdensome regulations [the federal government] imposed on our industry over the last several years, what would those be?” Newbrough said. “At least there might be a trade-off or a balance there [with reimbursement cuts].”
But Newbrough is still waiting for specific proposals about the federal budget that the long-term care industry can weigh in on.
In the meantime, Newbrough’s call to action is for community members to talk to lawmakers about sustaining long-term care in Minnesota.
“Let’s focus the cuts on where they need to be, and try to keep them within a reasonable level so that we can maintain our long-term care infrastructure,” Newbrough said.
“These are our elderly, vulnerable population — they deserve that care.”
