With Nick Vizzoca - President, Healthcare Council of Western Pennsylvania
Published reports say roughly 11,000 long-term care residents in Pennsylvania died since the start of the COVID-19 pandemic, which spotlighted problems in the nursing home industry.
Proposed regulations would require nursing homes to provide more hours of direct care to residents. The cost for nursing homes to provide the additional care is projected to be $634 million annually, according to a study commissioned by the Pennsylvania Health Care Association (PHCA). Many pundits said as many as one-third to one-half of those homes could close without expensive decisions. In fact, 14 nursing homes already closed in Pennsylvania since the beginning of 2020.
To help address the crisis, Pennsylvania Gov. Tom Wolf, the state legislature, Leading Age PA – a trade association representing about 380 senior care members, PHCA and the Service Employees International Union, did something normally unheard of in today’s politics industry – they collaborated and pushed $515 million, including federal matching funds, to the state’s beleaguered short- and long-term care homes – raising Medicaid reimbursements and providing a pathway for maintaining or adding staff.
That decision was a good first step in a journey to ensure the solvency and long-term health of our state’s nursing homes.
The bad news is we might just be kicking the can down the road without bold, creative strategies to truly redefine the future of how we care for elderly in our state. After all, our state will have a new governor in just a few, short months. Their policies will result in a positive or negative impact on nursing homes and, ultimately, families. Will they build upon the progress Gov. Wolf, the legislature and healthcare groups made just a couple of weeks ago, or will it be stymied by business as usual?
The reality is we might be having this conversation again in a few years – only it may be worse with the advent of more and more baby boomers needing care. About 10,000 Baby Boomers tip into retirement every day, which means the weight of elder care in Pennsylvania is only going to get heavier – especially given the population exodus of younger wage earners and the density of older residents across the state. Pray we can avoid another pandemic, which would only add insult to injury for nursing homes.
This is not a new problem. Pennsylvania’s reimbursement for Medicaid was behind the times with 2014 being the last time the rate was increased. Our neighboring states fared much better – with increases keeping pace with demand and costs.
Covid-19 shook the long-term care industry and it wobbled legislators into action – empowering them to agree to earmark nearly $500 million for nursing homes to help ease the burden of COVID-19-related costs. But this was a one-time injection into the system and did not address the continually squeezed Medicaid reimbursement rate gap and, as a result, did not provide the ability to increase staff or care teams.
Even now, reports about some certified nursing assistants caring for 20 to 30 patients are common. How much care and compassion could they possibly provide? Not a lot. According to data from the U.S. Bureau of Labor Statistics, the average pay for a nurse assistant is $16.44 an hour. They did better at Wal-Mart.
Now, however, with the influx of a half-billion dollars into the long-term care facility infrastructure, there is hope Pennsylvania can get with the times relative to Medicaid reimbursement – increasing the rate for the first time eight years by $35 per patient per day.
We must maintain forward momentum with creative, bold ideas, which will help reshape and recast the future we want for Pennsylvania’s families. Taking our eyes off the future will only result in us repeating the past.
President, Healthcare Council of Western Pennsylvania