State Budget

Seniors Must be a Priority in the 2019-20 State Budget!

We need YOU to support nursing facility residents in this year’s budget. There are two CRITICAL areas in which YOU must help:

  • Medicaid funded nursing facilities need a 2.8% increase in the FY 2019-2020 budget. This would require $47 million in state funds, which will bring in $50 million in additional federal funds. 2.8% is the SNF market basket update reflecting the annual cost increase associated with nursing facility care. This increase is the minimum necessary to keep nursing facility funding on track with rising costs.
  • Provide $25 million to fully fund the Medicaid Access Program that legislators created four years ago to preserve access to care by offering incentive payments to centers that serve high Medicaid populations. The $25 million in state funds will bring in an additional $26 million in federal funds.

Marialice Calls for More Nursing Home Funding

We chatted with Marialice, an employee of Brookside Healthcare & Rehab Center – She went from employee to resident, after a recent surgery. Her stay is short-term, but she would love to see #PABudget funding of nursing homes become a long-term commitment!

Pennsylvania’s nursing facilities are on a financially unsustainable path

This chart illustrates how the budget-adjusted Medicaid rates should have trended with annual adjustments for rising costs since FY 2009-10.

The blue area represents these hypothetical increases tracking closer to the full Medicaid rate.

Pennsylvania’s nursing facility residents are medically complex

The nursing facility resident population today has more chronic conditions, complex care needs and greater dependency on caregivers to meet these needs.

In a nursing facility caring for 100 residents:

  • 36 residents have severe cognitive impairment
  • 69 residents need assistance with at least four activities of daily living (toileting, walking, bathing, dressing, etc.)
  • 31 residents are incontinent
  • 88 residents are over age 65 and 9 residents are over age 95
  • The state Medicaid program pays for the care of 66 residents, and the federal Medicare program pays for the care of 13 residents

An average nursing facility caring for 100 residents is under-reimbursed by almost $1,000,000 annually or $27.25 per day of care by Medicaid, according to a national study.

Avalere Health, a Washington, D.C. research firm, released a study in 2016:

  • Pennsylvania nursing facility operational margins have dropped more than 28 percent between 2007 and 2014, from 3.2 percent to 2.3 percent.
  • The operating margin for those facilities with 75 percent or higher Medicaid occupancy was only 1.2 percent.

Current funding levels are not adequate to provide the quality care our
seniors need

  • SNFs can’t invest in advanced medical technology that could aid in patient care.
  • SNFs can’t invest in capital improvements to upgrade aged buildings.
  • SNFs can’t invest in staff by offering competitive wages and/or benefits, leading to higher turnover. Studies show higher turnover can lead to lower quality care.
  • Ownership turnover has reached an all-time high in Pennsylvania

If you have any questions about the budget contact Zach Shamberg, PHCA President and CEO at

Issue Briefs

2019-20 State Budget

This brief makes the case for seniors to be a priority in the 2019-20 state budget: Medicaid funded nursing facilities need a 2.8% increase in the FY 2019-2020 budget and the legislature must provide $17 million to fully fund the Medicaid Access Program to preserve access to care.

February 2019
Medicaid Funding for Nursing Facilities: A Crisis for Senior and Caregivers

An average Pennsylvania nursing facility caring for 100 Medical Assistance (MA) residents is under-reimbursed by almost $1.75 million annually or ($47.50) per day of care by Medicaid, according to PA’s own Case Mix Rate System. Current MA Rates do NOT cover the costs of providing quality care to Pennsylvania’s seniors. MA underfunding is directly contributing to the sales of PA nursing facilities.

February 2019
Pennsylvania’s Long-Term Care Medicaid Funding: MYTH VS. FACT

MYTH: Home and Community Based Services (HCBS) is less costly to the Pennsylvania Medicaid program than Nursing Home Care. FACT: When a Medicaid-eligible Pennsylvanian needs round-the-clock skilled nursing and rehabilitation services (which are provided to them in a nursing home), that level of care is the most efficient use of Pennsylvania’s tax dollars—and the safest and most appropriate level of care for that individual.

February 2019
Partner spotlight

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