350+ Rally at State Capital for Quality Long-Term Care

HARRISBURG — More than 350 caregivers and administrators from skilled nursing facilities, assisted living residences and personal care homes rallied in Harrisburg today to tell lawmakers that the state’s long-term care network is being undermined by a one-two punch of chronic underfunding and lawsuit abuse. These blows threaten the quality of care and services for frail elderly residents at a time when the state’s population is aging rapidly and their need for assistance is on the rise.

“Providing quality care for more than 81,000 skilled nursing facility residents each and every day is hard — and costly — work,” said W. Russell McDaid, President and CEO of the Pennsylvania Health Care Association. “And facilities are finding it more challenging than ever due to chronic Medicaid underfunding that has put our skilled nursing facilities on the brink of financial ruin.”

State Medicaid funding has been flat for five of the last seven years, even as older residents today suffer from more complex medical conditions and debilitating afflictions, such as dementia or Alzheimer’s disease. That means the level of care residents require is more advanced, more expensive and more dependent on skilled caregivers to provide the intensive, around-the-clock, restorative care that people need.

Based on current Medicaid reimbursement levels, skilled nursing facilities are paid $47.36 per day less than Pennsylvania’s payment regulations would require if their rates were fully funded— a gap of $17,200 annually for every Medicaid resident in their care. Two-thirds of all residents depend on Medicaid.

“The cost of care is rising, as are the costs for everything from labor to drugs and medical supplies to food and utilities,” said Sean Buckman, owner of Carbondale Nursing & Rehabilitation Center in Lackawanna County. “Medicaid is not keeping pace with any of these rising costs. It gets to a point where, after years of being asked to do more with less, you simply can’t do more. We are at that breaking point today.”

Skilled nursing facilities would need an increase of 2.6 percent in the 2018-19 state budget just cover to cover health care inflation over the past year. PHCA also is seeking continuation of the Medicaid Access Program that legislators created five years ago to help facilities with high Medicaid populations.

Adding to these challenges, Pennsylvania’s skilled nursing facilities, assisted living residences and personal care homes remain the target out of out-of-state predatory lawyers who are filing frivolous lawsuits seeking large cash settlements because of the state’s lax tort laws related to long-term care.

More than $104 million of state Medicaid dollars was spent on liability related costs in 2015, much of this in contingency fees to out-of-state predatory lawyers, rather than on the delivery of care. These high legal costs not only inhibit job growth, increase health-care costs and limit access to medical care, but they also affect the morale among residents and caregivers.

David Ferraro, Chief Operating Officer, Quality Life Services. A few years ago, his organization was the target of full-page newspaper ads that targeted residents and families with misleading statements. Since 2011, skilled nursing facilities across Pennsylvania have been attacked in more than 170 similar ads, all purchased by predatory, out-of-state lawyers.

“The nursing homes in Pennsylvania are the BEST nursing homes in the entire country and I know that the people who work in those homes are the BEST in the country,” said Ferraro. “I believe that our nursing homes should be fully funded and we need the legislature to tell these predatory law firms to get out of Pennsylvania and head back home where they belong to ensure our care remains the best!”

McDaid noted that Pennsylvania nursing homes continue to rank among the best nationally for the quality of care they provide, adding “I’m inspired at the excellent work the caregivers with us today continue to do in the face of chronic underfunding, a hostile tort climate, and the stress that comes with providing around the clock care to frail, vulnerable Pennsylvanians.  They, and the residents they care for, desperately need this increase in the FY 18-19 budget and meaningful tort reform.  The time for action is now.”

State Rep. Warren Kampf (R-Chester/Montgomery), introduced legislation (H.B. 1037) this session that would end lawsuit abuse joined the caregivers in attendance, noting that “You all have my admiration for the care you provide each and every day.  I’m glad you’re here today to let every legislator in the Capitol know how important it is to pass this common-sense legislation as soon as possible.”

Rep. Kampf’s bill would limit punitive damages awards to 250 percent of the amount of compensatory damages for long-term care providers. This legislation does not limit compensatory damages for individuals who may have been harmed, nor does it change the definition of punitive care in effect for physicians since 2002. It simply extends the same protections to long-term care facilities.

The bill currently is awaiting Second Consideration in the House of Representatives.