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

HARRISBURG — More than 400 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 the ability to provide that quality care is getting more and more difficult every day 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 four of the last six 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 $25.43 per day less than their actual costs of providing care — a gap of $9,300 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 2.7 percent in the 2017-18 state budget just cover to cover basic inflation over the past year. PHCA also is seeking continuation of the Medicaid Access Program that legislators created four 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.

Cynthia Labar, who marks 40 years of nursing this year, has been a licensed practical nurse for 28 years at Genesis HealthCare’s Silver Stream Center in Montgomery County. A few years ago, her facility was the target of a full-page newspaper ad that targeted residents and families with misleading statements. Since 2011, skilled nursing facilities across Pennsylvania have been attacked in more than 150 similar ads, all purchased by predatory, out-of-state lawyers.

“My fellow staff and I work hard every day to provide the best care we can. I don’t care if you’re new to this job, or you’ve been doing it as long as I have: quality care is our first priority,” Labar said. “When that ad ran, it was heartbreaking — and untrue. I read the paper every morning, and I take a deep breath every time I turn the page, because I don’t ever want to see an ad like that run against my facility and co-workers again.”

Pennsylvania nursing homes continue to rank among the best nationally for the quality of care they provide.

State Rep. Warren Kampf, R-Chester/Montgomery, has introduced legislation (H.B. 1037) that would end lawsuit abuse. His 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.

“Enacting these limits for long-term care providers will help to reduce frivolous litigation and shift some resources back where they belong: to patient care,” Rep. Kampf said.

The bill currently is before the House Judiciary Committee.