Flat-Funding From State, Staffing Shortages Continue to Pose Challenges to Quality Nursing Home Care

HARRISBURG — Four years of flat-funding and the challenge of recruiting qualified staff are an immediate threat to the quality of the care Pennsylvania’s skilled nursing facilities are able to provide to the state’s most vulnerable and at-risk populations, warned new Pennsylvania Health Care Association (PHCA) President and CEO Zach Shamberg. The comments came during a recent appearance by Shamberg on a statewide public affairs TV program set to begin airing on Sunday, April 21.

For Shamberg, the issue of quality care hits particularly close to home. Coming from a family of nurses, his grandfather was diagnosed with dementia five years ago. Realizing their loved one could no longer be cared for at home, his family made the decision to admit Zach’s grandfather into a skilled nursing facility.

“Last weekend I spent time with my grandfather in a skilled nursing facility and I watched the care that was provided to him,” Shamberg said. “I watched the caregivers who were assigned to him, and it brought tears to my eyes to see how well they cared for him. The well-being of our senior population is an issue that I believe transcends party lines. Funding for senior care and appropriate Medicaid reimbursement to care for our loved ones is something the governor and every legislator in Pennsylvania should support.”

Two-thirds of all nursing facility residents, more than 52,000 seniors and individuals with disabilities, rely on Medicaid for their nursing facility care. But Pennsylvania nursing facilities lose an average of $47.50 each day, or $17,300 annually, for each Medicaid resident in their care because the state does not adequately pay for the cost of long-term nursing care.

Shamberg believes Pennsylvania does not consider older residents a priority, nor does it consider caring for the sickest and frailest members of our communities to be a priority either. He noted that for five consecutive years nursing home administrators, staff and residents have watched as the Wolf Administration has flat-funded Medicaid rates in long-term care facilities such as nursing homes. Over the same time period, inmate medical care saw a proposed 5.6 percent increase in this budget.

Without any proposed funding increase for care, Shamberg warned that many facilities cannot offer competitive wages and benefits to staff, resulting in higher turnover and an inability to invest in the next generation of caregivers.

Shamberg also shared that nursing home ownership turnover has reached an all-time high in Pennsylvania, a dangerous trend that risks quality, as well as continuity of care.

For each resident, facilities provide nursing care and related services, specialized rehabilitative services, medically-related social services, pharmaceutical services, dietary services personalized to the needs of each resident, emergency dental services, and non-emergency medical transportation. All of these services are provided for an average reimbursement rate of $8.24 per hour, which makes retaining and attracting talent difficult. Additional state funding would help nursing facilities pay more to direct caregivers. Having a dedicated caregiver is important because it means he or she gets to know the residents, and that knowledge and consistency of care help to improve outcomes.

In addition to funding, Shamberg also shared that after five years of meeting with nursing homes, personal care homes and assisted living residences face, the number one concern he hears from care providers across the state is workforce shortage. As part of his comments, Shamberg shared his thoughts on why staff recruitment and retention is a challenge for facilities and his concern for the industry moving forward.

“While very rewarding, the work that caregivers do is physically and emotionally demanding,” Shamberg said. “On top of that, we haven’t focused on steering younger Pennsylvanians into this workforce and providing them vital work experience in skilled nursing facilities.

“These are in-demand careers with tremendous growth potential. We’ve estimated that in the next five years there will be 1,400 licensed practical nurse and 2,000 certified nursing assistant positions that are going to go unfilled because there’s no workforce ready to step into those jobs.”

To address industry workforce needs, PHCA is actively seeking industry partnerships with education providers, Workforce Investment Boards and other organizations specializing in placement and training.

One such partnership with United Way of the Capital Region utilizes their “Road to Success” program. The program, which helps individuals become ready for employment by assessing their skill level, providing training on soft skills and connecting participants to additional education and training support if needed, has already produced 20 certified nursing assistants who will be ready for hire for PHCA members in central Pennsylvania

Additionally, PHCA has worked with the Capital Region Partnership for Career Development to help educate school counselors, teachers and other educators on the career opportunities that exist in skilled nursing and long term care industry and outline how candidates can prepare themselves. Efforts connected to this partnership include job fairs, networking events, job shadowing opportunities and internships.

“Pennsylvania Newsmakers,” one of the state’s premier politics and public policy television talk shows, is available at www.phca.org and will air regionally:

• WGAL Channel 8 (Harrisburg and Lancaster) Sunday, April 21, at 11:30 AM
• WBPH (Lehigh Valley and Philadelphia) Monday, April 22, at 8:30 PM
• WKBS 47 (Altoona) Saturday, April 27, at 9:30 AM
• WPCB 40 (Pittsburgh) Saturday, April 27, at 9:30 AM
• MeTV (Susquehanna Valley) Sunday, April 21, at 11:30 PM