Governor’s Proposed Budget Leaves Seniors in Nursing Facilities Behind

HARRISBURG — W. Russell McDaid, President and CEO of the Pennsylvania Health Care Association (PHCA), issued the following statement in response to Gov. Tom Wolf’s proposed 2018-19 General Fund budget, which provides no additional Medicaid funding for nursing facility care for the fourth time in Wolf’s first four years in office:

“The continued underfunding of nursing facility care of Pennsylvania’s seniors and individuals with disabilities in Pennsylvania’s Medicaid program is unacceptable. The fastest growing population in Pennsylvania is individuals 85 and older, and they increasingly need intensive around-the-clock care, which is most safely and cost-effectively provided in nursing facilities. Pennsylvania should be reinforcing its commitment to this vulnerable population and those providing their care by adequately funding nursing facility and post-acute care.

“Currently, the Pennsylvania Medicaid program does not even come close to covering the real cost of care, and continued flat funding leaves our frailest and sickest residents, such as those with advanced dementia or severe chronic health conditions, at tremendous risk. The Governor’s proposed budget fails to address the escalating costs of caring for this vulnerable population or support the dedicated caregivers who work tirelessly to protect the people entrusted to their care.

“If the Wolf Administration wants to continue its intense scrutiny of nursing facilities, it must acknowledge the harsh realities of continued underfunding, the negative impact that underfunding has on residents, caregivers and quality in those facilities.

“Pennsylvania’s nursing facilities lose an average of $27.25 each day, or $9,900 annually, for each Medicaid resident in their care. Two-thirds of all nursing facility residents, more than 52,000 seniors and individuals with disabilities, rely on Medicaid for their nursing facility care. A $9,900 gap between costs and reimbursement for each Medicaid resident equates to almost $1,000,000 in underfunding for a facility serving 100 Medicaid residents. No healthcare provider can sustain real losses of this magnitude over time without negative impacts.

“We have grave concerns about the Governor’s decision to flat fund nursing facility care in his proposed budget for the fourth year in a row. This lack of investment in seniors living in nursing facilities and their caregivers is more than disturbing, it’s fiscally unsustainable for this critical component of the long-term care continuum. The proposed FY 18-19 budget puts additional stress on our nursing facilities at a time when it is essential that they have the necessary funding to invest in quality care for their residents, in a sustainable workforce and in technology and capital improvements for their aging buildings.

“We support consumer choice of care setting, but believe that when a consumer has multiple chronic health care needs and requires care on an around-the-clock basis, the most appropriate and cost-effective setting to assure they get the care and services they need is a nursing facility. Pennsylvania has an obligation to ensure that the system is not stacked against their access to that care. Unless a Medicaid-eligible person needs significantly less care AND can be safely cared for in their home, Medicaid-funded care in a nursing facility is the most cost-effective use of Pennsylvania’s tax dollars.

“We recognize that this is the first step in a very long budget process. We also recognize the difficult fiscal situation the state is facing with ongoing structural challenges in the state budget. But, in spite of those challenges, flat funding for the fourth year in a row is not fiscally responsible or sustainable.

“Education, for instance, has seen year-over-year increases in funding since the Governor took office. It is time that the Wolf Administration invest in care for Pennsylvania’s sickest and most frail residents in need of care in a nursing facility in the same way it invests in the future success of Pennsylvania’s youngest residents. It is time to make good on the promise Pennsylvania made to its oldest and frailest citizens to care for them when they are unable to care for themselves, and that begins with the FY 18-19 budget.

“Nursing facilities cannot sustain flat funding for a fourth straight year, and increased support for our sickest, frailest elderly residents and those providing their care in this budget is essential. PHCA remains committed to working with the administration and legislature to provide additional funding to allow nursing facility residents to receive the quality care and services they need, and support our dedicated caregivers the way they deserve.

“We are eager to work with the Wolf Administration and members of the House and Senate to ensure we meet our seniors needs in this year’s state budget.”