May Provides a Chance for Pennsylvania to Celebrate Older Americans and Nursing Homes, While Protecting Their Futures
HARRISBURG — May is shaping up to be an exciting month for long-term care in Pennsylvania as families throughout the commonwealth celebrate Older Americans Month, and communities honor their skilled nurses and caregivers during National Nursing Home Week from May 14-20. The celebrations come as the state’s General Assembly is engaged in ongoing discussions in response to Gov. Tom Wolf’s proposed 2017-18 fiscal year budget, and Pennsylvania’s long-term care industry continues to feel the strain of inadequate funding to care for the state’s rapidly aging residents.
While negotiations continue in a difficult budget cycle, PHCA President and CEO W. Russell McDaid took time to praise the dedicated professionals who work physically demanding and emotionally challenging jobs to keep their communities frail and elderly populations healthy and safe.
“Every day in Pennsylvania, more than 30,000 skilled nursing professionals provide high-quality, compassionate care to 81,000 frail elderly and disabled residents who need around-the-clock support for clinically complex medical conditions,” McDaid said. “These men and women form the backbone of our state’s long-term care system, so it’s only fitting that for one week, at least, we take a step back to appreciate the services these providers offer to our most vulnerable residents.”
Pennsylvania ranks fourth nationally in the percentage of residents who are seniors, with the fastest-growing segment of its population, residents age 85 and older, expected to exceed 400,000 residents in the year 2030. As the “baby boomer” generation comes of age, it is estimated that approximately 2.2 million Pennsylvanians are now over the age 65 and that nearly 70 percent of them will need long-term care in their lifetime.
While Pennsylvania’s nursing homes provide a high level of care to those who rely on them for their daily living needs, and comfort to the families who entrust them with the care of their loved ones, many facilities are at a crossroad where they can no longer afford to operate. Despite increases to the state’s elderly population and the number of residents requiring intensive care in their lifetime, Pennsylvania’s skilled nursing facilities have not seen a meaningful funding increase in six years.
Of primary concern, current Medicaid reimbursement levels pay skilled nursing facilities $25.43 per day less than the actual costs of providing care. With as many as two-thirds of all residents living in these facilities relying on Medicaid to pay for their care, funding shortfalls equate to a gap of $9,300 annually, on average, for every Medicaid resident in a skilled nursing facility in the commonwealth.
“With an estimated 70 percent of people turning 65 this year expected to require long-term care in their lifetime, the need for skilled nursing facilities is not going away any time soon,” McDaid said. “Patient acuity levels are only going to continue to rise, with residents requiring around-the-clock care for clinically complex medical conditions. So the question we have to ask ourselves is what kind of system of care are we going to create for our families?
“I can tell you with absolute certainty that the path we’re on is unsustainable and that skilled nursing facilities in the commonwealth are facing a crisis,” said McDaid. “It is essential that we acknowledge that our population is going to require the type of care skilled nursing facilities provide and that we find a way to increase Medicaid reimbursement levels.”
As Pennsylvania’s demographics continue to change and evolve, so too does the level and type of care provided by the state’s skilled nursing facilities. While some residents are in skilled nursing facilities on a short-term stay because they need post-acute around-the-clock care, many are being discharged from the hospital suffering from debilitating afflictions such as Alzheimer’s disease or dementia.
The typical skilled nursing facility resident population today has more chronic conditions and complex care needs, and requires a greater dependency on caregivers to meet these needs. In a skilled 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
And those numbers are going to increase as skilled nursing facilities care for a larger segment of the population as Pennsylvania ages.
The type of care required by most skilled nursing facility residents is costly to provide and in high demand. For example, if Pennsylvania were to provide the same level of 24 hour-per-day care under the Medicaid waiver program at home, it would cost Medicaid almost double what it costs for skilled nursing care — $112,128 to $167,491 a year per person at home compared to an average of $73,142 for skilled nursing facility care in the 2015-16 fiscal year. That’s a cost the state simply cannot afford.
“People want to age at home, and they should, when it’s safe,” McDaid said. “But it’s worth stressing that quality long-term is not, and cannot, be a cost-savings measure for the budget. No matter how difficult the budget situation, funding to provide quality care for our frail and elderly populations must be a priority in Pennsylvania.”
“Pennsylvania Newsmakers” is one of the state’s premier politics and public policy television talk shows. The show is available at www.phca.org and will air regionally:
- WGAL Channel 8 (Harrisburg and Lancaster) Sunday, May 14, at 11:30 a.m.
- WBPH (Lehigh Valley and Philadelphia) Monday, May 15, at 8:30 p.m.
- WKBS 47 (Altoona) Saturday, May 20, at 9:30 a.m.
- WPCB 40 (Pittsburgh) Saturday, May 20, at 9:30 a.m.