Perfect Storm Threatens Pennsylvania’s Long-Term Quality Care for Seniors and Other Valuable Populations

HARRISBURG — Pennsylvania Health Care Association (PHCA) President and CEO Zach Shamberg cautioned that long-term care providers in Pennsylvania are facing a perfect storm that will challenge their ability to provide quality care to the state’s most vulnerable and at-risk populations, and the influx of aging baby boomers who be turning age 65 and older in the coming decade. The warning from the head of the commonwealth’s largest association of nursing homes, personal care homes and assisted living residences came during a recent appearance on a statewide public affairs TV program set to begin airing on Sunday, June 16.

“We need to keep pushing forward with improving quality care and maintaining our role as a national leader in quality long-term care,” Shamberg said. “But in order to remain a quality leader, we’re going to need the state to address the challenges facing care providers and the inequities that threaten to undermine all of the progress we’ve made in recent years. Nursing homes must be an integral part of the health-care continuum, where care is provided around the clock for people with the highest acuity needs.”

For Shamberg, the perfect storm facing long-term care is comprised of four primary components which put residents at risk: Medicaid and state funding, Pennsylvania’s legal climate, workforce challenges and regulatory issues that govern the way long-term care providers care for residents.

Shamberg noted that two-thirds of all residents in nursing homes have their care paid for my Medicaid. However, current reimbursement rates fail to cover the costs of providing quality care to seniors, and there hasn’t been a significant investment in the Medicaid system by the Pennsylvania State Legislature since 2014.

Gaps in Medicaid reimbursement make it increasingly difficult for nursing homes to invest in medical technology that could aid in patient care, or invest in capital improvements to upgrade aged buildings. It also means nursing homes are losing experienced staff to other sectors because they struggle to offer competitive wages and/or benefits, leading to higher turnover.

To help keep pace with rising costs, Pennsylvania nursing home caregivers are asking for two things in the 2019-20 budget:

• A 2.8% increase to Medicaid funding. This increase equates to $47 million in state funds, which would bring in more than $50 million in federal dollars.
• To ensure that nursing homes continue to admit the frail elderly on Medicaid, legislators should again fund an “access add-on” payment of $17 million (which will be matched with $18 million in federal funds) so seniors on Medicaid don’t have to seek care outside their own community.

Shamberg cautioned that nursing homes across the country are closing including nursing homes in Massachusetts, Texas, Nebraska, South Dakota and Illinois, all because of insufficient Medicaid funding.

Despite these challenges, over the last two years Pennsylvania nursing homes have shown improvement in 20 of the 23 quality measures on Nursing Home Compare. Improvement efforts include staff/caregiver development, technological advancements, specialized program enhancements, focused care planning, medication reconciliation and resident education. However, Shamberg believes that the current regulatory climate concerning long-term care does little to improve quality or improve patient outcomes.

“Currently, in Harrisburg and Washington D.C., there’s more of a focus on paperwork, and checking off items on list, rather than spending time at a resident’s bedside,” said Shamberg. “Long-term care is first and foremost a service industry. We share their happy memories, and we sometimes see them during their most difficult moments. There’s no substitute for face-to-face interactions between caregivers and residents, and regulations should emphasize and recognize the importance of those relationships.”

“Unfortunately, I’m afraid Pennsylvania is not making the proper level of investment to ensure we can provide quality care in 10 years,” Shamberg noted. “The silver tsunami is a very real challenge that we’re going to be faced with sooner rather than later. It impacts you; it impacts me; it impacts every single legislator in the Capitol.

“This reality is not going to go away just because we don’t want to deal with it. We must invest in nursing homes today if we want to ensure quality care for our loved tomorrow and beyond.”

“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, June 16, at 11:30 AM
• WBPH (Lehigh Valley and Philadelphia) Monday, June 17, at 8:30 PM
• WKBS 47 (Altoona) Saturday, June 22, at 9:30 AM
• WPCB 40 (Pittsburgh) Saturday, June 22, at 9:30 AM
• MeTV (Susquehanna Valley) Sunday, June 16, at 11:30 PM