PHCA CEO: State’s Nursing Homes Provide High-Quality Care

HARRISBURG — Pennsylvania’s skilled nursing facilities rank among the best in the country in terms of the high level of care they provide to the more than 81,000 residents who rely on these centers for their rehabilitation or daily living needs, said Stuart H. Shapiro, M.D., CEO of the Pennsylvania Health Care Association and the Center for Assisted Living Management.

Shapiro appeared on a statewide public affairs show to discuss the quality of care in Pennsylvania’s 700-plus nursing homes, which serve frail elderly and disabled residents who need around-the-clock support for clinically complex medical conditions. To the contrary, he said, Pennsylvania’s skilled nursing centers continue to surpass major quality milestones.

“Managing a loved one’s long-term care needs is among the most difficult decisions a family can make,” Shapiro said. “That’s why it’s important to be clear and direct about the level of care these homes provide.”

Shapiro noted that from the first quarter of 2014 to the first quarter of 2015, Pennsylvania nursing homes improved on 10 of 11 quality measures, according to the U.S. Centers for Medicare & Medicaid Services, which has become the primary consumer tool for evaluating the nation’s nursing homes since launching launched five years. Pennsylvania nursing homes now rank better than the national average on 8 of the 11 measures.

The facts are that Pennsylvania nursing homes receive fewer deficiencies than the national average, and rank the lowest in serious deficiencies, which means that the state’s nursing homes rank better than all other 49 states. Penalties are down, he said, and bans on admissions are virtually zero.

Recently, Gov. Tom Wolf and the Pennsylvania Department of Health announced the formation of the Pennsylvania Nursing Home Quality Improvement Task Force to advance quality improvement in long-term care facilities across Pennsylvania. Shapiro applauded the task force and said he and his association remain committed to working with the department and its task force to ensure Pennsylvania’s most vulnerable citizens continue to receive the highest level of quality care.

Nursing homes already are subject to intensive and thorough regulation and enforcement. Each facility is licensed by Health and subject to unannounced inspections at least once a year. These official on-site annual surveys provide one of the best and most reliable measures of quality, ensuring centers are meeting strict regulatory guidelines for quality, operational integrity and staffing.

“These CMS rating systems and additional reviews by Health’s task force are valuable tools to ensure continuous improvements,” Shapiro said. “But for consumers, seeing is believing, and nothing beats visiting a facility itself. Anyone searching for care should visit your local nursing home to see first-hand the good work they do every day. Our doors are always open.”

PHCA recently launched a new Web site to help consumers understand better the metrics used to measure nursing home performance. That site is www.paforqualitycare.org.

Shapiro also noted that even as quality measures continue to improve in Pennsylvania nursing homes, mostly out-of-state predatory lawyers continue to target the centers because of the state’s lax laws against frivolous lawsuits in the long-term care arena.

Legislation currently is pending to conform the same protections given to physicians in cases involving punitive damages to skilled nursing centers. Right now, nursing homes aren’t protected against punitive damages. While punitive damages awards are infrequent, they can be astronomical. Without protections, providers and their insurers are more likely to settle a weak case than risk a runaway jury that could bankrupt their business.

One company, Extendicare, which has been in business for nearly 50 years nationwide, pulled out of Pennsylvania because of the financial pressures arising from frivolous lawsuits.

“All we’re asking is that the legislature enacts similar limits for long-term care providers as have existed for physicians for more than a decade,” Shapiro said. “The high costs of defending inappropriate and unnecessary liability claims add to the financial pressures on Pennsylvania nursing homes — that’s money that could be going to deliver care rather than defend against lawsuits.”

In terms of costs: Given that there are about 19.2 million days of care paid for by the commonwealth’s Medicaid program, $90.5 million was spent on liability-related costs in Pennsylvania nursing homes in 2013, the latest year for which statistics are available. A significant percentage of this goes to out-of-state predatory lawyers.

“Imagine how that $90 million dollars could be used to improve the quality of care and the quality of life for nursing home residents,” Shapiro said.

“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, Oct. 11 at 7:30 a.m.
• Pennsylvania Cable Network, Sunday, Oct. 11 at 4:30 p.m.
• WBPH (Lehigh Valley and Philadelphia) Monday, Oct. 12 at 8:30 p.m.
• WKBS 47 (Altoona) Saturday, Oct. 17 at 9:30 a.m.
• WPCB 40 (Pittsburgh) Saturday, Oct. 17 at 9:30 a.m.