PHCA President Says State Must Invest in Skilled Nursing Care, Protect Seniors From Frivolous Lawsuits

HARRISBURG — It’s summertime in Pennsylvania and senior care remains a hot topic in the Capitol as PHCA President and CEO  Russ McDaid continued to draw attention to the possibility of skilled nursing facilities facing a fourth consecutive year without increases to Medicaid reimbursement for residents. McDaid warned inaction by state legislators and Gov. Tom Wolf’s administration could have disastrous consequences for seniors during an appearance on a statewide public affairs TV program set to begin airing on Sunday, June 17.

“Almost all of us have a loved one who will need skilled nursing care during their lifetime and we want assurances there are no unnecessary compromises when it comes to receiving quality care,” said McDaid. “However, we’ve kicked the funding can down the road for far too long and now we are entering into dangerous territory in which staff is unequipped, unprepared or nonexistent. I can’t think of a single person who would willfully want to see such a catastrophe — and yet once again, nothing is being done by the governor or the state legislature.”

While reimbursement to nursing facility care providers for Pennsylvania’s oldest and most frail residents remains unchanged for the fourth year, correctional institutions have experienced a 10 percent increase in funding, including a 3.6 percent increase proposed in the governor’s proposed budget and an 18 percent increase in inmate medical care. These funding increases have occurred at a time when the Wolf Administration is touting a reduction in the state’s inmate population.

Pennsylvania’s present reimbursement system results in skilled nursing facilities losing an average of $47.36 each day, or $17,200 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 $17,200 gap between costs and reimbursement for each Medicaid resident equates to more than $1.7 million in underfunding for a facility serving 100 Medicaid residents.

Skilled nursing facilities would need an increase of 2.6 percent in the 2018-19 state budget just to cover health care inflation over the past year. PHCA is also seeking a continuation of the Medicaid Access Program that legislators created five years ago to help facilities with high Medicaid populations.

“I cannot think of any business or service in our local communities that can survive a million dollar annual budget gap — there comes a point where quality will suffer,” McDaid said. “We can no longer hide from the fact that skilled nursing facilities have now reached the point where a decline in quality will impact our loved ones. That warning should hit home for every Pennsylvanian.”

McDaid’s concerns about the quality of senior care in Pennsylvania come on the heels of PHCA’s annual rally day in Harrisburg. The event drew more than 350 caregivers and administrators to the Capitol to tell lawmakers that the state’s long-term care network is being undermined by a one-two punch of chronic underfunding and lawsuit abuse.

Pennsylvania’s skilled nursing facilities, assisted living residences and personal care homes remain the target out of out-of-state predatory lawyers who are filing frivolous lawsuits seeking large cash settlements because of the state’s lax tort laws related to long-term care.

More than $104 million of state Medicaid dollars was spent on liability related costs in 2015, much of this in contingency fees to out-of-state predatory lawyers, rather than on the delivery of care. These high legal costs not only inhibit job growth, increase health-care costs and limit access to medical care, they also affect the morale among residents and caregivers.

McDaid called on the state House to give second consideration to House Bill 1037, which would limit punitive damages against long-term care provides to 250 percent of the amount of compensatory damages for skilled nursing facilities, assisted living residences and personal care homes.

The legislation, introduced by State Representative Warren Kampf, takes aims at out-of-state law firms filing frivolous lawsuits for huge cash settlements and provides skilled nursing facilities with the same level of protection physicians have had in Pennsylvania for the last 15 years.

“To give you an idea of how bad things have become in our state, there are some long-term care providers in Pennsylvania that now spend more on defending these lawsuits than on food for their residents,” McDaid said. “We’re talking about more than $100 million that should be used to help seniors, and can if we’re willing to prioritize seniors over out-of-state predatory law firms. Imagine how those funds can be better utilized to care for our loved ones.

“Ultimately, seniors and the frail will be the ones who pay the price for any inaction by our legislators and the Wolf Administration. Our frailest and sickest residents need this HB 1037 to advance.”

The public can learn more about HB 1037 or ask their lawmakers to support this legislation by visiting www.EndLawsuitAbuseinPa.com.

“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, June 17 at 11:30 AM
• WBPH (Lehigh Valley and Philadelphia) Monday, June 18 at 8:30 PM
• WKBS 47 (Altoona) Saturday, June 23 at 9:30 AM
• WPCB 40 (Pittsburgh) Saturday, June 23 at 9:30 AM
• MeTV (Susquehanna Valley) Sunday, June 17 at 11:30 PM