PHCA Responds to Dept. of Health Nursing Home Quality Improvement Task Force Report

HARRISBURG — W. Russell McDaid, President and CEO of the Pennsylvania Health Care Association (PHCA), today issued the following statement regarding the Nursing Home Quality Report released by the Pennsylvania Department of Health’s Nursing Home Quality Improvement Task Force:

“PHCA applauds the Pennsylvania Nursing Home Quality Improvement Task Force for their extensive work over the past 15 months to advance quality improvement in long-term care facilities across Pennsylvania, and we embrace the overarching goals set out for nursing home care in the seven specific recommendations outlined in the report.

“Pennsylvania’s population is aging rapidly and the demand for long-term care services is growing, especially among residents and patients who have higher acuity levels, more complex medical needs and chronic health conditions that require around-the-clock care.

“Pennsylvania’s skilled nursing facilities fully support the three core components of the ideal care setting – quality of care, quality of living and person-centered care. However, there are times when the voluminous state and federal regulations that govern nursing homes are in direct conflict with or limit a home’s ability to fully embrace these core concepts.

“One of the biggest challenges the Commonwealth will face in implementing these recommendations is the availability of resources—both human and financial.

“While the report acknowledges the current gap between Medicaid reimbursement and the full cost of compliance with the regulations governing nursing homes, it does not contain a single recommendation on how to close that gap, currently over $25 per Medicaid resident day in Pennsylvania. Nor does it address a tort environment that is draining $95 million annually from the cash-strapped Medicaid program essentially to pay out-of-state attorneys who file frivolous lawsuits. These points must be part of the solution to protect seniors and help the state’s fiscal situation.

“Implementing the type of sweeping changes recommended in the task force report without dedicating additional state funding to pay for the increased costs that will be associated with the recommendations will further strain the finances of Pennsylvania’s nursing homes, impacting nursing home residents and direct care workers by taking even more dollars away from the resident’s bedside, where they are needed the most.

“We welcome the opportunity to work with the Department of Health and state policymakers to examine these recommendations and make changes to the system used in oversight of Pennsylvania’s nursing homes. As we discuss changes to the regulations, Pennsylvania’s dialogue must include a frank discussion of the availability of a competent, highly skilled workforce, and the financial resources necessary to pay and train them.

“Secretary Murphy noted that the Department has increased enforcement of regulatory sanctions and revised its calculations for how facilities are fined. It is important to note that more stringent penalties do not alone improve care. When any sanction or penalty is considered, the most important goal is to identify the practice in question, take steps to correct the practice and ensure that any sanction does not jeopardize the facility’s ability to improve resident care, comfort and safety. Taking financial resources away from the bedside does not improve resident care.

“Despite chronic financial challenges, Pennsylvania’s skilled nursing facilities have made strides in quality of care being provided with a focus on enhancing treatment services and improving the overall experience for residents, while improving in clinical outcomes, with reductions of urinary tract infections, pressure ulcers, use of antipsychotic medication, resident pain and more.

“We look forward to working with Governor Tom Wolf, Secretary of Health Karen Murphy and the Department of Health to continue to ensure that Pennsylvania’s most vulnerable citizens continue to receive the highest level of quality care.”