Skilled Nursing Facility Staff, Residents Deliver Petitions, Mail Handwritten Letters from the Heart to State Legislators
Skilled nursing facility staff, residents, families, volunteers, community leaders beg lawmakers to increase Medicaid funding for frail elderly
HARRISBURG — Representatives from skilled nursing facilities fanned out statewide to deliver petitions and mail letters that were handwritten by staff, elderly residents, family members, volunteers and concerned citizens, urging the General Assembly to make the care of the state’s frailest, sickest individuals a priority in the state budget.
The petitions were delivered to lawmakers’ district offices. Most petitions garnered hundreds of signatures at the facility where the petition drive was held over the last week.
Additionally, more than a thousand handwritten letters begging for increased funding were mailed to legislators’ district offices last week and this week.
“These communities are extremely concerned about the future of care for our frailest, sickest elderly residents and the future of their Pennsylvania’s skilled nursing facilities that they call home,” said Stuart H. Shapiro, M.D., President and CEO of the Pennsylvania Health Care Association (PHCA). “They want legislators to understand the fiscal realities facing care providers and how that is impacting access to care for seniors.”
The petition drive follows a Capitol rally that drew more than 600 skilled nursing center caregivers to Harrisburg in May — many of them carrying photographs of elderly residents or loved ones who need help with long-term care. They urged legislators keep their promise to the state’s frailest and sickest residents.
Skilled nursing facilities care for the state’s sickest and frailest residents, such as those with advanced dementia or severe chronic health conditions that require around-the-clock care. Over the years, the acuity (sickness) level of residents has increased, as has the cost of care. But funding hasn’t kept pace.
Dr. Shapiro commended Gov. Tom Corbett for increased funding in his proposed 2014-15 spending plan for the care of the elderly on Medicaid, and called on legislators to follow the governor’s lead to ensure the state’s frailest and sickest citizens have access to quality care. The state must adopt a budget by June 30.
Additionally, he called on the General Assembly to once again fund a program that they created last year to aid nursing homes that care for a higher-than-average percentage of residents on Medicaid. That “add on” program would cost the state $16 million but bring in an additional $17 million in federal funds, to ensure seniors on Medicaid have access to long-term care in the communities where they live.
Two new independent studies underscore the immediate dangers facing tens of thousands of Pennsylvania’s frail elderly and disabled residents as years of chronic under-reimbursements have pushed many of the state’s skilled nursing facilities to the brink of financial collapse, with centers caring for high Medicaid populations at the greatest risk.
According to Avalere Health, Pennsylvania nursing facilities have seen their margins drop by more than 60 percent between 2007 and 2012, from 3.2 percent to 1.2 percent. For facilities caring for more than 75 percent Medicaid residents, the margins have fallen almost 80 percent, to 0.3 percent, between 2007 and 2012.
In fact, the state’s nursing homes lose $9,500 annually for each Medicaid resident in their care, according to Eljay LLC, which found Pennsylvania to be among the worst states for Medicaid reimbursements. Pennsylvania reimburses nursing facilities $26 a day less per resident than the true cost of care. That shortfall has more than doubled since 2007, when it totaled $13.23 per resident per day. Unreimbursed Medicaid costs in Pennsylvania will exceed $470 million this fiscal year.
As a result, nursing facilities are losing money, when adjusted for inflation, or returning margins so low that they cannot invest in necessary capital improvements or advanced technology that would enhance care, nor can they pay competitive wages that would increase staff retention, which is so vital to high-quality care. Some facilities have had to turn away seniors on Medicaid because they cannot afford their care, creating access to care issues in parts of the state.
All health-care providers lose money on Medicaid patients, but none as much as skilled nursing facilities, whose Medicaid percentage is the largest among providers. Two-thirds of all residents in skilled nursing facilities in Pennsylvania rely on Medicaid.