Specialized respiratory care provider in Bucks County announces closure due to increased costs and state underfunding for patient care

HARRISBURG, Pa (March 31, 2021) –– On Monday, March 28, Fox Subacute at Warrington notified residents, their family members and staff of a 90-day closure plan filed with the Pennsylvania Departments of Health and Human Services. The Pennsylvania Health Care Association (PHCA) held a press conference Thursday addressing concerns that more long-term care providers –– especially those providing specialized care at higher costs –– will be forced to shutter their doors if Pennsylvania does not make necessary investments in the care of Medicaid patients.

“We have been sounding the alarm on access to care issues in Pennsylvania for months,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association. “We have continually communicated the challenges facing long-term care providers, primarily due to the underfunding of the state’s Medicaid program. As more and more facilities may be forced to sell, change ownership or even close, Pennsylvania residents will be forced to travel farther and distances to find essential and specialized long-term care.”

Fox Subacute at Warrington serves patients dependent on life-sustaining ventilators for short and long-term care services. The facility is currently caring for 46 residents. With four total facilities, Fox Subacute is the only Pennsylvania post-acute care provider solely specializing in ventilator care. Sixty ventilator beds will no longer be available in Pennsylvania after the closure of Fox Subacute at Warrington.

“Fox Subacute at Warrington has been a part of this community, providing specialized care for patients from Bucks County and beyond, for nearly 40 years,” said Jim Foulke, CEO of Fox Subacute. “Our residents and caregivers are family. This facility is both a home for some and a career for the others inside it. And unfortunately, we have been forced into a situation where we have to take that away because the care we provide to vulnerable Pennsylvania residents isn’t adequately funded by the state.”

Nearly 100% of all care provided at Fox Subacute at Warrington is paid for by the state’s Medicaid program. Pennsylvania’s Medicaid reimbursement rate for skilled nursing facilities has historically been underfunded. After years without an increase, the state’s General Assembly passed legislation in 2021 to allocate an additional $2 million for all post-acute care ventilator providers to help with rising costs. That additional funding helped Fox Subacute keep their Warrington facility open through 2021, but rising inflation on the cost for supplies and increased costs to hire high-priced agency staff to fill open shifts amid a workforce crisis have forced financial peril, prohibiting future operability. 

“We are concerned about the continued care of our residents,” Foulke said. “The type of care we provide is so unique, there are hardly any beds available at other facilities for our residents to transition into because providers can’t afford to offer this level of care. This is not only an access to care issue for our residents, but it will now become a greater access to care issue for all Pennsylvania residents.”

Fox Subacute is working with managed care organizations –– state-contracted companies responsible for the placement and funding distributions for Medicaid patients –– to identify other specialized facilities that can help with the transition of patients for their continued care. Fox Subacute provided solutions to state agencies and the managed care organizations after warning about the access to care issue this closure will cause. Those solutions were not accepted.

To allow time for managed care organizations to coordinate the transition of residents to other facilities, Fox Subacute filed a 90-day closure that was approved by the state on March 14. 

The Warrington facility has 100 employees. The staff expressed plans to continue providing care until patients are transitioned to other facilities. Fox Subacute will work with employees to transition as many staff members as possible to the remaining three Fox Subacute facilities.

“Pennsylvania has one of the oldest populations in the country, but the system in place to ensure access to care is broken,” Shamberg said. “This closure is a prime example of what the future might hold if we don’t start making meaningful investments in Medicaid today.”

Neighboring states reimburse post-acute care ventilator providers at higher rates. Ohio’s reimbursement is roughly $150 more a day per resident. New Jersey averages around $90 more a day per resident.

PHCA is advocating for the Pennsylvania General Assembly and Governor Wolf to increase Medicaid funding for long-term care residents in this year’s state budget. To learn more, visit WhoWillCarePA.com.

This closure notice is only for Fox Subacute at Warrington. There is no planned closure for any other Fox Subacute facility.

Photos and a video of Thursday’s press conference can be downloaded here.

Quotes from elected officials attending Thursday’s press conference

“My heart goes out to everyone impacted by today’s announcement. This closure is a real loss for our community: for the patients who call Fox Subacute home, the families who have put their trust in this facility, and the nearly 100 skilled caregivers and staff. If we want to prevent additional closures, protect patients, and preserve jobs, we must take bold action. It’s time for all of us in Harrisburg to have a collaborative and open conversation about the level of funding we dedicate to Pennsylvanians living in our nursing homes and long-term care facilities.”

– Senator Maria Collett (Montgomery County / Bucks County)

“There are only a few hundred post-acute care ventilator beds in the state, and Fox Subacute at Warrington accounted for a large portion of those beds. The lack of available ventilator beds will dramatically increase access to care challenges locally and within the Commonwealth, as well as vastly increase the cost of caring for these patients. More needs to be done to invest in the care of Medicaid residents in our long-term care facilities, especially those providing a very expensive and specialized service like Fox Subacute.

“We appreciate and thank Fox Subacute for their work here in Warrington Township and across the Commonwealth of Pennsylvania.”

– Representative Todd Polinchock (Bucks County)