Daily Local News (West Chester, PA)
How Pa.’s underfunded facilities affect you
Not only did COVID-19 take a very human toll on senior care facilities, with its residents generally the most at-risk of experiencing serious complications from the disease, the coronavirus also exposed the unsustainable financial situation facing the industry at large — one likely to have a direct impact on the care either you or a loved one will receive.
“What we have seen over the past 12 months is the COVID-19 pandemic both exacerbated and amplified the existing issues for longterm care providers,” said Zack Shamberg, president and CEO of the Pennsylvania Health Care Association.
“And not just nursing homes, but personal care homes and assisted living communities as well.”
Senior care providers were slammed with new, unanticipated costs such as testing, PPE and “hero pay” amid the pandemic, leaving many in the business to strive for success in longterm care while contemplating their own survival.
Yet, budget shortfalls and underfunded facilities are nothing new, remarked Shamberg, head of the state’s leading advocacy group for residents and their care providers. And, if current trends hold, the system may not be able to bend anymore — it will break.
“Right now, we are seeing an extremely volatile long-term care industry in Pennsylvania,” Shamberg said. “We’ve seen reorganizations. We’ve seen changes of ownership. We’ve seen sales.
“The next step is closures, and in the third-oldest state in the entire country, we can’t afford to have long-term care facilities shut their doors.”
The dollars and cents of senior care
The PHCA has been preaching about about the challenges facing the industry for some time now, with Shamberg able to distill those down to three major points of emphasis.
“For the better part of the last decade, we’ve warned of a Medicaid crisis, that Medicaid hasn’t kept up with medical costs,” Shamberg said. “We’ve warned of a workforce shortage, and we’ve warned of the legal climate allowing attorneys to run rampant and drive care providers out of PA.”
Medicaid lies at the heart of the matter. At the program’s current level of funding, there is a daily budget shortfall of almost $50 for every resident, creating an obvious strain on providers.
And that lack of funding doesn’t strictly pertain to the care seniors are receiving. It’s partly to blame for staffing shortages in facilities as well, as it impacts both their ability to recruit and retain employees.
“For more than 70% of all care provided, long-term care providers rely on the state’s Medicaid program to reimburse,” Shamberg said. “And there’s a direct correlation to recruitment in care facilities and investments in buildings and technology.
“When Medicare doesn’t keep up with medical costs, which rise on average 2% every year, that means cuts or scaling back everyday operations is inevitable.”
How the crisis could affect you
Shamberg said we’re already seeing the impact of the lack of investment in Medicaid and how it’s strained facilities.
If it continues and facilities begin to close up shop, it might result in the inability of many care providers to exist in the state.”
“In five, 10, 20 years, it means family members will be traveling hours in some cases to see their loved ones,” Shamberg said.
It could also wind up having a direct impact on your own care, too.
The PHCA cites a Center for Rural Pennsylvania report that estimates, by 2030, the number of people in the state ages 60 and older will rise to 3.9 million. In the 2019 census, 2.4 million Pennsylvania residents identified as 65 and older.
While people may not like to consider the possibility they could wind up in a senior care facility, the fact is the population is aging.
“I think everybody would prefer to be cared for at home,” Shamberg said. “However, that’s not reality.”
Steps in the right direction?
Shamberg noted there have been some positive legislative developments at the state level more recently. A bill passed at the height of the COVID crisis allowed facilities to utilize temporary nursing aides who can perform limited functions after completing an eight-hour course online and some hands-on training.
The PHCA’s hope is more legislation follows so that the scope and types of training evolve and make entering careers in senior care more accessible.
“We don’t have enough workers to care for our population moving forward,” Shamberg said. “We as a state need to ensure we continue to build that workforce pipeline.”
Another bill that passed in the state House would grant senior care providers and other businesses some liability protection.
“If enacted, this will essentially provide long-term care providers, facilities, workers and residents the protections they need against opportunistic lawsuits just seeking to profit from COVID-19,” Shamberg said, adding the uptick in litigation has helped push some in the industry to the brink.
What gives Shamberg the greatest reason for optimism of all though is simply the way senior care staff have battled through underfunding to do their jobs, especially during a pandemic.
It’s exactly the resilient mentality workers are going to need moving forward if things don’t dramatically change.
“What gives us hope is what we’ve seen on the front lines throughout the past year,” Shamberg said. “That even in the face of every challenge and every adversity and being at the epicenter of this pandemic, we have seen our health care heroes step up.”