Nursing home crisis demands state action

Three-quarters of homes in Pennsylvania atrisk of closing

Owing to staff shortages, 75% of nursing homes in Pennsylvania are at-risk of closing — and half are operating at a financial loss. The business model for these homes is broken. With the health and welfare of nearly 80,000 elderly people at stake, state government must help fix this crisis.

Pennsylvania’s 683 nursing homes face unprecedented financial stresses, including a Medicaid reimbursement rate that hasn’t changed since 2014, large numbers of employees who left during the pandemic, increased costs for workers from temporary staffing agencies, and higher utility and supply costs.

Gov. Tom Wolf has proposed adding $91 million in Medicaid funding to raise daily reimbursement rates for nursing home residents. Nursing home owners say current rates do not even cover their operating costs.

Additional money from the state through Medicaid reimbursements, along with additional state oversight, will help nursing homes sustain acceptable levels of care.

We urge the General Assembly to approve it.

Still, a small increase in Medicaid reimbursements is, at best, an interim measure, a band aid on a gaping wound. More fundamental changes are needed to keep nursing homes afloat and providing high-quality care.

Nursing home regulations must be updated to better protect patients.

Lax staffing requirements, for instance, have led to numerous complaints from families of patients. In the worst instances, large numbers of residents have died from COVID-19, partly due to thin staffing and poor safety protocols.

One year ago, the state Department of Health proposed new regulations to improve patient care, including requiring a minimum number of hours for staff to have direct contact with patients. Those regulations were generally ineffective, however, partly because nursing home operators did not receive enough money to cover the costs of increased staffing.

In raising standards for patient care, the state must also ensure nursing home operators have enough money to meet them. Conversely, If the state provides $91 million in new funding, it should, in return, ask more of nursing home providers.

Corporate and nonprofit owners of nursing homes should not resist government oversight, as government pays for 79% of their residents, mostly through Medicaid. Increased oversight could include requiring higher minimum staffing levels, and even livingwage compensation for nurses and aides. Higher Medicaid reimbursement from the state should also eliminate, or alleviate, another problem in the nursing home industry: Accepting patients based on whether they’re covered by Medicare, which provides higher reimbursement rates.

Legislators should regard Gov. Wolf’s proposed $91-million increase in Medicaid funding as an essential interim step that will enable them, and the industry, to work out more fundamental reforms to sustain nursing homes in Pennsylvania and improve their quality-of-care.

— Pittsburgh Post-Gazette

With Roe gone, need to step up

Many conservative state legislators cheered when the U.S. Supreme Court eliminated the constitutional right to abortion that an earlier court had affirmed in Roe v. Wade in 1973.

The 6-3 majority also overturned the 1992 decision, Planned Parenthood of Southeastern Pennsylvania v. Casey, under which the justices at that time further affirmed the abortion right but found that there is a legitimate public interest in regulating abortion.

Pennsylvania is not among the 13 states that immediately will outlaw and, in some cases, criminalize, abortion within the next 30 days.

But there is no doubt that some Pennsylvania lawmakers will move quickly to introduce such measures.

In doing so, they will answer the question raised by Gov. Robert P. Casey when he crafted the Pennsylvania Abortion Control Act, the law that led to the Supreme Court decision in Planned Parenthood of Southeastern Pennsylvania v. Casey.

Tragically, the answer to that is just as predictable as this conservative court supermajority’s decision to overturn what two of its members, Justices Neil Gorsuch and Brett Kavanaugh, had assured Sens. Susan Collins and Joe Manchin was “settled law” as they sought confirmation of their appointments.

— Wilkes-Barre Citizens’ Voice/The Associated

Press