Nursing home bill requires boost in aid

Nursing home care across the entire spectrum of services should be improved, and the COVID-19 pandemic could be the catalyst of that change, the state Senate chair of the Elder Affairs Committee said Monday.

“We have to build up assisted livings, supportive housing, home care and support for family caregivers, and change the funding — increase the funding — for all of them, and make it possible for people to get care in the community,” Sen. Pat Jehlen said at a virtual AARP Massachusetts advocacy day.

Jehlen, a Somerville Democrat, and Newton Rep. Ruth Balser talked to event participants about their bill (S 414, H 727) that proposes new requirements for nursing homes, with the aim of improving the quality of care.

The bill includes provisions that would increase the minimum number of hours of daily care for residents from 3.5 to 4.1, require nursing facilities to have outbreak response plans, develop a pathway to single-occupancy rooms, and increase staff training through career advancement programs.

Financial challenges, facility closures and worker shortages plagued nursing homes long before the COVID-19 pandemic reached Massachusetts.

For more than five years, the primary advocate for the state’s nursing home industry, the Massachusetts Senior Care Association, has been lobbying for increased Medicaid reimbursements and higher wages for nursing home aides and other low-paid staff.

In February 2020, the same month the state confirmed its first coronavirus case, a nursing home task force that included Jehlen and Balser released a report that stated four policy goals: adjusting the industry size “in response to current and future demand,” reforming the rate structure, promoting high-quality care, and ensuring a sustainable workforce.

And existing data and future projections indicate a burgeoning demand, which will require a comprehensive increase in funding to provide a proper level of care.

Of the roughly 6.9 million

Massachusetts residents as of 2018, more than 1.58 million, 23%, were 60 years old or older, according to the

U.S. Administration for Community Living. That’s up from 1.27 million residents aged 60 or older in 2010.

The Administration for Community Living said that the nationwide 65-or-older population is projected to reach 80.8 million by 2040 and 94.7 million by 2060.

And according to the Alzheimer’s Association, as of last year, 130,000 people 65 or older in Massachusetts had Alzheimer’s disease or another form of dementia.

By 2025, that number is estimated to climb more than 15% to 150,000 in Massachusetts.

That $3.82 billion spending package the House passed last week included $70 million for nursing facilities — an insufficient senior-care commitment, according to that major state industry group.

In September, the Massachusetts Senior Care Association sought a one-time, $98 million investment for the 22,000 nursing home residents whose care is paid for by Masshealth (Medicaid), along with another one-time investment of $461 million over three years to finance a nursing facility workforce fund, a quality care and resident experience fund, and an infrastructure fund.

Association President Tara Gregorio said in a Sept. 21 statement that nursing facilities in Massachusetts faced an “urgent and immediate need to hire and retain direct-care workers.”

She said “increasing financial instability” had led to 11 recent closures and projected that more than 100 facilities were “at risk of closure in the next 12 months.”

Senate leaders, expected to detail their plans for an American Rescue Plan Act bill this week, should approve funds more in line with the Massachusetts Senior Care Association’s stated needs.