By Adam Marles
Everyone knows America is experiencing a hiring crisis. Many local restaurants and stores are struggling to find staff to open. Now imagine running a nursing home, where the pandemic remains a real threat, and trying to retain and find new employees. Even if you could find potential candidates, nursing homes find themselves at a financial breaking point after seven years of flat Medicaid funding by Gov. Tom Wolf’s administration.
That’s why the administration’s recently proposed regulations to mandate sharp staffing increases at nursing homes couldn’t come at a worse time. The proposal is disappointing, but hardly surprising, given Wolf’s record on Medicaid funding. Our members support best staffing practices and provide high-quality senior care, but a lack of state funding continues to stretch our resources to the very limit.
Those aren’t empty words.
After years of being ignored by Wolf, several nonprofit facilities have closed or have been sold, including: the Charles Morris Nursing & Rehabilitation Center in Pittsburgh; St. Mary’s East in Erie; Westminster Village in Allentown; Twining Village in Berks County; and the Madlyn and Leonard Abramson Center for Jewish Life, Abramson Senior Care campus, in Montgomery County.
This list will likely grow. In a recent survey, only a quarter of the country’s 15,600 nursing homes believe they can stay open for a year. That’s frightening. If they don’t close, they’re typically purchased by an out-of-state corporation that doesn’t have the same quality of care standards. Unfortunately, most Pennsylvanians aren’t aware of this unless they’ve had to find a new home for a loved one when a facility closed or when the quality of care dropped under new corporate ownership.
We can support staffing to meet the residents’ needs and provide quality outcomes, but it must be fully funded. The administration indicated it would increase Medicaid Assistance to help pay for the new mandate, but we’re long past the point where we can just take them at their word. The track record simply isn’t there. After all, Wolf has never proposed or provided a Medicaid funding increase. He also has never supported any funding initiatives by the General Assembly.
In fact, Pennsylvania is so far behind in meeting the needs of seniors who rely on Medicaid care that it will take years to catch up. Had the Wolf administration funded Medicaid adequately through the years, those dollars would’ve gone to staff to continue providing quality care to residents.
The pandemic’s financial burden has only exacerbated the funding crisis created by Wolf. These regulations ignore that the pandemic is far from over for long-term care facilities, which remain in a daily battle with a virus that targets our oldest citizens. Costs for personal protective equipment (PPE), ongoing testing and other pandemic-related costs continue to total in the millions of dollars.
In its proposal, the Wolf administration discloses it’s not even sure of the implications but acknowledges nursing home providers will bear much of the cost at a time when everyone understands they can least afford to do so. Here’s the reality: Wolf’s regulations will lead to more quality care providers taking Medicaid beds offline, selling to poor-quality, out-of-state companies, or closing all together.
There was an opportunity to work together to improve Pennsylvania’s long-term care system for future generations. Instead, long-term care providers, which continue to be on the front lines of the pandemic, haven’t had input in these regulations since 2018. For some reason, Wolf has never been interested.
We’re hopeful to have the opportunity to provide meaningful input during the regulatory review process. LeadingAge PA members have a wealth of experience and knowledge that would be helpful in finding real solutions. They’re going to continue to work to make their voices heard because the quality of care for our older loved ones is absolutely at stake here.
It’s time to tell Wolf to take care of Pennsylvania seniors who require 24-hour care.
Adam Marles is president and CEO of LeadingAge PA, a trade association representing more than 380 senior housing, health care and community services in Pennsylvania.