Nursing homes across Pennsylvania say they’re facing a funding crisis exacerbated by longer life expectancy, sicker patients as compared to two decades ago, and less federal aid for patients on Medicaid. Now they’re asking for state lawmakers for additional financial aid.
Managers of long-term care organizations say they’ve cut costs as much as they can. If they don’t get more state aid, they say more institutions will have to turn away Medicaid patients because reimbursement rates don’t match the costs of care.
“For the first time in Pennsylvania history, some skilled nursing facilities are actually, for economic reasons, being forced to turn seniors on Medicaid away because they cannot afford their care,” said Stuart Shapiro, president of the Pennsylvania Health Care Association, which represents long-term care providers.
Nearly every state agency and constituency is asking for a funding boost right about now. But Rep. Glen Grell (R-Cumberland) said what’s unaffordable is denying more aid.
“If these institutions — the long term care institutions — are not there, then these folks will end up in much more expensive settings in hospitals,” Grell said.
Federal funding for Pennsylvania’s Medicaid program has taken a dive recently. It’s based on a formula tied to per capita income, and designed to funnel less money to states with higher income relative to the national average.
Long term care organizations are asking for $16 million more in commonwealth funding, which would be matched by as much as $18 million in federal money. That, they say, could help stave off the effects of income margins that have plummeted since 2007, according to one commissioned study.
The Pennsylvania Health Care Association, and its nationwide parent group, commissioned two separate studies to examine the recent financial challenges faced by long-term care providers in Pennsylvania.
One study by Avalere Health, a research company, finds that the commonwealth’s nursing facilities have seen their margins drop by about 60 percent between 2005 and 2012 — and margins have dropped by about 80 percent for facilities serving largely patients on Medicaid.
Another study by Eljay LLC, a consulting company on long-term care, finds reimbursements from Pennsylvania’s Medicaid program pay far below the costs of meeting patients’ needs.
“This industry is in jeopardy,” Shapiro said, “and unless these issues are addressed ... it could become a wholesale crisis of access to care for the frail elderly.”