Pressures from high staffing requirements and lagging Medicaid reimbursement rates are reaching a new and concerning peak in Pennsylvania, according to provider surveys published by the largest for-profit and nonprofit nursing home associations in the state.
Approximately half of all members of the Pennsylvania Health Care Association had to deny admissions in the first quarter of 2024 and 46% revealed plans to sell or close at least one facility in the next year.
Fully 85% of all PHCA respondents characterized the current nursing home operating environment as “not viable.”
Providers primarily cited low reimbursement rates, but a complex mixture of other challenges persists as well — a rapidly increasing 80 and older population, increasing reliance on expensive agency staff, and a soon-to-increase staffing mandate paired amid an existing worker shortage.
That toxic cocktail of operational problems will sound familiar to long-term care professionals around the country, especially when considering the new federal nursing home staffing mandate from the Centers for Medicare & Medicaid Services.
These challenges are no longer a future threat, but rather one finalized that needs to be urgently addressed, said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association.
“Our PHCA member survey is not a future outlook –– the results are being affirmed by the access to care crisis that is already underway today,” Shamberg told McKnight’s Long-Term Care News Tuesday. “In a matter of weeks, Pennsylvania has seen two emergency evacuations, two nursing home closure announcements, and two company bankruptcy filings. This is beyond alarming for a state with one of the oldest populations in the country.”
Shamberg also noted that the incoming requirements of the federal staffing mandate only further complicates the challenges providers face by creating “two differing increased staffing regulations that Pennsylvania providers have to meet.”
Increased Medicaid funding is urgently needed to address providers’ situation, according to Garry Pezzano, president and CEO of LeadingAge Pennsylvania.
“It’s no longer just a threat that Pennsylvania’s mission-driven nursing homes will close due to chronic Medicaid underfunding. They are closing,” he told McKnight’s. “Pennsylvania can begin to answer this critical healthcare challenge by raising Medicaid reimbursement rates and, in doing so, move closer toward the aging services system that our seniors deserve.”
A similar member survey released by LeadingAge PA in February indicated that 93% of member providers would use a Medicaid increase to increase wages to help retain and recruit more healthcare workers.
