No matter if there’s an increase or not in Medicaid reimbursements for nursing homes across the state, local health officials say much more money is needed.
Under the 2016-17 state spending plan, the state Office of Medical Assistance appropriations for nursing facilities increased by $29.451 million in state funds, or 3.04 percent, and the state Office of Long Term Living’s appropriations grew by $97.183 million or 5.26 percent, according to information from the state’s Department of Human Services.
But W. Russell McDaid, president and chief executive officer of the Pennsylvania Health Care Association, counters that claim.
“Nursing facilities received flat funding in this year’s budget, which leaves Pennsylvania’s frailest and sickest residents, such as those with advanced dementia or severe chronic health conditions that require around-the-clock care in skilled nursing facilities, vulnerable,” he said in a prepared statement sent to the media. “The funding shortfall in Pennsylvania’s Medicaid program is the single biggest challenge facing Pennsylvania’s nursing homes and long-term care providers as the Commonwealth works to ensure high-quality, person-centered care for a rapidly aging population.”
Even so, Medicaid continues to be shortchanged, said Dennis McCarthy, spokesman for Upper Allegheny Health System, which includes Bradford Regional Medical Center and Olean (N.Y.) General Hospital.
“While we are grateful for any increase, we are still way behind in terms of being reimbursed for the true cost of care. This has been going on for years,” McCarthy said. “The cost of caring for residents of nursing homes is rising and they are more medically complex. Remember, these are the frail elderly. The government has the expectation that they will be taken care of, but our health associations have to fight year after year to get even small increases.”
And absent adequate funding going forward, McDaid said some seniors might have to be declined services at facilities.
“It becomes very challenging. Pinecrest Manor (St. Marys), along with other long-term care facilities, faces these issues as Medicaid is the primary payer source,” Penn Highlands Elk spokeswoman Karen J. Hazlett said. “Approximately 65 percent of the resident population at Pinecrest Manor is covered through Medicaid. It is vital to the sustainability of long-term care organizations to maximize Medicaid funding to ensure that our residents continue to receive quality care and service for years to come.”
With everything considered, McCarthy said Pennsylvania is hailed at being one of the worst states for Medicaid reimbursement.
“A study two years ago indicated that Pennsylvania’s nursing homes lose $9,500 per year for each Medicaid resident,” he said. “Budgets should not be balanced on the backs of the elderly. Like most nursing facilities, The Pavilion (Bradford) will continue to do more with less and ensure our residents receive the care they need.”
