Governor Tom Wolfe has told the Pennsylvania Parliament millions of dollars to raise the key reimbursement rates for skilled nursing homes in the state and offset the costs from the proposed new regulations to increase the care needed daily. I’m asking you to spend.
With the state’s June 30 budget deadline approaching, Democrats want to allocate $ 91.25 million to increase the amount received by skilled nursing homes for Medicaid residents.
Approximately 11,000 caregivers in Pennsylvania have died since the COVID-19 pandemic began. The victim renewed attention to long-standing issues such as dangerously low staffing and outdated regulations.
A group, including the Pennsylvania Healthcare Association, lobbying on behalf of the state’s long-term care providers, states that the state’s low Medicaid reimbursement rate is a major obstacle to providing higher levels of care. They say that current rates allow them to leave nursing home facilities without the funds to raise employee wages or purchase supplies for patient care.
The association estimates that Medicaid’s investment will increase Medicaid’s daily repayment rate from an average of $ 199.96 to an average of about $ 210 per resident. Prices are higher in neighboring states such as Ohio, Maryland, and New Jersey.
However, while PHCA sees Wolf’s proposal as a welcome first step, the organization argues that it is not enough. Industry groups estimate that regulatory changes will require hiring 10,000 additional workers and spending $ 434 million annually. As a result, some people rejected the plan as an unfunded mission.
According to the Pennsylvania Department of Health, there are 683 nursing homes in the state, serving a total of approximately 80,000 residents. This number is expected to increase over the next few years as the population of states over the age of 65 grows. According to PHCA, about 66% of residents of nursing homes throughout the state are paid for their stay by Medicaid. Medicare accounts for an additional 13%.
There seems to be an agreement among lawmakers that more investment is needed, but how to do so is still under debate. If funding for nursing homes remains as-is, ground-based horror facility advocacy networks, professionals, and nurses may not be equipped to support an aging population.
Zack Schaumburg, President and Chief Executive Officer of the Pennsylvania Healthcare Association, said: “It will be disastrous for our elderly.”
Why is refund important?
In a way that Medicaid and Medicare funds are distributed, many nursing home facilities are seeking to accept Medicare-funded patients rather than Medicaid-funded patients.
David Grabowski, a professor of healthcare policy at Harvard Medical School, said: “So it’s really one of the main parts of the service being pushed by Medicaid today.”
Medicare is a federal insurance program that typically covers patients with short stays, such as those receiving physiotherapy or postoperative care.
Medicaid is a state-owned support program that follows federal guidelines to support low-income earners and is usually targeted at long-term stay patients. The repayment rate is the amount paid by the state government to each nursing home on behalf of a qualified patient.
According to Grabowski, Pennsylvania’s low-cost Medicaid reimbursement encourages nursing homes to look for Medicaid patients who are planning a short-term stay, rather than accepting Medicaid patients who require long-term stays.
He goes on to say that this dynamic move makes the federal government a “very generous payer,” and its plunge allows care facilities to reach double-digit margins for short-stay patients. On the other hand, Medicaid patients usually have negative facility margins, creating a gap between the cost of resident care and the amount of state funding, he said.
According to a February survey conducted on Leading Age PA, an industry group representing about 380 providers serving seniors in Pennsylvania, they spent what Nursing Homes received for Medicaid residents. The daily gap with the medicaid averaged $ 86.26 per resident.
Gravowski said increasing Medicaid’s redemption rate could alleviate some of the problems. Lobbyists and industry proponents in Pennsylvania are seeking an investment of $ 294 million instead of Wolf’s proposed $ 91.25 million.
Grabowski argues that investing in the industry should also be accompanied by some accountability to improve the quality of the funds and prevent them from being misused.
“I think we need to rethink what both living and working in a nursing home mean,” Grabowski said. “The current economic model is definitely broken.”
More money, more surveillance
Wolf’s $ 91.25 million pitch comes with a proposed regulation that requires nursing homes to take more time directly to residents.
A spokesperson for the State Capitol and the Senate Republican Party confirmed that the caucuses would consider the proposal and continue to invest in nursing homes, but did not provide details.
In 2020, Spotlight PA reported on the long-criticized staffing and training regulations that were exposed to the pandemic. According to Schaumburg, PHCA found that in addition to rising national costs, nursing homes today face the same problem.
Since the beginning of the pandemic, the state has allocated nearly $ 500 million to nursing homes through Law 24 of 2020 and 2021. These funds are intended to reduce the burden of additional COVID-19 related costs. However, as a one-time infusion, PHCA said the funds did not address the Medicaid redemption rate gap and therefore did not increase personnel.
Karen Hipple, an associate nurse at the Oil City Healthcare and Rehabilitation Center in Venango County, said the staff ratio was too high. She said that increasing staff needs to be a top priority, which requires more funding.
Hipple blames the low wage shortages many workers face in nursing homes. The average wage for a nursing assistant is $ 16.44 per hour, according to data from the US Bureau of Labor Statistics.
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