BOSTON— Saying “there has never been more urgency,” frontline workers, resident family members, administrators and the Massachusetts Senior Care Association (MSCA) today told lawmakers, on the Joint Committee of Elder Affairs, that unless they take drastic action to reverse the lack of investment in the nursing home industry, several facilities face closure, displacing hundreds of residents.

A recent analysis of 2016 state cost report data, filed with the Center for Health Information and Analysis (CHIA) shows three quarters of the state’s nursing facilities have a combined negative margin of 4.4%, an indication that the sector is experiencing an unprecedented financial crisis. The crisis impacts nursing facilities across the spectrum---not-for-profit, for profit, family and regionally owned and operated.

Because of the “Great Recession” and competing state budget priorities, there has been negligible investment in nursing home care in the last decade resulting in Massachusetts being ranked fourth worst in the nation for funding quality nursing facility care.

“The vast majority---nearly 70%---of long term nursing home residents have their care paid for by the state Medicaid program. Today MassHealth reimburses facilities $37 per day below the cost of providing quality resident care, said Matt Salmon, Vice Chairman of MSCA Board of Trustees and President and CEO of Salmon Healthcare and Retirement, testifying on behalf of the MSCA. “This translates to an average annual loss of roughly $900,000 per facility for a total of more than $350 million across the entire provider community (non-profit, for profit, family and regionally owned).”

Every year more than 150,000 Massachusetts residents rely on skilled nursing facilities to provide quality care when they can no longer live safely in their home, and when they are undergoing rehabilitation services after a short hospital stay so they can return home safely.

Now, the ability of nursing facility care providers to render quality of care is in jeopardy, due to the extended period of government disinvestment.

Because three-quarters of a nursing facility’s budget is used to fund employee wages and benefits, a facility’s ability to invest in staff is directly tied to state funding. The severe MassHealth underfunding and cuts have thwarted the ability to provide meaningful wage increases to employees, many of whom do not make a living wage.

“These direct care workers are the backbone, the lifeblood of our facilities as they provide the majority of direct care services by assisting residents with all aspects of daily living, as well as vital companionship,” said Salmon.

The lack of investment in the nursing facility skilled workforce makes it difficult to attract and retain staff. Currently 1 in 5 nursing positions remains unfilled---a significant jump from 2015.

“We are the front-line workers, the ones who see them (the residents) every minute of our shift. Now many Certified Nursing Assistants (CNAs), feel trapped,” said Jim Buchanan, a CNA with at Baldwinville Skilled Nursing & Rehabilitation Center in Baldwinville, MA, who provided written testimony. “They don’t make enough money, to continue their education, or sometimes, even pay their own monthly bills. And the single parents, whom struggle to make ends meet for their families. This bill would help nursing home workers like me by investing in staff wages, attracting new workers to the field, and actually providing a career ladder to further our own careers.”

House bill 2072, sponsored by Representative Thomas Golden Jr., and Senate bill 336, sponsored by Senator Harriette Chandler are part of the solution to this funding and staffing crisis. Both bills call for amending state law to require MassHealth to update funding for quality nursing home care to more accurately reflect the true cost of caring for Medicaid residents. This would begin the process of reinvesting in nursing facility resident care and staff.

Nursing home facilities are the second largest health care employer in the state, employing more than 77,000 individuals.

ABOUT MSCA: The Massachusetts Senior Care Association represents a diverse set of organizations that deliver a broad spectrum of services to meet the needs of older adults and people with disabilities. Its members include more than 400 nursing and rehabilitation facilities, assisted living residences, residential care facilities and continuing care retirement communities. Forming a crucial link in the continuum of care, Mass Senior Care facilities provide housing, health care and support services to more than 120,000 people a year; employ more than 77,000 staff members; and contribute more than $4 billion annually to the Massachusetts economy.