RICH BANE: MassHealth must act to save nursing care
March 11, 2017
The work they do is demanding, both physically and emotionally. As the owner of five South Shore skilled nursing facilities that employ nearly 1000 workers who care for more than 700 patients, I see our team's incredible dedication every day. Our direct care workers put in long hours and are there in the middle of the night when someone needs care and personal assistance or just someone to talk to. Their compassion and patience run deep.It's hard to put a price on caregiving, especially when dedicated workers are looking after our parents. Most of us would say they deserve yeoman's pay for the work they do and the peace of mind they give us. Unfortunately, in Massachusetts, most of the frontline workers at our skilled nursing facilities don't even make a living wage. That's the sad truth.
But their future, and the future of our vulnerable residents is now in jeopardy. The reality is, the majority of residents in our homes are dependent on MassHealth—the state's Medicaid system— to pay for their care. But for nearly a decade, the state's Medicaid payments to reimburse homes hasn't kept up. Currently, our skilled nursing facilities lose $37 per day for every Medicaid resident. If you were running a business that had been losing money for years, you'd think about shutting it down. And that's exactly the predicament that many in our profession find themselves in.
Several, perhaps dozens of nursing homes in the state are on the verge of closing. That would mean the loss of thousands of jobs, not to mention hundreds of our frail elderly being displaced or relocated, making it harder for their loved ones to visit close to home.
The threat is made worse by the just-released Republican plan to repeal and replace the Affordable Care Act. Under the new bill states will receive less Medicaid money in upcoming years, than they do under current law. In addition, changes in the way the federal government will contribute the money doesn't guarantee that the state will spend the funds on nursing home services.
All of this foreshadows an increasingly aging demographic. The baby boom population is the fasted growing population in the country. According to a 2014 UMass-Boston (McCormack Institute) report, by 2030 seniors will comprise 30% or more of the population in two-thirds of the state. So, precisely at the time when the need for long-term care increases, the boomer demographic will swamp the system and there will be nowhere for them to live and be cared for.
But there are ways to fix this problem. Two years ago, the Massachusetts Senior Care Association embarked on a legislative campaign called Quality Jobs for Quality Care. It asked legislators and the Governor to allot $90 million in the state budget as a direct wage pass through to go to our frontline staff, including our certified nursing assistants, an amount that would begin to put them on a path to earning enough to live on and help support their families. Last year, legislators did allocate $35.5 million for our workers, and while it was a good start, they need more, and this year the Association is back, asking for the additional money needed to accomplish the task.
The fact is, currently more than half of our workers rely on public assistance to help them live. We have systems in place for career ladders, but because wage rates are so low, many must work two jobs and don't have time for development opportunities that exist.
Most value their jobs more than the money. But that is changing as evidenced by the jump in job vacancies, which are 15%; up from 10% the year before. They simply can't afford to stay when they can make more elsewhere. Our dedicated caregivers deserve better.
Skilled nursing homes cannot afford to keep losing money, for if they do, they will close, leaving our most needy residents unable to access care when they most need it.
Investing in the skilled nursing industry is the smartest thing we can do. To do otherwise is penny-wise and pound-foolish.