No one disputes the fact that seniors in Massachusetts' 371 nursing homes deserve the best possible care. Unfortunately, there's no consensus on how to provide the resources needed to deliver that care.
It leads to a substantial funding gap that averages out to about $37 a day for those who rely on Medicaid -- approximately 70 percent of the state's roughly 42,000 nursing-home patients. That's because Medicaid reimbursements have not increased for several years, which leaves MassHealth, the state's dispenser of Medicaid, scrambling for other income sources.
This deficit's trickle-down effect hurts those most vulnerable -- the elderly clients and the poorly paid nursing-home staff on the front lines delivering that needed care.
According to study by the Massachusetts Senior Care Association, nearly 60 percent of all elder-care facilities in the state are losing money. The cumulative loss in 2014 was $62 million.
The study also made a direct correlation between the number of MassHealth residents at a facility and the financial losses. The more clients, the higher the deficit.
The widening gap between reimbursement rates and the cost of providing quality care has led Massachusetts to a dubious distinction -- fourth worst in the nation for funding nursing home care.
Slowly, but surely, the nursing homes are sinking into insolvency. The study found that a majority of facilities only have four days worth of operating capital on hand.
They are at risk, which also puts elderly clients and workers at risk.
Two recently filed legislative bills seek to change the dynamic and avert a crisis.
Measures by state Rep. Tom Golden of Lowell and state Sen. Harriette Chandler of Worcester would provide nursing homes and rehabilitation facilities more funding by updating a decade-old Medicaid reimbursement formula that facilities rely on to operate and pay workers.
The Baker administration tried to correct the funding shortfall by inserting $35 million into the 2017 fiscal budget targeting nursing-home workers. Initially, however, the money didn't include those on the bottom rung of the wage ladder -- certified nursing aides who prepare food, clean patients' rooms and do their laundry. Public outcry persuaded the administration to reverse course, making aides who earn less than $14 an hour eligible.
The other side of the nursing-home care crisis concerns the quality of the personnel who interact with senior clients on a daily basis. Nearly one-third of newly hired nursing aides quit within a year, the MSCA study found. Given the demands of the job and low wages, it's understandable. But that turnover creates constant staff shortages that can impact care.
Both bills also call for career-advancement funding through the Commonwealth Corporation, and a scholarship program for certified nursing aides through the Department of Public Health.
These bills would create a comprehensive blueprint for raising MassHealth reimbursements to nursing homes and provide for a reliable flow of trained staff that deserves to earn a living wage.
Simple demographics tell us this problem will only get worse without immediate action.