Massachusetts skilled nursing homes are facing an unprecedented crisis that currently threatens our ability to fulfill our obligations. Yes, it’s that’s serious. Unfortunately, it’s not a surprise. Two years ago, I suggested that closures were coming, staffing challenges were escalating, and that the high quality care that our sector provides to frail elders who can no longer be cared for at home was in jeopardy. Sadly, today those warnings have become reality, and the situation is only getting worse.
Consider the facts today. The majority of residents in our homes are dependent on MassHealth — the state’s Medicaid system — to pay for their care. For more than a decade, the state’s Medicaid payments to reimburse homes hasn’t kept up, and the result is devastating. Medicaid funding doesn’t even cover the cost of care – it would be like buying a car but only getting three tires. Across the commonwealth, the overall margin for the sector in negative 1.6 percent -- and more than half of the facilities are operating in the red. That means that many facilities can’t keep up with wages for our amazing staff members, who deserve to be paid far more than we can afford. Unfortunately, in Massachusetts, most of the front-line workers at our skilled nursing facilities don’t even make a living wage. That’s the sad truth.
The work they do is demanding, both physically and emotionally. As the manager of two North Shore skilled nursing facilities that employ nearly 400 workers who care for more than 250 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.
Beyond the staff, the Medicaid underfunding gap has a ripple effect. Dozens of facilities have closed in the last two years, 20 in 2018 alone, including some who had been in business for three generations and were led by dedicated local family owners. With the coming baby boomer “Silver Tsunami,” access to care will become an issue. Let’s face it – no one really wants to go to a nursing home, but for those of us who have needed long term care for a loved one, we know just how important, how valuable and how compassionate quality skilled nursing can be. As more nursing homes are forced to close, who will care for us when we need it?
There is a solution, and it is a simple one. It is time to make nursing home funding a top priority in the state budget, starting with the Baker administration and across the Legislature, and not simply a bargaining chip in a budget conference negotiation. In a recent voter survey, nine out of 10 agree that lack of state funding has a negative impact on care, so if our leaders are looking for political cover, they can be assured that the voters want it. Beyond the politics however, proper funding for quality care for frail elders isn’t just the smart thing to do – it is the right thing to do.
Rich Bane is the president of BaneCare, past president of the Massachusetts Senior Care Association, and manages Ledgewood Rehabilitation and Skilled Nursing Center in Beverly and Seacoast Nursing and Rehabilitation Center in Gloucester.