Last year 20 nursing homes in the state shut their doors, including Island Terrace, a family owned four-star facility in Lakeville. Now,. Managing the closing of a nursing home, which we had to do in six of the 20 homes, is a difficult and painful task for all concerned and it is something I hope I never have to do again.
Relocating people, especially fragile people, from their home is a traumatizing experience – for those displaced, for the workers who have to find other jobs, and for those charged with overseeing it. And as much as we don’t want to hit the replay button, more are set to close this year.
That’s because nursing homes in Massachusetts are facing a crisis. I know because I lead an organization whose 24 Massachusetts nursing homes provide care for 2,300 residents, and 79 percent of these residents have their care funded by MassHealth (Massachusetts’ Medicaid program). Unfortunately, the care of MassHealth residents is under-funded on average by $38 per resident, per day, by the state. You read that right - $38 per person per day. This shortfall is due to the fact that MassHealth reimburses nursing homes based primarily on their cost of care in back in 2007. Costs that do not reflect the actual costs of care in 2019 – over a decade later, with older and sicker residents.
Try living on a budget that’s outdated by more than a decade when everything around you has increased in cost -- staff wages, food, electricity, heat, clothes -- and additional costs have been added by new regulations.
It’s not only an untenable situation financially, but also unfair to those who have entrusted us to care for them or their loved ones. We are the stewards for their physical and emotional wellbeing. These men and women are our mothers, fathers, veterans, friends and neighbors.
At a recent 106th birthday celebration for one of our residents, I said, “There is not a more noble and gratifying profession. This is why we do what we do.”
I meant it. Our residents are the people who constitute the very foundation of Massachusetts, and they deserve nothing less than the very best quality care. We also owe our dedicated caregivers our support and gratitude.
Since the dollars available to us for staff wages and all other costs are tied to state funding, nursing homes find it increasingly difficult to compete for staff in such a low unemployment economy. The work is physically hard and often psychologically draining. Some staff leave because they can’t afford to stay. Instead, they find jobs that are less demanding with better pay. Other caregivers try to make ends meet by working longer hours and extra jobs.
Quality of care has already suffered. The number of Department of Public Health surveys showing deficiency-free homes has rapidly declined, as more facilities across the Commonwealth increasingly have difficulty remaining in full compliance with regulatory standards.
MassHealth has provided periodic funding increases to the nursing homes that serve its beneficiaries, but not at an adequate pace to keep up with the costs of care.
That’s why, as part of our Save Our Seniors campaign, we have been advocating for lawmakers and the governor to immediately make an urgently needed investment in nursing home care, to support our caregiving staff who provide the daily care to nursing home residents who can no longer live in the community. Nursing facilities are the ultimate safety net and we need the state to recognize and address this crisis.
Next Step’s Massachusetts nursing homes employ about 3,000 hard working, dedicated personnel from nurses, to certified nursing assistants, cooks, laundry cleaners, housekeepers and many others.
Our advocacy is for them and for every resident living in a nursing home, so they receive the care they are entitled to, deserve, and most importantly, need.
Damian Dell’Anno is Co-Founder and CEO of Next Step Healthcare which owns Wedgemere HealthCare in Taunton, Garden Place HealthCare and Attleboro Healthcare in Attleboro, Oak Hill Healthcare in Middleboro, and Fall River HealthCare.