After struggling with shortfalls for years, Pennsylvania’s nursing home operators are cheering a state budget that will double funds available to facilities with the highest Medicaid census.
The spending plan passed late last week includes $16 million for the Medicaid Day One Incentive (MDOI) program. Designed to aid nursing homes with at least 65% Medicaid residents, the program had been funded at a level $8 million annually since its inception in 2013. The local increase is also expected to trigger an additional $17 million in federal match funds for Pennsylvania nursing homes.
“This increase represents, for the first time since 2014, a real acknowledgment from state government that our long-term care system is severely underfunded,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association.
“While we haven’t seen the widespread closures that are occurring in other states across the country, we have seen more than 100 changes of ownership, reorganizations, bankruptcies and/or sales in the last two years,” Shamberg elaborated in an email to McKnight’s. “If our funding doesn’t keep pace, I fear the next step will be closures in Pennsylvania.”
To qualify for MDOI, Pennsylvania facilities must meet the Medicaid census threshold and have a minimum overall occupancy of 85% per quarter. Their payment is calculated as the total Medicaid days for the quarter, multiplied by a MDOI per diem.
While the program’s growth was seen as a victory, Shamberg said the state still needs to do more to shore up its regular Medicaid rates to ensure all providers get the support they need to stay open.
Pennsylvania has 699 nursing homes facing an average Medicaid shortfall of $49.29 per resident day. That’s nearly $5,000 per day for an “average” 100 Medicaid-bed facility.
Providers in several states have enjoyed successful legislative sessions this spring. In Oklahoma, SNFs will get a “landmark” $34 million increase that ties $12 million partly to performance metrics. In Massachusetts, lawmakers pressed for a $15 million funding boost and agreed to study long-term solutions after learning as 35 more nursing homes could close by year’s end without an increase.
Pennsylvania’s U.S. Senators have put enormous pressure on nursing homes to improve quality and recently were responsible for the unveiling of more than 400 candidates for a federal improvement plan. PA has 16 candidates on that list.
With that backdrop, Shamberg said his members blanketed lawmakers with calls, emails and visits over the last few months and created new affiliations with other stakeholders.
