Editorial: Long-term care homes face fierce fiscal reality
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Nursing homes have been talked about a great deal over the last eight months.
Most of the talk has been alarming, as the first real outbreak of covid-19 happened at a long-term care facility in Washington state. The same location saw the first medical worker infected and the first U.S. death in the coronavirus pandemic.
It has been tricky, because while the residents don’t circulate throughout the community as much as younger people, they are the demographic most likely to be in danger. In Pennsylvania, almost a third of covid-19 deaths are attached to long-term care, as opposed to total positive cases of the disease, where just 14% are nursing home related.
So it has been a rough year for elder care.
But if you look at the state list of nursing homes tracking positive tests and deaths amid residents and staff, there are facilities you might expect to succumb to the pressure and those you wouldn’t. Out of more than 600 long-term care facilities, only about three dozen have more than 100 deaths.
Charles Morris Nursing and Rehabilitation Center in Pittsburgh’s Squirrel Hill neighborhood is one of those that has fought hard to control the virus and protect residents. Fourteen residents have tested positive over the months of lockdowns and seven died, but the home was not one of the contagion hot spots some have become.
And yet on Thursday, the Jewish Association on Aging announced that the well-regarded and highly rated facility would be closing on Jan. 12. The news struck residents and families hard.
“My first thought was my mom’s health and well-being. Change for seniors is not easy. I am beside myself. I am afraid to tell her,” said Robert Wyner of Monroeville.
The closing is not being attributed solely to the pandemic, although the cost of prevention protocols are noted as a factor.
The problem is that the pandemic didn’t happen in a vacuum. It comes after years of other complications. Part has been a move for many families to home health services. Perhaps most significant is a chronic financial condition — Medicaid reimbursing nursing homes less than it costs to provide the care residents require.
This is not news to anyone in state or federal government. It has been talked about for a long time. In March 2019, a year before covid hit Pennsylvania, a Tribune-Review editorial said the issue of low reimbursement was strangling care for the elderly.
“Medicaid must begin to pay a higher rate commensurate with the costs of delivering high-quality long-term care to frail older adults,” David Grabowski and Vincent Mor said in a Journal of the American Medical Association article in May, as they predicted how the pandemic could hit the weakened financial immune systems of long-term care homes.
We need more quality options for caring for an increasingly aged population in Pennsylvania. We need to have confidence that those people providing the care are not being forced to cut corners.
And maybe the coronavirus pandemic will force a conversation that long-term care professionals have been trying to start for a long time.
It’s just unfortunate that a home like Charles Morris and its residents could be collateral damage.