A crisis in care

May 23, 2017

State Sen. Thomas M. McGee deserves praise for working to address large-scale financial problems plaguing Massachusetts’ nursing homes.

McGee filed a budget amendment increasing the state Senate allocation for the nursing facility Medicaid rates account to $362.9 million from $345.1 million now budgeted by the Senate and Gov. Baker.

Nursing home advocates are begging for help to close a $37 a day gap between the cost of care and the state MassHealth reimbursement rate. They say Massachusetts nursing homes are facing a crisis. It is hard to call that claim an exaggeration.

Half of the state’s nursing homes have less than four days cash on hand, according to a State House News Service report quoting advocates. To worsen the problem, nursing homes face a staff shortage that has more than doubled during the past six years.

Nursing homes are dependent on state money with the News Service reporting that two-thirds of nursing home residents depend on state MassHealth payments for their care. Those sobering, even frightening, revelations point to the need to make nursing homes a top legislative priority this year.

The nursing home crisis affects every Massachusetts resident except, perhaps, the very wealthy who can afford to pay out of pocket for private care. Every family in the state has an elderly member and everyone knows someone who is elderly and trying to make ends meet or who is caring for an elderly loved one.

McGee nurses senior health spending

Nursing home advocates have already highlighted challenges faced by senior care workers to earn a living wage that will attract more talented people to the senior care and personal care professions.

The shortage of qualified workers is a problem related to nursing home finances. It will only worsen as the financial crisis deepens. McGee’s answer to solving the problem by boosting the Medicaid rate account makes sense. But as a veteran legislator, McGee knows his amendment is barely a stop-gap measure to address the overarching problem.

Just as he has advocated for long-term instead of short-sighted approaches to increasing spending on transportation infrastructure across the state, McGee realizes the daunting financial challenges involved in resolving the nursing home spending crisis.

MassHealth costs are the largest spending area in the state budget and identifying the dollars to cover rising healthcare costs is a challenge for legislators and Baker. Solving the problem requires elected officials to look over the proverbial policy horizon and imagine new financial models for nursing care. That vision may require a firm grasp on private sector solutions for nursing home management.

With baby boomers aging into nursing care, broad-minded solutions for keeping senior care solvent are needed now more than ever.