'Decreased availability:' Long-term care officials highlight staffing and other challenges straining industry

REPOSTED FROM TIMES-TRIBUNE Jeff Horvath

Staffing shortages exacerbated by COVID-19 continue to plague nursing homes and long-term care facilities in a post-pandemic world, local officials told a panel of Democratic state lawmakers.

Workforce, financial and other challenges facing providers and impacting care at facilities here and statewide were the focus Monday of a House Majority Policy Committee hearing held at Allied Services Skilled Nursing and Rehabilitation Center in Scranton.

As a system, Allied continues to grapple with staffing issues despite bolstering wages, providing paid training, offering sign-on bonuses and undertaking numerous other efforts to attract and retain invaluable workers, Vice President of Skilled Nursing James Cooney told the panel.

The facility hosting the hearing had 50 empty beds Monday and about 20 patient referrals from hospitals that it couldn’t satisfy.

“We can’t accept those 20 people today and it’s not because ... we don’t have the beds available,” Cooney said. “It’s because accepting them would change our staffing ratios in the facility such that we would be below the minimums required by the current state regulation, and also then we would of course be potentially compromising the quality of care that every resident in the facility deserves.”

Carbondale Nursing and Rehabilitation Center Administrator Noelle Lyon-Kovaleski told the lawmakers that staffing challenges and mandated staffing ratios have also forced her organization to limit admissions. It’s one of the “unintended consequences” of workforce limitations, regulations and inadequate funding, she said.

“The state staffing ratios that became effective in July 2023 certainly posed challenges,” Lyon-Kovaleski said. “To attempt to comply with the ratios we have been forced to limit our census at Carbondale to 86% capacity. That’s leaving 15 of our beds empty at all points in time. This July, we will be decreasing our capacity even further with the increased staffing ratios. This is leaving our hospitals with less resources to discharge patients and our community with decreased availability.”

She and Pennsylvania Health Care Association President and CEO Zachary Shamberg also noted fiscal challenges posed by insufficient Medicaid reimbursement rates.

“Our Medicaid reimbursement for Carbondale in 2023 fell short by $39.62 a day for each Medicaid resident,” Lyon-Kovaleski said. “We have 75% Medicaid residents.”

All told, she said the shortfall amounted to a roughly $1 million loss that could have otherwise been invested in resident care and workforce recruitment.

Shamberg’s organization expects the shortfall situation to get worse for providers when state Medicaid reimbursement rates are recalculated in July.

PHCA is calling on the state to increase its contribution toward Medicaid reimbursements by $25.4 million, an increase that would be matched at the federal level, and to implement a program that would provide supplemental quarterly payments to high-performing providers, he told the legislators.

“So let’s be clear, what you’re hearing about today and what you’ve heard from folks at Allied and from folks in Carbondale is happening across the entire state,” Shamberg said. “No part of this state is safe from what’s going on.”
 

Local Democratic state Reps. Kyle Mullins, Bridget Kosierowski, Kyle Donahue and Eddie Day Pashinski all participated in Monday’s hearing, which Mullins hosted. It was the first of three health care-focused hearings scheduled in Lackawanna County this week.

The House and Senate Democratic Policy committees will discuss Tuesday the emerging issue of health care deserts, where economic, social and geographic barriers limit the availability and accessibility of care. Kosierowski and state Sen. Marty Flynn, D-22, Dunmore, will co-host that session at Lackawanna College.

Wednesday’s session at Scranton Counseling Center, hosted by Donahue, will focus on independent pharmacies.

The upcoming hearings will each begin at 10 a.m. Viewers can watch the testimony by visiting pahouse.com/policy.