Long Term Care: Pressing Priority

Member Group : Lincoln Institute

In Pennsylvania and particularly in our area, long-term care for our seniors is a pressing priority. As a member of the Aging and Other Adult Services Committee in the legislature, I have participated in numerous hearings on the concerns about the costs of long-term care, Medicaid, and the long-term sustainability of the nursing homes and long-term care facilities.

Recently, a constituent asked why his insurance carrier for his long-term care insurance policy was allowed to increase rates by 70% in 2017 and another 15% in 2018. The constituent, rightfully so, indicated that these increases are not sustainable.

The Insurance Department of the Commonwealth of Pennsylvania regulates and approves these rate increases but that only tells part of the story.

There are a number of factors that must be addressed for us to ensure that our seniors are able to access the care that they need in the later years and at an affordable cost.

Some of the factors include that we are living longer, the cost of medical care has been increasing rapidly as well for staff salaries, facility maintenance, complexity of age related medical problems and regulatory costs.  There is also a significant shortage of healthcare professionals in almost all fields as there is in senior care.

Additionally, Medicaid and Medicare reimbursement rates to the nursing homes and long-term care facilities are not sufficient to cover the costs of care and as such those costs are sometimes paid for by others or the facility itself as long as it is financially able.  Finally, litigation expenses for senior care facilities have been increasing at an alarming rate in the Commonwealth.

The paradox is that if we do not address all of the myriad of problems for the centers there is likely to be a critical shortage of healthcare facilities for seniors in Pennsylvania.

In one particular effort, House Bill 1037, a bill intended to provide caps or limits on punitive damages, which currently exist for physicians, to nursing homes and assisted living facilities failed in the House of Representatives by a vote of 91 to 103.

The defeat of this bill increases the costs of operating a senior center and senior health care facility. It is important to note that the limitations on damages did not apply in the case of abuse.   Abuse of those in care is never acceptable and should never be sanctioned and it was not in this bill. The bill was intended to reduce the likelihood that Pennsylvania would become a litigation haven paid for by those with long-term care insurance, the facility, and the current residents of the facility.

In addition to regulatory reform, we will make an effort to improve Medicare and Medicaid reimbursement rates so that they more accurately reflect the costs to the facilities. We are also encouraging the facilities to adopt best practices to help reduce costs.

The long-term consequences of not addressing all of the cost drivers for senior centers and healthcare facilities are problematic for those who are entering their golden years.

We are working diligently with the federal government, our federal legislators, as well as state officials, particularly Secretary Osborne, Secretary of Aging to address these critical issues.

As a senior myself and a CPA, I would encourage all Pennsylvanians to get active in this issue. We are seeing a significant number of families in which middle-aged couples who are still raising their children are also struggling to find out how they can care for their parents.  With proper planning we can reduce this struggle.

If the cost of long-term care is not brought down, the implications for all Pennsylvanians will be severe. A substantial percentage of the Pennsylvania’s budget, including federal dollars which flow through the Commonwealth, is devoted to our seniors.

Our Aging and Other Adult Services Committee will be continuing to work for resolution for the rest of this term and into the next term until the solution is found.

I too remain committed to resolving this problem.

If you have specific concerns or questions, please call our offices so we can help you and your family.

Frank Ryan, CPA, USMCR (Ret) represents the 101st District in the PA House of Representatives.  He is a retired Marine Reserve Colonel, a CPA and specializes in corporate restructuring.  He has served on numerous boards of publicly traded and non-profit organizations.  He can be reached at [email protected].  Our website is  www.repfrankryan.com