Getting older isn’t cheap.
The cost of taking care of the elderly just keeps rising, but not at the same speed the state is willing to pay for it.
This week, the Pennsylvania Health Care Association, which represents about 500 Pennsylvania nursing home operators, expressed concerns about the increase in Medicaid reimbursement rates for nursing home residents. Specifically, the association is concerned because there is no increase.
Since 2010, the rate has gone up $8.12.
Compare that to what the nursing homes provide. The flat rate of $198.97 doesn’t just cover the bed where the resident sleeps and the round-the-clock nursing care mandated by the state. It doesn’t just cover laundry and food and keeping the lights on.
It also includes the most expensive aspects of geriatrics, like wound care for skin tears, therapy for those adapting to broken hips or replaced knees, transportation to specialists and what might be the most persistent expense, prescription drugs.
According to the Centers for Disease Control and Prevention, about 10 percent of Americans have diabetes, but that number goes up to 25 percent when you look at the population over 65. A month’s worth of Humalog cost about $40 when it was introduced in 1996. Today those two vials cost about $550.
An elderly diabetic at home might decide to scrimp on their meds, using less insulin than recommended to stretch it out or skipping a dose altogether if supplies were low. That’s one reason nursing home care might be better, to make sure they get the care they need. A nursing home has to give that shot when it’s scheduled.
Even if they don’t get paid enough to provide it.
The state regulates nursing homes aggressively, as they should. They demand accounting of nursing hours to make sure the elderly are receiving proper care. They inspect homes annually, and they inspect when there are complaints.
But where can the nursing homes — or the residents or their families — complain when they are being paid 76 percent of the average cost for care that has to be provided 100 percent of the time?
Gov. Tom Wolf’s office said he “remains open to input” on addressing the issue and that it is more complicated than just giving more money. That’s no doubt true.
But let’s be more than open to answers, because we are all getting older every day.