Opinion: PA’s long-term care centers are rapidly shuttering – here’s how to save them

Last month, we made the difficult decision to close Pittsburgh Skilled Nursing and Rehabilitation, a long-term care facility. The center is home to 140 residents who must now find a new one in their golden years.

This was not our first choice, and we held off as long as we could. The work we do every day in long-term care is challenging, but nothing is as hard as telling a resident that we can’t keep our doors open any longer, or telling an employee that in a few short months, their job will no longer exist here. 

But on Aug. 12, our doors will close for the last time and I hope that what happened here will be a cautionary tale for the entire industry – and a wake-up call for state government to ensure that this doesn’t happen again.

In many ways, long-term care has yet to recover from the strain of the COVID-19 pandemic. Long-term care centers were some of the hardest hit as patients and residents were highly vulnerable to illness, regulations increased and reimbursements remained stagnant. Our costs continue to rise to this very day.

Unlike other industries, nursing homes cannot increase prices to accommodate surging costs and inflation. Our rates of reimbursement are set by the federal and state governments through Medicare and Medicaid programs, respectively. We have pleaded for increases. Older adults deserve to age with dignity, yet their care has not been prioritized, which is especially harmful in a state like Pennsylvania with a large and growing senior population. 

In addition to the flat rates and rising costs, our facility has provided unreimbursed care that requires a difficult and extended approval process, which can take upwards of six months in Allegheny County. Ultimately, these problems forced our closure and are not unfamiliar to other skilled nursing facilities.

Our situation is not unique – the problems we faced in Pittsburgh are being faced by long-term care facilities statewide. We should be a warning to Harrisburg and Washington of what happens when you don’t value senior care. They know there’s a problem – and have promised to address it for years. 

In 2022, nursing home facilities increased staffing levels based on the promise of additional funding from Harrisburg over a two-year period, but the funding never fully materialized. Not only have we been unable to invest in necessary infrastructure and facility improvements, but we could barely cover the cost of daily care. Now, we have reached a point where we can no longer afford it.

The General Assembly can prevent the next closure. A $160 million increase in funding this year from the state will open up $200 million in additional federal matching funds, keeping hundreds of long-term care facilities open, operational and safe for patients and residents. These facilities are essential and must be treated as such. It’s an honor to grow old and it’s our collective duty to treat aging Pennsylvanians with the respect they deserve; the state has to step up in this responsibility. 

Long-term care is on the precipice of a full-blown crisis; the alternative to public investment is a senior homelessness epidemic. I hope that the General Assembly learns from the closure of Pittsburgh Skilled Nursing and Rehabilitation. It’s too late for our hundreds of patients, residents and staff, but it’s not too late for the tens of thousands working and living in facilities across the state – if Harrisburg acts now. 

Cristine Williams is an administrator at Pittsburgh Skilled Nursing and Rehabilitation.