YORK, Pa. — Despite safety measures and visitor bans, more than half of all coronavirus deaths in the Commonwealth are linked to nursing homes and long-term care facilities. Now, they are facing another crisis: they are running out of money.
FOX43 Reveals a closer look at what is going on inside Pennsylvania nursing homes as they battle new challenges against the backdrop of a global pandemic.
It has been one year since long-term care facilities closed their doors and banned in-person visits. Some facilities allowed outdoor visits, but those quickly ended once the weather got colder. Window visits and FaceTime just haven’t been enough for families, especially as coronavirus restrictions are beginning to ease up elsewhere.
Rachel Yonkunas: Families fear their loved ones are deteriorating.
Bob Rundle: That’s something we were concerned about from day one.
Bob Rundle is the president and CEO of SpiriTrust Lutheran, a life-plan community with services in 12 Pennsylvania counties and three in northern Maryland.
Rachel Yonkunas: People want to know when they can see Mom or Dad again. What’s the answer to that question?
Bob Rundle: We don’t have the answer to that question, unfortunately, because it’s CDC and it’s the Department of Health who are setting the guidelines.
Rachel Yonkunas: If it were up to you, would families be allowed back in?
Bob Rundle: That’s a difficult question. For me, I don’t have the expertise. I have to rely on the expertise of the CDC and the medical directors so we would follow their guidelines. Of course we want families to be in there.
FOX43 Reveals asked the Department of Health (DOH) about reopening long-term care facilities. A department spokesperson said nursing homes are to follow the visitation guidance set forth by the Centers for Medicare & Medicaid Services, dated September 17, 2020.
Those guidelines state that facilities should accommodate and support indoor visitation if there has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing. The guidelines also recommend no indoor visitation if the COVID-19 positivity rate in the county is above 10 percent.
A department spokesperson said the DOH will look for guidance from the federal government in regards to next steps for nursing homes once more residents and staff are vaccinated.
"At this point the CDC and the Centers for Medicare and Medicaid Services have not changed their guidance for visitation at long-term care facilities, and the Department of Health and Department of Human Services are following recommendations from these organizations when considering guidance for our licensed facilities," Maggi Barton, Deputy Press Secretary for the DOH, said in an email to FOX43 Reveals.
According DOH’s COVID-19 Early Warning Monitoring System Dashboard, York County has an 8.3% positivity rate and SpiriTrust Lutheran has not had a new case of COVID-19 in more than two weeks at one of their skilled care facilities.
SpiriTrust Lutheran runs six life-plan communities, but residents within their skilled care centers have been hit the hardest by COVID-19. There have been 18 coronavirus-related deaths at The Village at Sprenkle Drive in York County. The outbreak raises questions about state guidelines that allow skilled nursing facilities to admit COVID-positive patients from hospitals.
Rachel Yonkunas: Why take in COVID-positive patients? Isn’t that dangerous?
Bob Rundle: We have admitted very few from the outside community as we tried to protect those that are in the organization, but the reality is—as a faith-based organization—we have people out there that need services. You can’t abandon these people so we take all our precautions and where we can we admit them into a cohort, which keeps them in a confined area within a facility.
Rachel Yonkunas: And they are filling beds that would otherwise be vacant?
Bob Rundle: Well, the other issue right now for all of us is our census is down. There is not this influx into the nursing homes so there are beds available within nursing homes to be able to create these safe areas.
Rachel Yonkunas: What would you say to people who assume you’re putting profits over quality of care?
Bob Rundle: We do not put profits—I will tell you, sitting in meetings, the conversations are ‘what’s best for our residents.’ Now that being said, we are still a business. We still need to pay our team members. We still need to pay our utilities, but we always look at stretching as hard as we can to serve as many people as we can.
The organization may be stretched too thin due to increased costs associated with COVID-19. Rundle said SpiriTrust Lutheran is facing a multi-million dollar budget deficit. The organization has had to cut seven community programs including Counseling Services, Domestic Abuse Solutions, Financial Education & Coaching, Senior Companion Program, Stephen Ministry, Touch-a-Life and Volunteer Income Tax Assistance.
“Our budget in 2020 was actually $20 million higher than what we actually received in 2020. So there was a $20 million gap. On top of that, we’ve spent close to $3 million in overtime, PPE, other things of that nature,” Rundle said. “Support from the state, local and federal governments has only been about $17 million so we had a $6 million gap. We also believed going into 2021 that gap is probably going to grow $4 million to $5 million. At the end of the day, that was $10 million to $11 million that was just taken out of our ability to fund those programs.”
SpiriTrust Lutheran is not the only organization experience a significant shortfall in funding. Nationwide, nursing homes are running out of money.
A survey by the American Health Care Association found that only 34 percent of nursing homes believe they can survive the next year. Twenty-eight percent of facilities said they will not make it another six months at their current operating pace. The concern is hitting close to home.
“In Pittsburgh late last year, we saw a nursing home announce their closure altogether. In southeastern Pennsylvania, we’ve seen a nursing home announce their sale was completed a couple of months ago. This is the beginning of a trend,” said Adam Marles, president and CEO of LeadingAge PA.
Abramson Senior Care in Montgomery County was sold to a New Jersey for-profit group and Charles M. Morris Nursing & Rehabilitation Center in Pittsburgh was shut down. Mount Vernon of Elizabeth and Mount Vernon of South Park also announced that they are closing their doors.
“When you take into account the COVID-19 expenses, whether it’s added for staffing or testing or PPE, you’re talking $100 million in added costs to the sector, sometimes per week just to keep up with new COVID costs. That’s on top of a Medicaid program that has been underfunded for the better part of the last decade,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association.
Advocates for long-term care providers are calling for more state and federal funding to help facilities stay open. Rundle said SpiriTrust Lutheran is also facing staffing shortages and team members have been working overtime throughout the pandemic. He and other providers are bracing for impact.
“I’m worried when this is over. When the adrenaline that has had people continuing to push every day goes away. That’s when I think we’ll see some of the impact of the emotional drain on individuals,” Rundle said.
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