Future funding of long-term senior care across New Hampshire is in peril

As part of its mission, Catholic Charities New Hampshire has provided facility- and faith-based care to the elderly since our 1945 founding. In 1948, our first two nursing facilities opened – Saint Teresa (Manchester) and St. Francis (Laconia). Still open today, we are proud that both facilities, which have since been joined by five others that we currently operate, are rated at five stars on the federal government’s five-star quality rating system.

A lot has changed since 1948. Today, longevity carries with it a price, and many arrive in nursing homes bereft of resources, having spent their money receiving home care or living in an assisted living facility. They are among the majority of nursing home residents who are on Medicaid, and we are committed to serving them. Yet maintaining quality, and our mission, cannot be done indefinitely so long as New Hampshire ranks last in New England when it comes to the gap between Medicaid care costs and payments. It has become increasingly difficult to recruit and retain staff given the state’s meager financial commitment to care. On January 1, for example, the average nursing home rate only went up 17 cents per day. Since then, the Consumer Price Index (CPI) alone has gone up 2 percent.

For years, New Hampshire’s Medicaid funding has failed to keep pace with the CPI, let alone the medical inflation recognized by federal Medicare payments. In effect, the state has balanced its budget on the backs of our dedicated caregivers, most of whom are women serving one of the nation’s most-elderly nursing home populations. In 2016, the average Medicaid payment deficit for nursing home care costs the state itself will recognize (even after adjusting costs downward through applying medians) was $46.70 per resident, per day. The latest national accounting analysis suggests that for 2018, it had grown to a $49.45 deficit per resident, per day.

Facilities, even nonprofit facilities, cannot continue to lose that kind of money year-after-year. Furthermore, the price of correcting this neglect will only grow unless the state steps up. Will it take a wave of facility closures, as has occurred in other states, including others in New England, to finally bring action? If so, imagine the human suffering that would occur. Where facilities close, residents suffer transfer trauma and can be tragically-displaced far away from place-bound loved ones.

In Concord, a bipartisan bill, Senate Bill 308, would make workforce investments, including the provision of long-overdue Medicaid rate increases. We thank those senators supporting it, especially its prime sponsor, Democrat Cindy Rosenwald of Nashua, and Republican Jeb Bradley of Wolfeboro. The bill is not only compassionate but economically necessary if there is to be a future for long-term care in the nation’s second-oldest state. It plays no favorites and recognizes that all of long-term care – from that provided in homes, to that in skilled nursing facilities – deserves support.

As Pope Francis has said, “We are all a little fragile, the elderly. Some, however, are particularly weak, many are alone, and affected by illness. Some depend on the indispensable care and attention of others. Will we take a step back for this? Will we abandon them to their fate?”

At Catholic Charities, New Hampshire we hope the answer to these moral questions is a resounding “NO,” and that legislators will do the right thing and support SB 308.

Tom Blonski is president and CEO of Catholic Charities New Hampshire.