Thousands of Pennsylvania nursing home workers could strike despite $600 million for care in state budget

Months after the state approved hundreds of millions of taxpayer dollars to bolster care delivery in nursing homes, thousands of nurses, orderlies and other support staff could soon go on strike over how two for-profit companies plan to use the money.

The question is how much of the $600 million allocated by Governor Tom Wolf and the Legislature will actually go to workers who say they are working longer hours, taking on duties outside of work and even rationing food for residents.

The plan directed $250 million in one-time payments to long-term care providers with no requirements on how the money is spent. Facilities have used similar payments on COVID-19 costs like testing and PPE as well as for one-time worker recruitment or retention bonuses.

The remaining funds represent a permanent increase in state funding to pay for low-income residents to stay in care facilities, with a new requirement that 70% of all costs go to ‘resident-related care’ – although it is unclear what exactly this encompasses.

SEIU Healthcare Pennsylvania, a union representing nursing home workers, says problems for residents and their caregivers are growing.

He calls for the increased funding to be spent on higher wages and better benefits for care home workers to stem turnover. The union is also calling for language that protects workers’ next contract in the event of a home sale, transparency in how homes use outside contractors, and a guarantee that companies won’t fight future union campaigns.

The union reached an agreement with one employer, Guardian Healthcare, earlier this week, although the final contract has yet to be ratified by workers as of August 31. Negotiations are still ongoing with two other retirement home companies, Comprehensive and Priority.

Unless there is an agreement, workers at 14 houses are expected to go on strike on September 2. Workers from four others would join them on the picket line on September 9.

“We put everything into this business. They took advantage of it. Why aren’t they even ready to sit at the table with us and listen to us? Union member Simone Whyte, an LPN at a Dauphin County facility, said at a recent press conference. “If they just humble themselves for a minute and listen, maybe something can come out of it.”

In a statement, facility managers at eight Comprehensive-owned residences in western Pennsylvania said there had been “great progress” in negotiations so far, but further discussions were ongoing. necessary to reach a final agreement.

“In our recent bargaining sessions, we made a number of substantial offers, including proposals that will see every employee receive another sizeable pay rise this year and every year thereafter, as well as care benefits. improved health, and more,” the managers said.

However, the facilities also have “contingency plans in place to ensure there is no disruption to care for our residents”. A spokesperson declined to answer specific questions about those plans or the use of state funding.

The new $600 million does not come all at once. First, this fall, long-term care providers such as nursing homes will receive $250 million in federal stimulus funds.

Then, starting in January 2023, providers will see an increase of about $35 per day in the state reimbursement rate for care of low-income residents, an increase of 17.5%. Facilities will need to demonstrate that 70% of their total costs are related to residents, rather than overhead or administration.

But exactly what resident costs are isn’t defined in the legislation, said Diane Menio, executive director of CARIE, a Philadelphia-based nonprofit that advocates for people’s well-being and independence. elderly.

“I don’t know what’s going on in that 70%,” Menio said.

She also noted that the Wolf administration backed away from a proposed rule that would have required nursing homes to provide residents with 4.1 hours of direct care per day — the federal recommendation — instead agreeing to pass the current requirement. from 2.7 hours to 2.87, as well as new minimum ratios of nurses and orderlies per inhabitant.

Zach Shamberg, chief executive of the Pennsylvania Health Care Association, said the increased funding should help reverse years of low state spending on elder care and bring security to the industry amid of the COVID-19 pandemic. Its trade group for long-term care facilities counts Priority among its members.

“It’s good for suppliers, it’s good for workers, and it’s good for residents and their families,” Shamberg said.

But if all union demands were met, Shamberg said, nursing homes would need an additional $35 a day from the state to meet the additional costs.

Even without requiring higher staffing levels, research suggests that increasing the reimbursement rate will increase the quality of care. A National Bureau of Economic Research working paper based on Pennsylvania data estimated that a 10% rate hike would “increase the number of qualified nurses per resident by 8.8%.”

Menio agreed that the rate should be increased, but any increase should come with transparency on how homes are spending those dollars.

Private investors bought nursing homes, Menio said, then hired outside agencies to recruit staff and provide key services such as food and laundry. Sometimes investors may even have a stake in contracted agencies.

Such a setup, Menio said, allows private companies to use nursing home funding as a “piggy bank.” Transparency, as demanded by the union, could help counter this trend.

“Wouldn’t it be better to increase the salaries of the people who work there and who devote themselves to it rather than spending them on temporary staff? said Menio.

The contract dispute caught the attention of Harrisburg decision makers. A spokesman for Wolf, the Democratic governor, said in a statement that the impending strike was an “unfortunate and completely avoidable situation.”

The increase in state long-term care spending “has been accompanied by bipartisan support and has been celebrated by both industry and the workforce,” the spokeswoman said. de Wolf, Elizabeth Rementer.

“Now, less than 60 days after the Governor signed this landmark legislation, we are hearing of some nursing home operators who are refusing to commit to the kinds of investments this funding was intended to support.”

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