Guest columnist Sarah Wright: How much do old lives matter?

  • Senate President Emerita Harriette Chandler addresses a statehouse committee on Monday, April 8. SARAH WRIGHT

Published: 4/14/2019 6:10:15 PM

At a state budget hearing last month, the state’s Secretary of Health and Human Services Secretary Marylou Sudders said, “There will be additional closures.”

She wasn’t talking about family-owned sugar shacks or small liberal arts colleges. Alarmingly, the closures Sudders described are the long-term care residences many of the state’s frailest elders live in and call home.

When I started my social work staffing business nearly 20 years ago, there were over 550 licensed nursing facilities in Massachusetts. Today, there are fewer than 400, in spite of our aging society. The closure of 20 homes last year alone is not unique to the commonwealth. For example, the New York Times recently ran a front page story about the effect of such closures in rural areas across the country.

Closer to home, readers of the Gazette may have seen recent investigative reporting by reporter Haven Orecchio in The Berkshire Eagle about a troubled home in Williamstown. In years past, similar in-depth articles with Boston Globe reporter Kay Lazar’s byline arguably have performed a journalistic public service.

Of course, no one likes to read gut-wrenching stories about deteriorating conditions at certain locations. However, the root cause of the state’s current nursing home crisis is the use of outdated funding formulas to cover the actual costs of care. Inadequate MassHealth rates have been underpaying nursing facilities since 2007 — four score and 64 months ago.

The cheapening of this entire health care sector does little to recruit and retain top talent or provide dignity and respect to some of the oldest old. In fact, it’s truly remarkable how many low-paid nursing home staff and long-term care residents have persevered day in and day out for the last 12 years.

With over half of all nursing homes now hemorrhaging losses, it’s also a foregone conclusion there will be more closures. While one appreciates Secretary Sudders’ candor, many geriatric care providers also consider the state’s chronic underfunding of nursing homes tantamount to class actionable neglect. This harsh reality is especially disorienting to the mandated reporters within our ranks, which is to say every one of us.

Just imagine you’re a long-term care resident who has lived happily for years at a home that suddenly ceases to operate. And you’re in your mid-90s. Your whole world changes with little notice and less regard for the trauma triggered by the inevitable relocation of your remaining life. You and your loved ones become migrant families. As the long-term care sector reels from years of literally being shortchanged, it’s worth noting, “Today’s nursing homes are yesterday’s hospitals,” according to Dr. Michael Wasserman, president of the California Association of Long Term Care Medicine.

Wasserman understands exactly how clinical operations and financial operations are critically intertwined in our fitful health care system. That the business case for quality nursing home care is inseparable from the human face of all who rely on us to provide safety and security is hard to miss.

The strong advocacy coalitions now urging elected officials to make quality nursing home care a funding priority today, tomorrow, and next fiscal year need you. We may yet avert a state of emergency. More importantly, we will create a legacy of stability for generations to come.

Sarah Wright is a social worker who runs Social Work in Progress. She lives in Lee.

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