Harrisburg Jewish Home board sells senior care facility to real estate investment firm 

Non-profit senior care facility The Campus of the Jewish Home of Greater Harrisburg will be sold to New Jersey-based real estate investment firm, Tryko Partners. 

The board of The Campus of the Jewish Home of Greater Harrisburg announced the sale this week, citing a “persistent and increasing” gap between Medicaid reimbursement rates and the cost of caring for residents—challenges that were exacerbated by the pandemic. 

The Jewish Home also pointed to persistent staffing shortages, which have limited the number of residents the home has been able to accept. 

The sale includes the organization’s campus at 4000 Linglestown Road, Lower Paxton Township, consisting of the Jewish Home’s 138-bed skilled nursing facility and 58-unit personal care home, known as The Residence. 

“This was a very difficult decision,” said Richard Spiegelman, president of the Jewish Home Board. “Because of the significant fiscal challenges we have faced as a stand-alone facility, we decided the best option for residents of the Jewish Home and Residence and the staff was to sell the facility to an organization with the scale and resources to uphold the high standards we have followed for 40 years.” 

Tryko, which expects to complete the purchase of the property by March, currently owns 6,000 skilled nursing/assisted living beds across the country. The facilities are supported by Marquis Health Consulting Services, a nursing home consulting company. 

“The Jewish Home and Residence provides outstanding care for the Jewish community and larger population,” said Uri Kahanow, director of acquisitions at Tryko. “Our mission is to carry that forward and quickly earn the trust of residents, their families and the dedicated care team at the Jewish Home and Residence.”   

Willow Valley Communities aligns with Acts Retirement Services in new strategic alliance 

Willow Valley Professional Building located at 226 Willow Valley Lakes Drive in West Lampeter Township. (Photo: Submitted)

Lancaster-based Willow Valley Communities has entered a strategic alliance with competing not-for-profit senior living organization Acts Retirement Services in Montgomery County. 

The two organizations announced on Tuesday that their board of directors unanimously approved a definitive agreement of a partnership that is expected to enhance their ability to serve seniors and advance their shared missions. 

As part of the alliance, both organizations will have representation on the others board, with Acts serving as sole corporate member and manager for Willow Vally Communities. 

John G. Swanson, CEO of Willow Valley Living, the management company for Willow Valley Communities, will step aside from management oversight to focus entirely on future development of new properties. 

Dennis Griest will continue his role has president of Willow Valley Living, and all other current Willow Valley leadership will remain in place and have access to additional resources and scale through Acts. 

“We are excited to join forces with Acts. Having two highly respected and successful organizations enter this strategic alliance speaks to our shared values, dedication to the persons we serve, and commitment to the future.” said Jill Gilbert, Willow Valley Communities Board Chair. “As this alliance was contemplated and designed, maintaining the unique identity and operating autonomy of Willow Valley Communities was of paramount importance to our organization; with this alliance, we’ve achieved that goal. Bringing Acts in to support our existing management and operations leverages the scale and shared expertise important to both organizations.” 

Willow Valley Communities’ campuses house more than 2,500 residents from 40 states. Acts Retirement Services, the sole corporate member of Acts Retirement-Life Communities, operates a network of 26 campuses in nine states serving more than 10,000 residents. 

“Aligning with Willow Valley Communities is a proud moment for Acts. Willow Valley Communities is clearly one of the finest senior living providers in the nation,” said John Esterhai, Acts Board Chair. “Our organizations coming together in this strategic alliance provides a platform for future success and our ability to serve seniors. With so much already in common, this alliance simply makes both organizations stronger.” 

Caring skillfully: A lot has changed in the senior-care industry in the past year

It’s one of life’s most potentially difficult decisions – even without a raging global pandemic: where to live out retirement. 

 Battered by the coronavirus pandemic and public perceptions many senior living communities offering a range of care and living options are implementing lessons learned over the past year. They’ve cross trained staff, pivoted food services and meal deliveries, restricted access to their campuses and most fragile residents and are making better, more frequent and timely use of digital technology. 

For many, knowing they aren’t alone and someone’s “got this” made all the difference. 

“Team members are more aware of emotional well being. They are more aware of how people are doing and not necessarily just task oriented” in their jobs, said Laura M. Gifford, director of marketing for Providence Place Senior Living, with corporate offices in Hummelstown, Dauphin County. 

“When we do tours, you can sense it’s a true second family,” she said. 

Providence operates seven retirement and assisted living campuses in Pennsylvania. She said the pandemic and lockdown strategies strengthened bonds among staff and residents, calling that boost to emotional trust “one silver lining.” 

According to the Senior Living.org website, about four in 10 Pennsylvania residents are 50 or older, or about 39.2 percent of the commonwealth’s population.  

Tina L. Lutter said she has been awed and inspired by the genuine kindness and care demonstrated by everyone across all job levels at Masonic Villages in Elizabethtown, Lancaster County.

Lutter is corporate director of public relations at Masonic Villages, which operates retirement community and care campuses in Lafayette Hill, Warminster, Dallas and Sewickley near Pittsburgh. 

“We learned a lot,” Lutter said. 

History lesson 

Masonic drew on its history and experiences more than 100 years ago when the 1918 Flu Pandemic infected an estimated 500 million and killed at least 50 million world-wide. 

“We [Masonic] were around during the 1918 Flu…we closed all but one entrance and had guards at the entrance. We incorporated from the past those things we needed to do now,” she said. 

Lutter said to date Masonic did not have any coronavirus pandemic-related deaths in spring and early summer last year, but have since lost 27 to COVID-19 related issues. 

Along with a place to live people need to eat. Converting dining services for its 500 nursing and personal care residents from plated meals served in dining rooms to delivering three meals a day was among the most daunting daily challenges, according to Lutter.  Masonic’s retirement living residents received one pre-packaged meal a day.


Employees across the organization “pitched in” learned each others’ jobs and roles and keep the Masonic community and staff fed. 

“In some instances, you learned what it was like to work in dining services, or help with health care, or screening or security. People took on different roles,” she said. 

The pandemic drove more communications between Providence administrators and families, more Facebook postings, more pictures and videos, Gifford said. 

She said more consistent frequent newsletters and communications have built better relationships. Adding Zoom and other virtual platforms for visits was “the only way to visually connect family members.” Gifford expects those virtual visits will continue, as a way to be engaged and involved. 

“It’s been super helpful for family members who are out of the area and for grandparents to be part of their grandchildren’s lives and activities, she said. 

Keeping a distance 

Social distancing – a 2020 watch word may become the new normal 

The Masonic campus in Elizabethtown sits on 1,400 acres and includes a working farm, a farm market, orchards, ponds, formal gardens and picnic areas and over 12 miles of walking paths – along with plenty of outdoor opportunities for socially distanced exercise and activities. 

More space and physical distancing between people helps to reduce the overall risk of illness – especially in care facilities where populations are naturally more vulnerable. 

“We’re more conscious about space – even in a normal year, about having people spread out. We had zero flu cases this season, which is unheard of,” Gifford said. 

While it’s too soon to tell if mask wearing will become a staple or illness prevention tool in retirement and care living facilities, Gifford said there is no doubt masks help to manage risk and reduce illness.  

“I think staff would be happy to [shed] all the PPE (personal protective equipment) and go down to just wearing a mask,” she said. 

Even when Covid is no longer the primary threat to residents or staff members, Lutter said flu season will still be an annual reality. Whether it is significantly less flu infections, significant and simple lessons learned like regular temperature checks, could prevent other illnesses moving forward. 

Isolation’s impact 

Assisted living and memory care unit intakes have been higher since the second half of last year, a trend Providence Place’s Gifford expects will continue. 

Someone with dementia at home alone for a year progresses quickly,” she said. 

Gifford attributes the isolation caused by the pandemic as a cause for a rise in assisted living and memory care admissions. She said those living on their own with memory deficits or dementia are more vulnerable to faster disease progression. 

Making full use of technology is another service expansion Masonic Home’s Lutter expects will continue after COVID-19 transmission is less of an immediate threat. For residents, it may mean experiencing wellness or exercise classes in their apartments over Zoom or taking part in clubs. 

Virtual tours, events and online Zoom opportunities to meet and learn about the facility have also been popular, and Lutter expects that outreach to continue. 

Residents accustomed to gathering in groups now stay in their rooms and use technology to gather. “Every Friday was virtual bingo people loved it,” she said. 

Having experiences to share with new prospects such as the organizations response to the public health crisis, or providing appropriate in-person or virtual campus tours, helps allay the trepidation that can come with a big move. 

Moving to a retirement facility – either for self or a loved one – is a huge decision, especially if it means moving to an unfamiliar location or far away from family or friendssaid Lutter. 

“I think a lot of people [considering a move] are wondering, ‘can your community care for me or my loved one. It’s not just how did you ride the storm, but how did you improve from it,” she said. 

Wolf administration faces potential investigation of COVID-19 guidance to senior homes

Pennsylvania’s House Republicans plan to refer an investigation into the Wolf administration’s handling of senior and long-term care facilities during the COVID-19 pandemic to the House Government Oversight Committee later this month.

House Majority Leader Kerry Benninghoff, R-Centre and Mifflin counties, announced he would be leading the referral in a statement on Monday. In the announcement, he said the Wolf administration has lacked transparency in its guidance for nursing homes and other long-term care facilities in the past year.

“We believe Pennsylvanians deserve better from their government when they are seeking answers as to why something so tragic has occurred and they are not getting answers,” Benninghoff said. “Unfortunately, as of today, including our recent budget hearings where members directly asked the administration about this issue, Pennsylvanians and their families are left only with excuses and deflection from an administration that has been anything but transparent.”

In March 2020, the state Department of Health issued several pieces of guidance to provide direction to long-term care facilities to allow for specific infection control measures to protect residents and staff.

Some of this guidance included restrictions on visitors and volunteers and a stipulation that nursing care facilities must continue to accept new admissions and receive readmissions for current residents, including stable patients with COVID-19.

The Wolf administration’s alleged lack of transparency in the reasoning behind its directives for Pennsylvania’s long-term care homes during the pandemic has been subject to criticism from the right.

As of Feb. 26, 23,937 Pennsylvanians have died from COVID-19 and 12,470 of those deaths have occurred in residents from nursing or personal care facilities, according to the state Department of Health.

“We want answers for the people who lost loved ones in our nursing homes under Secretary Levine’s order and Gov. Wolf’s leadership,” said Rep. Clint Owlett, R-Tioga, Bradford and Potter counties. “The problem has been, no one will step up and do the investigation here in Pennsylvania. So, if no one else will do it for these families, we will.”

Lyndsay Kensinger, Wolf’s press secretary, called the GOP accusations “baseless,” and said they “portray a significant lack of understanding of the role of the Department of Health and guidance provided to nursing facilities.”

Kensinger said that the state’s guidance mirrored the federal government’s recommendations and required facilities to follow specific infection control measures, but it rested on each individual facility to follow through with the recommendations.

“It is incumbent upon the nursing homes to follow infection control and other guidance designed to keep patients safe during both regular periods and the COVID-19 pandemic,” she said. “Failure to institute protections can result in sanctions, license suspensions or revocations.”

A representative of the for-profit long-term care industry seemed to welcome the investigation, which facilities could emphasize a need for the state to bring providers to the table in a greater way when it makes such decisions, said Zach Shamberg, president and CEO at the Pennsylvania Health Care Association (PHCA).

PHCA is a statewide advocacy organization for for-profit long-term care providers. According to Shamberg, he and other members of the industry have testified to the state’s decision makers regarding the needs of the industry but were not brought to the table to help with those decisions like states like West Virginia have done.

“I have to believe that as these detectives were being given in March and April 2020, if providers were at the table you would have seen different guidance that would have done more to protect residents and guide staff,” he said.

Dr. Rachel Levine signs PPE requirement order for long-term care facilities

A new state order for Pennsylvania’s long-term care facilities mandates all organizations to provide pre-approved personal protective equipment to all staff working directly with COVID-19 positive residents by Aug. 27.

Secretary of Health Rachel Levine issued the order Monday.

While many long-term care facilities have worked diligently against the spread of the virus, she said the order is a response to safety concerns from nurses and staff of facilities across the country.

“The order requires that the necessary steps are in place to deliver a safer environment to continue providing high-quality care during these challenging times,” Levine said in a press release.

As part of the order, facilities must provide respirators, such as N95 masks, to any staff working directly with COVID-19 positive patients. The respirators need to be approved by either the National Institute of Occupational Safety and Health or the Food and Drug Administration.

These facilities may find that they won’t be able to comply with the order in just a week’s time thanks to continued shortages in the supply chain that have created gaps in PPE procurement for most health care providers. The shortages have left some independent physicians with only a week’s worth of equipment.

Adam Marles, president and CEO of LeadingAge PA, said the nonprofit trade association supports efforts to protect residents in long-term care facilities, but that state funding doesn’t cover the costs for PPE or Pennsylvania’s testing requirements for facilities.

“We have additional concern that personal care homes and assisted living residences, in particular, will have difficulty complying given they are only just beginning to receive CARES Act funding, and it will likely not be enough to cover universal testing,” he said.

Long-term care providers began receiving CARES Act funding through Act 24 of 2020, signed by Gov. Wolf in June. The Act included $457 million in relief funds for providers of long-term living programs.

Marles added that the Mechanicsburg-based nonprofit will be looking to work forward with the administration and lawmakers to address critical funding needs among its members.

Long term care providers reopen doors to weary families

IntegraCare’s senior homes have erected “Conversation Stations” made of plexiglass and plywood so families can come visit their love dones without the worry of giving them COVID-19. PHOTO PROVIDED –

Pennsylvania’s long term care organizations face the challenge of communicating to new residents and their families that facilities are safe to visit after closing their doors to visitors and prospective residents for months.

The Pennsylvania Department of Health reported on Friday that 4,345 of the state’s 6,399 total deaths from COVID-19 occurred in residents from nursing or personal care facilities.

The department’s data, along with similar reports across the country, have made an uphill battle for providers of senior care trying to continue operations after months of decreased admissions.

“The census is down in nursing homes. There are families that are simply unwilling to send their loved ones to nursing homes and frankly that makes sense” said Zachary Shamberg, CEO and president of the Pennsylvania Health Care Association. “The ramifications for this will be long lasting.”

In the midst of the crisis, skilled nursing facilities, post-acute providers, assisted living residences, personal care homes and other senior care organizations were advised by the association to keep weekly communication with families and provide up to date information on any COVID-19 cases in their buildings.

IntegraCare, an Allegheny County-based senior living organization with facilities in Lancaster and Camp Hill, temporarily halted admissions in March and kept in contact with families of their residents through emails, phone calls and letters.

“In mid-March we put a halt on all admissions until we really wrapped our brain around how we were going to take care of our team members and residents,” said Eric Walker, executive director of sales and marketing with IntegraCare. “We’ve been communicating with family members regarding why they can’t come into the community and how much longer that will last.”

IntegraCare employs 600 staff members and oversees 670 residents at nine senior homes in Pennsylvania, one in Maryland and one in Virginia.

Now that the facilities are once again welcoming new residents, Walker said that the organization’s marketing has changed dramatically to mirror the precautions IntegraCare has taken with its residents.

“When you think of initial lead generation, we initially drove people into the community,” he said. “We know that most people want to take the community for a test drive but now with no visitation we can’t do that as easily.”

IntegraCare instead offers virtual tours and outdoor tours where potential residents walk through the community and look into houses from their windows.

To ease the minds of potential residents, patients and their families and to better care for COVID positive patients, Genesis Health Care, which operates the Hamilton Arms Center in Lancaster County, opened quarantine units in each of its facilities.

The senior care provider also converted one of its buildings in Philadelphia to a COVID only facility to help hospitals discharge stable patients with the virus to begin rehabilitation.

Sylvania, Ohio-based ProMedica Senior Care, a not-for-profit organization with skilled nursing and assisted living facilities in 22 states, saw admissions drop by 60% in April, which improved to 50% in May.

ProMedica Senior Care, formerly HCR ManorCare, operates a number of post-acute and long term care facilities in the midstate including Arden Courts of Susquehanna in Harrisburg, ManorCare Health Services in Camp Hill and Lebanon and Linden Village in Lebanon.

Marty Grabijas, vice president and director of marketing with ProMedica Senior Care, said that early on in the crisis he advocated his authority to ProMedica’s clinical team.

“They decide if we can bring patients in or not because it’s all about safety,” Grabijas said, adding that ProMedica has insisted on training its admissions team to be as good as nurses when evaluating risk.

“We are very clean and very locked down and we screen everyone coming in,” he said. “By making our staff experts in referrals and admissions, they are able to talk about how clean and safe the buildings are and can convince patients that it’s better to shelter in our environment when you recover if you are a short-term or long-term patient.”

Grabijas said that a primary worry of the system is that the increased stigma against long term care due to the high rates of COVID-19 in facilities will cause patients to stay home rather than seek out post-acute care.

ProMedicare is preparing a national campaign across all of the states it operates in to communicate that its facilities never took shortcuts and patients shouldn’t either.

“Going home is taking a shortcut and we aren’t taking shortcuts in managing the virus so you shouldn’t either,” Grabijas said. “All we’ve done as an industry is manage chronic conditions. We are really good at that.”


How a boom in personal health devices, from Fitbits to iWatches, is changing the face of health care

The booming wearables market is transforming the health care industry as patients use smartphone apps, the Apple Watch, Fitbits and Garmins to track their heart rate, check for heart arrhythmia, and monitor physical activity, sleep patterns and hydration.

And they’re getting smarter.

“Apple’s newest iWatch can obtain EKGs, a company is coming out with contact lens that measure blood sugar, and Under Armour is going to put sensors in its clothing,” said Dr. Robert Kruklitis, vice chair, Department of Medicine, Clinical Programs and a pulmonologist at Lehigh Valley Hospital and Health Network based in Allentown. “We are right at the beginning of patients staying at home (and being remotely monitored). There is a lot of work being done to use data to educate patients to diseases, conditions and to stay healthy.”

Health care officials say wearable devices, sensors and mobile apps have exploded in popularity, and will only get more sophisticated over time.

Kruklitis said a lot has happened in the last 15 years. Today, a patient with an iWatch can go to the doctor and show the physician how they’re doing.

“They will say, ‘Here are what my values are,’” he said.

Wearable devices can only get better from this point on, offering biometric and other data health care providers can obtain, save and analyze to measure health and wellness than ever before.

Sophistication improves

Use of so-called wearbles is rising among all age groups, said Dr. Ron Nutting, director of medical affairs for Tower Health.

“All these devices are becoming more sophisticated and precise,” he said. “They have evolved from simple step-counting to expand into areas like monitoring heart rates and rhythms, tracking the quantity and quality of sleep, intensity of work outs, and other metrics.”

Some wearable devices are now tracking heart rates with very small EKG leads, which improves accuracy and allows measuring heart rhythms as well as rates. This will be helpful for people with heart arrhythmia, he added.

Insurance companies are not paying for these devices yet, but they are affordable enough for patients to purchase. Insurers do, however, cover most devices that might be used for diagnosing a specific heart condition, such as a 24-hour Holter monitor, or Mobile Cardiac Telemetry, which are wearable patches that record heart rhythms for up to 30 days.

“It is a little early to draw any hard conclusions about the role wearable devices might have in preventing or treating a specific disease across a large population or particular group of patients. The research is not conclusive at this point,” Nutting said.

Tower Health did its own Fitbit challenge recently and got 4,200 employees to participate. One employee reported losing 45 pounds and at least 1,400 others continued to track their wellness when the challenge ended.

Nutting said that he believes the next frontier in wearables will include greater accuracy, broader range of body functions that can be tracked, and smaller devices.

Wearable devices in the future will be able to continuously monitor glucose levels to help patients with diabetes or those prone to becoming diabetic, he said.

The devices are getting smaller, too, some the size of a ring, Nutting said.

Used in nursing homes

Residents at one senior living facility in Bethlehem have been wearing lightweight smart bands since March to monitor daily activity and help keep residents healthier.

According to Eran Ofir, CEO and co-founder of New York-based Somatix Inc., the company has software that detects potential threatening conditions, sends alerts and notifications to nursing staff, and monitors hand movements and gestures to gain information about a person’s daily activities.

Somatix, which developed this software in Israel and then won government grants to bring its product to the United States, has partnered with Catholic Senior Housing and Health Care Services Inc. (CSHHCS) in the Lehigh Valley. The program was introduced SafeBeing to senior residents at the Bethlehem campus in March. The smart band determines how much a person walks, eats, sleeps and drinks. SafeBeing can detect if someone falls or wanders away.

Ofir explained that there are several components to SafeBeing, including the smart band, the Mobile App seniors use to monitor their activity, a center at the Bethlehem facility where activity is monitored and a Mobile App for caregivers or family members to remotely watch the activity of residents at the senior living campus.

“We know it works beautifully and it has been providing peace of mind,” Ofir said, indicating that the software will be used in triage centers, hospitals and drug and alcohol centers.

Dr. Charles Herman is the president and chief medical officer at Somatix as well as a medical executive with the Lehigh Valley Health Network. He said the software is also being used at Brookdale drug and alcohol facility in Scotrun, Pa., but the partnership with CSHHCS is the first on a larger scale.

According to Herman, the software measures hard data, helps health care workers determine who is most frail, who needs the most care, and nothing has to be installed in a patient’s room for monitoring. He said the device detects various kinds of falls, which sets it apart from its competitors.

Often, a fall device can only detect when a person falls forward, he said. This device detects different kinds of falls by patients, including if they fall backward or off their wheelchair.

“It allows for improvements in efficiency of care and determines those at higher risk for medical problems,” Herman said. “It is going to help hospitals with their readmission rates and save them $12,000 to $18,000 per patient.”

Home care company buys historic building in downtown Carlisle

Griswold Home Care has purchased the former Red Cross building at 79 East Pomfret Street in Carlisle’s historic downtown district.

Griswold Home Care is a non-medical home care agency that has served seniors in Cumberland County for more than 35 years.  Griswold Directors Terry and David Rosen stressed the need to serve seniors in the greater Carlisle area. In a written statement today they said they hope to provide seniors with the opportunity to “age in place with dignity and honor in the comfort of their own homes.”

The Red Cross vacated the property several years ago and it has been on the market for approximately two years. Before that, the building housed organizations such as the Salvation Army, Carlisle Day Care Center and Greater Grace Church.

Andy Wolfe of Wolfe & Company Realtors in Carlisle represented the buyers in the sale.

Home care business turns to pediatrics

Sonia Perez, a home help aide with Right at Home Care, removes Quinn Banta, 15, shoes after school Monday, November 4, 2019 in Stewartstown, York County. The home care organization is branching out to work with kids. Photo/ Mark DeLoatch

When the adult-care company Right at Home of Southern Pennsylvania was asked to care for a 20-year-old brain cancer patient earlier this year, it struck a chord with franchisee Keith Zimmerman.

He lost his son to a similar illness years ago. At the time, Zimmerman said, he wished he could have used the same services his franchise offers to its older clients for his son.

Now, the York-based home care franchisee is adding pediatric care to the company’s services.

“My wife had to quit her job to take care of my son and it made a tough financial situation on top of everything else,” he said. “In retrospect, if we had the ability to have someone come in, and she could still work, she would still have seen him every day and it would have been a relief for her.”

While caring for the young man, Zimmerman’s staff received numerous requests for its non-clinical care, which includes house cleaning, transportation and meal preparation, to even younger patients.

Seeing the struggles that the client and his family were going through, and realizing that even more local families were interested in receiving Right at Home’s services, he began working with Right at Home’s corporate headquarters in Omaha, Nebraska, to see how he could provide the company’s services to younger patients.

“He said he was seeing a need in his market where there were individuals that were less than 18 years of age that could benefit from Right at Home’s care,” said Margaret Haynes, Right at Home’s COO. “This looked like a great idea, to understand what it means to take care of minors.”

Sonia Perez, a home help aide with Right at Home Care, helps Quinn Banta, 15, exit his school van on Monday, November 4, 2019 in Stewartstown, York County. The home care organization is branching out to work with kids. Photo/ Mark DeLoatch

Zimmerman founded the York-based franchise in 2009 and over the last 10 years, grew the operation to offer services in York, Adams, Lancaster, Dauphin and Cumberland counties to more than 190 clients 18 and up.

Right at Home allowed Zimmerman to begin a pilot program and within two months, the company added six new clients under 18.

Home care services can be skilled, meaning that the caretaker is someone trained to offer medical assistance to a client; or unskilled and focused more on making a client comfortable. Some patients receive skilled care if they need help with tube feedings or receiving medication.

Patients may need a mixture of the two, or in the case of many of Right at Home’s pediatric patients, have intellectual disabilities that require them to have someone with them for more basic care only.

Various national companies have taken to offering unskilled care for pediatric patients, but regionally the offerings are few, said Zimmerman.

Insurance companies such as Gateway Health and UPMC Health Plan have pediatric case management units that connect their young patients with home care services. With few firms to go to, Right at Home receives many of their requests.

“They latched onto us because we served this 20-year-old young man,” Zimmerman said. “We quickly saw through them that there was a big need.”

The York franchise has offices in Lancaster, Hanover and Camp hill and employs nearly 200 workers. Only a portion of its caregivers have experience or training with pediatric cases, so the franchise is limiting the number young patients it will accept.

“We could take 20 cases tomorrow but we want to be sure we can adequately staff them,” Zimmerman said. “We want to see results before we jump in but we aren’t going to take cases we aren’t confident in.”

If Right at Home continues to see success in its pediatric offerings, the company could consider expanding the service to its franchises nationwide using the model developed by Zimmerman and his team.

“Zimmerman and his team have been thoughtful in thinking of how to service their clients,” Haynes said. “At the moment there are no red flags but we are in our learning mode and we want to learn from this experience.”

Auditor General: Pa. unprepared to care for aging population

Pennsylvania is ill-prepared to serve a fast growing-population of older adults, according to state Auditor General Eugene DePasquale.

DePasquale released a special report on July 23 that followed up on his 2016 audit of oversight of nursing homes by the state Department of Health.

DePasquale’s 2016 audit cited issues with inadequate review of nurse-staffing levels, complaint handling and sanctions imposed against poor-performing facilities.

His new report, “Who will care for Mom and Dad?” was developed to see how the department has implemented the audit’s recommendations.

“My team and I spoke with more than 50 experts for this report, and we heard from more than 20 nursing home residents, families and staff members about their experiences,” DePasquale said. “While much of what we heard was encouraging, we also heard about serious challenges such as staffing, equipment and supply shortages.”

The report suggests the department of must adopt thorough, clearly outlined policies for investigating nursing-home operators.

“We found at least one case where lax vetting processes resulted in granting a license to a financially unstable operator who had a poor quality track record in another jurisdiction,” DePasquale said.

The report also urges the DOH to produce better data to offer a clearer picture of which homes are truly improving.

In addition, the report calls for a stronger collaboration between state agencies to prepare for a large wave of aging baby boomers, some of whom may not have spouses or children to help them as they age.

“By 2040, nearly a quarter of Pennsylvania’s population will be 65 or older,” DePasquale said. “That’s over 3 million Pennsylvanians who will likely need some kind of care, many of whom may lack personal financial resources or family support and end up relying on taxpayer-funded programs like Medicaid.”

The Department of Health responded to the Auditor General’s report with a statement maintaining that the DOH’s objective is improved care for seniors in aging-care services, not increased fines for aging-care institutions.

“We want our civil penalties to be meaningful but not punitive,” said Rachel Levine, secretary of health. “The priority is not the fine, the priority is to make sure the problem is corrected. The department regularly reviews all sanctions and as a team establishes progressive discipline sanctions, as needed if the facilities fail to make improvements to the quality of life and care for residents.”

In addition to a lack of effective disciplinary measures for poor facilities, DePasquale said shortages of registered nurses and direct-care workers will worsen the aging care crisis.

“By 2030, there will be 38 older adult dependents for every working-age resident,” DePasquale said. “At about the same time, Pennsylvania is projected to be short by thousands of registered nurses and tens of thousands of direct-care workers, creating a looming workforce crisis that must be addressed.”

He called on colleges and universities to help develop solutions.

“Pennsylvania’s State System of Higher Education and community colleges across the state should view this healthcare workforce crisis as an opportunity to grow,” he added. “The public and private sectors, along with labor organizations and educators, must work together to recruit and prepare more professionals to enter the field and nurture the next generation of healthcare workers.”

However, some organizations are placing part of the blame for the aging care crisis in Pennsylvania on a lack of adequate Medicaid funding.

“Some of the best facilities in Pennsylvania are struggling to remain open,” said Adam Marles, president and CEO of LeadingAge PA, a trade association representing aging services providers in the state. “Others are forced to sell to out-of-state, low-quality operators. It is our hope that state lawmakers will begin addressing this funding crisis in next year’s state budget. We’re running out of time.”

Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, also believes that more Medicaid funding should be part of the solution to the crisis.

“The Pennsylvania Health Care Association has continually fought for higher Medicaid reimbursement, a more favorable legal and regulatory environment and workforce training programs,” he said. “Without each of these key components, the next few years will only result in more and more long-term care providers selling their facilities, changing ownership or closing their doors altogether.”

Pa. sees success and failures in new senior report

Food insecurity and mental distress among Pennsylvania seniors rose over the last year even though most of its older residents regularly see health care providers and many take advantage of federal nutrition assistance, according to an annual report by the United Health Foundation.

In the seven years that the foundation has ranked the health of seniors in each state, Pennsylvania has consistently been in the low 20s and upper teens. This year, the state ranked No. 19.

United Health Foundation ranks the quality of care for seniors through data collected from agencies such as the Centers for Disease Control and Prevention, the U.S. Census Bureau and the federal Administration on Aging. The report determines rankings based on five points: clinical care, community and environment, behaviors, policy and outcomes.

The Minnesota-based United Health Foundation is a nonprofit created to build healthier communities through initiatives like its America’s Health Rankings, a series of reports that rank each state’s quality of health care.

When it comes to its senior citizens, Pennsylvania kept up with national trends even as it climbed two places in the report from No. 21 in 2018, according to Rhonda Randall, executive vice president and chief medical officer of UnitedHealthcare and an adviser for the report. UnitedHealthcare, a Minnesota-based insurer doing business in Pennsylvania, established the United Health Foundation.

“Two ranks is a subtle movement,” Randall said. “If you look at specific majors, we can see some of the areas where Pennsylvania made some really significant improvement over time and areas where it has made some decreases.”

According to the 2019 data, more older Pennsylvanians reported having frequent mental distress, with the overall share rising from 5.9 percent in 2018 to 8.1 percent. More seniors also reported that they didn’t have reliable access to food, with the share jumping from 11.8 percent in 2018 to 16.5 percent.

Pennsylvania ranked 42 for its high rate of obesity with 32 percent of Pennsylvania seniors self-reporting that they were obese compared to the national average of 28.2, according to the report.

The report was not all bad news for Pennsylvania as the state led the country in a number of areas. Pennsylvania is No. 1 for having the most seniors on the federal Supplemental Nutrition Assistance Program, or SNAP, an assistance program that gives people a monthly stipend to spend on food. According to the report, 100 percent of Pennsylvania’s impoverished elders are signed up for the program, meaning that they receive credits they can use to buy nutritional foods such as fruits, vegetables, poultry and fish.

“It’s interesting that we are seeing Pennsylvania doing the best in the nation with outreach in the SNAP program,” Randall said. “There are more seniors receiving nutritional assistance but there are also more seniors reporting that they are worried about food security.”

Pennsylvania ranked No. 2 for seniors with dedicated health care providers, with 96.7 percent reporting that they have a dedicated doctor or other provider. The state also had the third-highest share of seniors reporting that they had succeeded in managing their arthritis with 58 percent noting they did not feel daily pain despite having the condition, which Randall said could correlate to the high number of Pennsylvania seniors seeing health care providers.

Other changes from last year in Pennsylvania included a 17 percent decrease in excessive drinking, a 9 percent increase in poverty and a 4 percent decrease in early deaths of people aged 65 to 74.

Randall said the point of reports such as the America’s Health Rankings’ Senior Report is to be a call to action for communities and individuals to tackle problems like obesity and mental distress.

“Some of the trends we’ve seen are that our lifestyle choices are getting us into a lot of trouble with our health and there just isn’t enough medical care available so it has to start with healthy lifestyles,” Randall said.