Pennsylvania's nursing homes suffered a Medicaid funding shortfall of more than $631 million in 2017-2018, according to a Medicaid Funding Gap Analysis commissioned by LeadingAge PA and conducted by consulting firm RKL LLP. The reimbursement gap translates to an average daily loss of $82.16 per resident for nonprofit nursing homes, and $47.85 across all nursing homes in the commonwealth.

"The results of this analysis boldly reinforce the crisis skilled nursing facilities continue to face," said Adam Marles, Chief Executive Officer of LeadingAge PA. "Excellent care and services cannot be sustained without reimbursement rates to match the escalating costs. Pennsylvania's seniors deserve better. We have to do better."

To determine the potential gap between nursing home expenses and the reimbursement amount facilities receive through the Medicaid program, RKL's Senior Living Services Consulting Group developed a custom database using publicly available Medicaid cost reports to conduct granular calculations.

"My team and I pride ourselves on conducting independent data analysis to identify the trends, challenges and opportunities in today's post-acute care industry," said Jeffrey E. Boland, CPA, Partner and Leader of RKL's Senior Living Services Consulting Group. "We value the chance to provide LeadingAge PA with detailed information that paints a clearer picture of the Medicaid reimbursement deficits facing Pennsylvania's skilled nursing facilities."

The 2019-2020 budget proposal unveiled by Governor Tom Wolf in early February continued the dangerous trend of flat or reduced funding for skilled nursing services. Pennsylvania's Medicaid reimbursement rate has remained nearly stagnant for 10 years, rising only one percent for half of the commonwealth's providers in last year's fiscal budget.

"Without reversing this shortfall trend and properly funding Medicaid in Pennsylvania, some doors may be forced to close on nursing facilities providing critical services to our senior population," said Marles.

To view the full Medicaid Funding Gap Analysis, visit


About LeadingAge PA - LeadingAge PA is a trade association representing more than 320 not-for-profit senior housing, healthcare and community services across the commonwealth. These providers serve more than 75,000 Pennsylvanians and employ over 50,000 dedicated caregivers on a daily basis. For more information, visit

About RKL - RKL LLP is a leading professional services firm with offices located in Pennsylvania and beyond. More than 450 team members strong, RKL taps into a wide range of services - tax, accounting, data analytics, performance improvement, risk mitigation, human capital management, cybersecurity and more - to deliver solutions that prepare businesses and organizations for real, sustained growth. RKL is ranked 61st on Accounting Today's "2019 Top 100 Firms" and 5th among large companies on the 2018 Best Places to Work in PA. Learn more at