Central Pa. lawmaker sounds alarm over care for people who can’t breathe on their own

• David Wenner/PennLive
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  David Wenner has worked for The Patriot-News/PennLive since 1999 and has won numerous awards for his reporting. He often writes about health care as well as breaking news. He appreciates knowing about any important, troubling or otherwise newsworthy situation in central Pennsylvania. He can be reached at dwenner@pennlive.com or 717-255-8172.

It can result from many common things: car accidents, strokes, falls, pneumonia, among others.

Some victims of those things lose their ability to breathe. In that case, they become dependent on a machine called a ventilator, which pumps air to their lungs through a tube and pipe attached to an opening in their throat.

State Sen. Mike Regan on Monday toured a Cumberland County facility that cares for ventilator patients, hoping to sound an alarm over what he believes is a crisis that threatens the availability of ventilator care in Pennsylvania.

“Hospitals aren’t set up to handle people on ventilators,” Regan, a Republican, said during his visit to Fox Subacute in Mechanicsburg.

Hospitals typically care for ventilator patients until they are stabilized, then transfer them to a skilled nursing facility such as Fox Subacute. If the ventilator patient were to stay in the hospital, it would cost the state Medicaid program, which covers the costs of most ventilator patients, about four times as much, Regan said.

Moreover, patients don’t get the specialized care typically required to get them to the point they no longer need a ventilator, according to Geni Fisher, a registered nurse and Fox Subacute’s vice president of business development and clinical strategy

It often takes weeks or months of specialized care before a patient can breathe on their own again, and such care is labor-intensive and expensive, she said. As result, Fox Subacute has entered Chapter 11 bankruptcy, and several of the dozen or so other facilities that provide such care in Pennsylvania are considering closing, according to Fisher.

Regan is among the backers of a state Senate bill that would add $130 per day to what the state pays facilities to care for ventilator patients.

According to Fisher, the state Medicaid program pays Fox Subactute about $300 per day, plus a $67 per day supplement because it cares exclusively for ventilator patients. The supplement is less for nursing homes that have a smaller percentage of ventilator patients, she said.

The $130 per day day for ventilator patients would be on top of the supplement, she said. If the state were to make such a payment, it would qualify for federal matching funds. That would add up to $1.6 million per year for Fox Subacute, and ensure that it can leave bankruptcy and continue to caring for ventilator patients, Fisher said.

Backers of the bill, SB 959, say about 700 people covered by Medicaid need ventilator care annually in Pennsylvania. They say authorizing the $130 payment would cost the state about $7 million per year.

According to Fisher, Fox Subacute, located near the intersection of Simpson Ferry Road and Filbert Street, cares for about 50 ventilator patients at any given time. Seventy-four percent are covered by Medicaid.

The average stay is about two months, although it sometimes takes much longer before someone can be “weaned” from the ventilator. A small portion can never be weaned, and Fox Subacute becomes their permanent home, she said.

Fisher said facilities such as Fox Subacute, as opposed to hospitals, have the time and specialized staff to wean ventilator patients and send them home. Hospitals typically lack such specialists, she said.

“We make sure we give them the time,” Fisher said. “Everybody weans at a different rate. We don’t give up on them.”

Allan Ditzler of Lebanon has been at Fox Subacute for months. The 72-year-old Vietnam veteran’s lungs failed him in February after a severe case of the flu and pneumonia. He required a ventilator for more than three months and is receiving additional therapy to help him recover. He no longer needs the ventilator.

Ditzler, who spent much of his career working at places including a mine, a foundry and Bethlehem Steel, expects to spend Thanksgiving Day at home, and hopes to be discharged for good by Christmas.

“It was the best thing for him,” said his wife, Susan, referring to the care at Fox Subacute. She said such care wasn’t available at the Lebanon VA Medical Center, which is much closer to their home.

SB 959 was only recently introduced and sits in a committee. A member of Regan’s staff said it has about 14 sponsors, including several Democrats.

J.J. Abbott, a spokesman for Gov. Tom Wolf, said in a written statement: “The Administration recognizes the importance of providing ventilator care. We work closely with nursing facilities and our Community HealthChoices managed care organizations to ensure these services are available to participants who need this level of care. We are currently reviewing the language of the bill to determine the impact and cost.”

Regan said he’s optimistic lawmakers in both parties will support the bill.

“It’s about taking care of people and I think that will give a bi-partisan flair to it,” he said. “It’s just common sense. At the end of the day it will save money.”

PennLive and The Patriot-News are partners with PA Post.