THE MASSACHUSETTS NURSING HOME INDUSTRY says inadequate state funding caused 20 facilities to close last year and is putting another 39 at risk of going out of business this year.

Tara Gregorio, the president of the Massachusetts Senior Care Association, and Naomi Prendergast, president and CEO of D’Youville Life and Wellness Community in Lowell, sounded the alarm on the Codcast, saying rates provided by MassHealth are way too low because they are based on cost benchmarks from 2007. There are 398 skilled nursing care facilities in Massachusetts.

“We’re very concerned today that we don’t have the resources, whether it’s staff or funding, to support today’s needs let alone what’s coming in the next five to 10 years,” Gregorio said, referring to the so-called silver tsunami caused by the aging of the state’s baby boomer population.

Both Gregorio and Prendergast said more and more elderly people are staying in their homes longer, which the state prefers because seniors maintain their independence and typically require less costly support services. But the flip side of the stay-at-home trend is that when seniors do end up in a nursing home they are often at the end-stage of life and need care to do just about everything.

“People are coming to us much older and much sicker with complex medical conditions, and the MassHealth system doesn’t reimburse us for that,” said Prendergast. She said the typical nursing care facility in Massachusetts loses $37 to $38 a day on each MassHealth patient.

“This is a severely underfunded system,” said Gregorio, who noted the industry as a whole had $440 million in accounts payable in fiscal 2017. She said the financial plight of nursing homes is starting to spill over to suppliers to the industry; Trident Healthcare, which supplies x-ray and blood testing services, filed for bankruptcy two weeks ago, she said.

With funds scarce and the economy strong, many nursing homes are having problems finding workers willing to work for basically the minimum wage. Gregorio said the industry has 4,000 positions currently vacant; she estimated 1,100 workers, most of them Haitians, could be impacted by the Trump administration’s decision not to extend temporary protected status.

Gregorio said the industry is lobbying Beacon Hill for several pieces of legislation, including a requirement that MassHealth rates be based on 2017, not 2007, costs; a bill restructuring how nursing homes are paid; and an initiative providing more support and career enhancement opportunities for nursing home workers.

The updated rate-setting approach was not included in Gov. Charlie Baker’s budget for fiscal 2020; the proposal would give the industry a cash infusion of $75 million, roughly half of which would be reimbursed by the federal government, Gregorio said.