The residents of Pennsylvania should be told the truth about Gov. Ed Rendell's budget and its implications for the frail, poor elderly who depend on Medicaid to pay their bills in nursing homes.

Armed with the facts, nursing home residents, their families and friends, and their hardworking caregivers no doubt will rise up and ask our legislators to prioritize Medicaid funding to care for America's "Greatest Generation" who are now living in our nursing homes.

Average citizens will join with them to ask legislators to find the money in Pennsylvania's $28 billion budget to adequately fund care for our seniors.

They will do this because Pennsylvania nursing homes are at their breaking point.

Two-thirds of the 80,000 Pennsylvanians who rely on nursing homes for their daily living needs receive Medicaid. Regulations require the state to pay for the care of these individuals, often the sickest and most vulnerable among us. But that's not happening.

Nursing homes had agreed for two years to accept lower payments to help the state cope with budget crises. But over the last three budget cycles, Pennsylvania has paid nearly $290 million less than it owed for the care of Medicaid residents in nursing homes, even though the sickness level of these individuals has increased dramatically.

The national accounting firm BDO Seidman reported that in 2006, Pennsylvania shortchanged those providing long-term care to seniors an average of $12 per resident per day, or $4,300 per resident per year.

For three years, nursing homes have done what they can to reduce costs while improving the quality of care and quality of life for their residents. In fact, the Post-Gazette last December reported that the number of penalties issued by the state Department of Health for nursing home care has dropped dramatically from earlier this decade, and consumer complaints have also declined significantly.

Another year of inadequate funding for nursing homes could change that picture. There is nowhere left for nursing homes to trim. Many are struggling to meet the medical, physical and social needs of residents; most no longer can afford to invest in improvements. Some have had to close their doors.

This chronic underfunding for our commonwealth's most vulnerable residents comes at a dangerous time; Pennsylvania is on the verge of a boom in the elderly population. The state ranks third nationally by percentage of population 65 or older, and fourth in the number of residents 85 or older. By 2020, more than a quarter of the state's population will be 65 or older.

Here are some of the other undisputed facts that Western Pennsylvania residents should know when they ask their legislators to reject the governor's proposal to provide no additional funding for nursing homes this year:

• According to AARP, Pennsylvania's nursing home residents are older and sicker than the national average and receive more registered nursing hours than those in nursing homes in nearby Ohio, New York, Maryland or New Jersey.

• Nursing homes work closely with the Area Agencies on Aging and the state Department of Public Welfare to transition residents back into their homes and communities. However, few long-term care nursing home residents have been able to move back home because they are too sick to be safely cared for in another setting.

• Despite the physical and emotional challenges of caring for nursing home residents, their caregivers are paid less than caregivers in other health-care settings, resulting in high turnover.

• A federal government report stated that nursing home costs (wages, medications, food, laundry, transportation, utilities, etc.) will rise 3.3 percent in the coming year. You don't have to be an accountant to recognize that Gov. Rendell's proposed budget, with no increase in funding, will leave nursing homes operating in the red.

• While some other health-care providers also lose money caring for Medical Assistance residents, nursing homes are far more dependent on government reimbursements for survival. When they lose money on two-thirds of their residents, they are forced to charge higher prices to self-paying residents, essentially creating a "tax" on those who have saved for their golden years.

Clearly, nursing homes already are doing more with less.

The message is clear: Gov. Rendell and state lawmakers shouldn't abandon Pennsylvania's seniors. The state must adequately fund quality care in nursing homes. Anything less would be unfair to our poorest, frailest elderly and disabled who rely on these services each and every day -- the men and women who built our communities, labored in our factories and fought in our world wars.

It's time we cared for those who cared for us.