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Pa. officials call for higher staffing requirements in nursing homes

A proposed measure to reform nursing homes in Pa. is drawing fierce opposition from industry groups.

HARRISBURG, Pa. — A proposed measure to reform nursing homes in Pennsylvania is drawing fierce opposition from industry groups.

The Pennsylvania Senate Aging and Youth and Health and Human Services Committees heard testimony Sept. 15 on proposed regulations to increase the minimum staff required in long-term care nursing facilities.

Currently, nursing homes must provide each resident with 2.7 hours of direct nursing care per day. Under the proposed regulations the required direct nursing care time would increase to 4.1 hours per day. Pennsylvania nursing homes had an average of 3.8 direct nursing care hours per day in the first quarter of 2021, according to the Long Term Care Community Coalition.

A highly cited study from 2001 established 4.1 nursing care hours per day as a minimum for effective care

The measure comes after more than 14,000 people died of COVID-19 in Pennsylvania’s nursing homes and assisted living facilities since the start of the pandemic, according to the Department of Health.

Healthcare advocates applauded the idea as a way to lessen employee workload. Caregivers often are in charge to 20 to 30 nursing home residents in a single shift, according to SEIU Healthcare Pennsylvania.

“Whether it's unanswered call bells, developing bed sores from lack of movement or getting cold food, nursing home staff don't have time to do the basics, let alone give residents the attention and time they deserve," SEIU Healthcare Pennsylvania president Matthew Yarnell said. 

Industry groups, however, said the increased requirements would exacerbate an already existing workforce crisis in nursing homes.

A survey by the Pennsylvania Health Care Association (PHCA) found 80% of members were forced to limit new admissions due to a lack of staff.

SEIU Healthcare Pennsylvania estimated the proposed regulation would require facilities to hire an additional 7,000 workers and face $400 million in extra costs.

“What steps will the Department of Health and the legislature take to help us build our workforce pipeline?" PHCA president Zach Shamberg asked at the hearing. "Who will fund this new cost, given that providers pre-pandemic were operating at -2.4% margins?” 

As facilities are only reimbursed through Medicare and Medicaid when they meet minimum staff requirements, industry leaders warned some facilities would be forced to close.

“County homes would disappear and many residents who can't afford private care will have no place to go,” Chase Cannon, executive director of the Pennsylvania Coalition of Affiliated Healthcare and Living Communities said. 

The staffing requirement proposal is the first in a five-part package of changes proposed by the Pa. Department of Health. Officials hope to get the regulations passed by the end of 2022.

The changes would be the first regulatory updates since 1999.

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