Wolf Administration Proposes Changes to PA Nursing Home Care:

Gov. Wolf’s proposed regulation looks to improve the quality of care for residents and workers in Pennsylvania nursing homes. The current regulations have not been updated since 1999. 

The Wolf Administration announced on July 21 proposed regulations for nursing home care in Pennsylvania, according to an article on Media.pa.gov. These proposed changes, which will impact thousands of residents in the over 690 licensed skilled nursing facilities regulated by the PA Department of Health, seek to increase both staffing levels and the amount of time spent giving direct patient care per day.

The initial package of proposed regulations—the first in a series of five—focuses on increasing the required hours of daily direct care for residents. Under current regulations, the minimum standard of hours of direct care per resident per day is 2.7 hours. The proposed regulation seeks to add 1.4 hours of direct care in order to reach a new minimum standard of 4.1 hours of direct care within a 24-hour period.

Wolf Administration proposes changes to PA nursing home care which would provide a corrective to the following problems that often amount to nursing home abuse and neglect in Pennsylvania nursing homes:

• Bedsores—Also known as decubitus ulcers, pressure ulcers, or pressure sores, bedsores are pressure-induced skin ulcerations that occur when residents are left in the same position in beds or wheelchairs for prolonged periods of time. Bed sores can occur as a result of low staffing or an insufficient amount of direct patient care.
• Falls—Low staffing and other impediments to attending to fall protocols in PA nursing homes can contribute to resident falls. Nursing home falls by elderly residents can result in serious injuries and might lead to the decline of independence and/or quality of life of residents.
• Malnutrition—Nursing home malnutrition happens when residents’ proper nutritional levels are not adequately maintained, which can result in Pennsylvania nursing homes when low staffing and insufficient direct care prevents care providers from ensuring residents are fully and safely fed according to individual nutritional needs.
• Dehydration—Nursing home dehydration can occur in PA nursing homes when caregivers do not properly monitor the fluid intake of residents. Dehydration can occur quickly, and low staffing levels and inadequate direct care can impact workers’ ability to closely monitor residents for dehydration.
• Infections—Issues with staffing, training, and supplies can contribute to the development of infections among residents in PA nursing homes. When infection protocol cannot be maintained and residents develop infections, the results can be serious, and even deadly.

According to the article, the proposed regulation stems from research and input from industry experts and stakeholders as well as from information gleaned as a result of the coronavirus pandemic. The proposed changes have been submitted to the general assembly for review. Meanwhile, the PA Department of Health is developing the four other regulation proposal packages, which will pertain to issues such as:

• Change of nursing home ownership
• Nursing home staff development
• Nursing home staffing ratios
• Nursing home infection control and prevention

Protecting Your Loved One

It is important to ensure that the Philadelphia/PA or NJ nursing home where your loved one lives provides a safe, nurturing environment. At all times, Pennsylvania and New Jersey nursing homes are required to meet specific health and safety requirements and to protect the physical, mental, and psycho/social well-being of their residents. This includes ensuring adequate, quality staffing. Should you have concerns about a Pennsylvania or New Jersey nursing home during COVID-19, or if you suspect neglect, abuse, or fraud has occurred at the Pennsylvania, Philadelphia, or New Jersey nursing home where your loved one lives, please contact nursing home abuse attorney Brian P. Murphy to discover your legal rights and options.

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Pennsylvania Nursing Home Reforms Discussed by Senate Democrats:

On November 5, members of the Senate Democratic Policy Committee hosted a virtual public hearing on Pennsylvania nursing home reforms, according to senatormuth.com.

Senator Katie Muth (D- Berks/Chester/Montgomery), Chair of the Pennsylvania Senate Democratic Policy Committee, and state Sen. Wayne Fontana (D-Allegheny), Caucus Chair, heard a number of testimonies regarding the need for funding and staffing reforms in PA homes.

Among the testifiers at the hearing were CARIE executive director Diane Menio, Leading Age PA senior vice president and chief government affairs officer Anne Henry,  Pam Walz of Community Legal Services of Philadelphia, Tyreika Tate, a dietary aide from Walnut Creek Healthcare and Rehabilitation Center in Erie, PA, and SEIU Healthcare Pennsylvania president Matt Yarnell.

Intended to discuss matters such as staffing issues, quality of care, work conditions, and staff wages, the discussion also sought potential ways of improving transparency in the ways funds are used by homes and to ensure more money goes toward wage funding and direct care.

As Pennsylvania nursing home reforms were discussed by senate democrats, a prominent topic of conversation was nursing home staffing issues; the state was called upon to take measures to ensure increased staffing, improved working conditions, and higher wages.

“In a world where Amazon and Wawa are paying $15 an hour, we can’t expect nursing home staff to do some of the most demanding and difficult work in the Commonwealth for $12 an hour,” said Yarnell. “We need to ensure decent working conditions for caregivers.”

“When workers feel like we are so disrespected, and simply don’t earn enough money to stay on the job and can find other less stressful work – then you understand the seeds of this short-staffing crisis,” said Tate, who has worked at Erie’s Walnut Creek Healthcare and Rehabilitation Center for 36 years.

In his testimony Yarnell applauded the PA Department of Health’s proposed revisions to nursing home regulations, which, among other changes, look to increase the minimum amount of direct nursing care from 2.7 to 4.1 hours per resident per day. But, he said, regulation alone isn’t enough to address a crisis in Pennsylvania nursing home care that long predated the pandemic.

“Nursing homes are largely funded by taxpayer dollars,” said Yarnell, “and comprehensive reform will require a new approach to nursing home funding.”

Yarnell’s proposed new approach to funding would consist of two components: increased resources to achieve more staffing, better working conditions, and higher wages, and strong accountability measures to ensure that resources are directed toward resident care.

• Increased Resources-Yarnell calls for a permanent rate increase for long-term reform. He says SEIU estimates a required investment of $350 million per year from the state, matched by federal Medicaid funding for a total investment of around $700 million.
• Accountability Measures-SEIU requests the Pennsylvania follow the lead of such states as New Jersey, New York, and Massachusetts, who have implemented a nursing home industry care percentage. Yarnell suggests that PA requiring facilities spend at least 75 cents out of every dollar of revenue on resident care.

Yarnell said he feels the accountability requirement should be of particular interest to the public, since the  majority  of  nursing  home  funding comes from taxpayers via Medicare and Medicaid.

“In an industry where most nursing facilities are for-profit, and private equity plays a growing role, it is vital to ensure that taxpayer dollars are spent on resident care, not corporate profits,” said Yarnell. “Too often, we’ve seen money intended for resident care siphoned off to pay for inflated rents, related-party transactions and executive bonuses.”

Both Muth and Fontana acknowledged the need to address necessary nursing home reforms, and considered the public hearing just the beginning of what will be an ongoing dialog.

“Pennsylvania’s nursing homes are some of the most expensive in the US, yet many are struggling to remain afloat financially, and the COVID-19 pandemic has only compounded and added to the many difficulties facing our nursing homes and their employees,” Muth said.

“It is imperative that long-term drastic changes need to take place in terms of adequate staffing ratios that pay living wages as well as comprehensive funding reform on various levels,” Fontana added. “We have an obligation to not only to the dedicated employees of these care facilities but also to provide safe and quality living conditions to the residents.”

Fighting for Your Loved One’s Best Interests

Determining the quality and safety of the Philadelphia/PA or NJ nursing home where your loved one lives is essential. Pennsylvania and New Jersey nursing homes are required to meet health and safety standards requirements and to ensure the physical, mental, and psycho/social well-being of their residents. To meet these standards, the Philadelphia/PA or NJ nursing home where your loved one lives must be equipped to avoid the kind of substandard care that amounts to nursing home neglect or abuse [https://www.thenursinghomeattorneys.com/nursing-home-abuse-and-neglect/]. Should you have concerns about the quality of care in a Pennsylvania or New Jersey nursing home, or if you suspect neglect, abuse, or fraud has occurred at the Pennsylvania, Philadelphia, or New Jersey nursing home where your loved one lives, please contact nursing home abuse attorney Brian P. Murphy to discover your legal rights and options.

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