New nursing home regs expected in fall, but staff say they can’t wait much longer

After a year of the pandemic, on top of years of regulatory inaction, Pennsylvania’s nursing home employees are fed up with their hectic workplaces that barely give them time to feed and bathe patients — let alone offer them the emotional support they need after a year in isolation.

“This issue has been going on for years, as long as I can remember, as long as I’ve been a [certified nursing assistant],” said Yetta Timothy, a 44-year-old who has worked in nursing homes for 27 years.

Caregivers such as Timothy rallied in five different cities across the commonwealth Friday afternoon, demanding the state Department of Health increase the number of staff hours to which each patient in a long term care facility is entitled. This would, effectively, increase the number of employees at each nursing home.

Even before the pandemic, nursing home staffing was low, studies have found. Under current state regulations, nursing homes must be able to guarantee each nursing home resident at least 2.7 hours of care every day.

That state minimum is less than the 4.1 hours of care per-day that a federally-commissioned study from 2001 recommends to improve resident health.

Since at least 2019, SEIU Healthcare, a 45,000-strong labor union of nurses, caregivers, and support staff has pushed for Pennsylvania to increase that ratio.

“It’s time for the Department of Health to stop dragging their damn feet,” Timothy said at the rally, which was organized by SEIU.

A spokesperson for the Department of Health said that the state is reviewing and updating its long-term care facility regulations, including the nursing staffing ratio. 

Zach Shamberg, president of Pennsylvania Health Care Association, a trade group for long term care facilities, sat on a committee to develop those regulations and said he expects them to be released in November. 

Given the state’s rule-making process, they might not be effective for a few more years more.

But Shamberg argued that “using a blanket number to address individual needs and facility needs is not the best approach.” He added that homes typically exceeded the current 2.7 hour per patient state standard, but were below the federal suggestion.

An increased ratio, Shamberg argued, wouldn’t address the root causes of low Medicaid reimbursements for nursing home care — rates set by the state — or a lack of trained nursing staff.

Issues with Pennsylvania’s nursing home regulations have been noted since at least 2016. Then-Auditor General Eugene DePasquale said in an audit that the Department of Health was not properly responding to complaints or holding nursing homes accountable for low staffing.

Enforcement has only become harder during the pandemic, which Timothy and Shamberg agreed exacerbated staffing shortages. Yetta herself took two months off of work out of concern for her family.

In an April 2020 post on the Department of Health website, the department advised nursing homes that it understood if facilities had difficulties reaching that mark during the pandemic. 

But resident quality of care must continue despite shortfalls in staffing, the department added.

Another issue caregivers raised is the increasing Wall Street investment in for-profit care facilities. A recent study found that mortality at homes owned by private equity firms was 10 percent higher than average.

In the past year, 12,900 residents of state long term care facilities have died due to COVID-19, according to state data. However, some of those numbers are self-reported, according to the online news site Spotlight PA, and may be inaccurate.

It’s unclear how many caregivers have died, due to incomplete record keeping, a SEIU Healthcare spokesperson said.