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Wolf administration officials gathered at a skilled nursing care facility in Harrisburg Wednesday to unveil the first of five proposed rulemaking packages aimed at updating nursing home regulations in the commonwealth.
“Revising nursing home regulations is one piece of the administration’s ongoing effort to improve care for residents and working conditions for staff in nursing homes,” acting Secretary of Health Alison Beam said during a news conference at Homeland Center in Harrisburg.
The first proposal would mandate an additional 1.4 hours of direct care for residents each day, increasing the minimum standard from 2.7 hours to 4.1 hours in a 24-hour period.
“For many years, residents and long-term care ombudsmen have recognized and reported what more than 100 national studies and reports have shown, that the current minimum staffing requirement in Pennsylvania falls short of meeting the needs for quality of care and quality of life,” Department of Aging Secretary Robert Torres said in a Wednesday statement. “As Pennsylvania’s senior population continues to increase, these overdue updates will help ensure that skilled nursing facilities provide residents with high-quality care now and in the future.”
In addition to requiring more direct care hours, the first proposal would mandate that skilled nursing facilities comply with U.S. Centers for Medicare & Medicaid Services regulations.
In a statement announcing the proposal, the administration acknowledged that skilled nursing and long-term care facilities were “disproportionately affected by the impact of COVID-19.”
“Robust and ongoing support for all skilled nursing facilities and long-term care facilities has been, and will continue to be, critical in the efforts to battle the pandemic and protect residents and staff,” Beam said in a statement. “Lessons learned during the pandemic are being incorporated into the new regulations.”
SEIU Healthcare, a labor union made up of nurses, as well as direct care and support staff, has been calling on state officials to update the rules and regulations governing long-term care facilities for more than two years as staffing shortages and complaints of resident isolation plagued the commonwealth’s facilities.
LeadingAge PA, a trade association representing more than 380 quality senior housing, health care and community services across the commonwealth, said it was “disappointed” by the administration’s proposal.
“[Wednesday’s] announcement by the Wolf administration is disappointing, but hardly surprising given its record on Medicaid funding,” the statement reads. “In its own proposal, the Wolf administration discloses it’s not even sure of the implications but acknowledges nursing home providers will bear much of the cost at a time when everyone understands they can least afford to do so. Our members support best staffing practices and provide high-quality senior care, but a lack of state funding continues to stretch our resources to the very limit. This administration has never provided a Medicaid funding increase or supported any funding initiatives by the General Assembly. This latest unfunded mandate for staffing couldn’t come at a worse time as long-term care facilities are still fighting a pandemic while suffering the worst staffing crisis in generations.”
The Pennsylvania Health Care Association, a statewide advocacy organization, echoed LeadingAge PA’s comments, saying that the Health Department was “out-of-touch” with the “providers, workers and residents” it oversees.
“In our current operating environment, this proposed regulation is an unattainable, unfunded mandate that will cripple an essential component of the long-term care continuum in one of the oldest states, in terms of population, in the entire country.
This announcement is not ‘historic’, the association’s president and CEO, Zach Shamberg, said. “Instead, it’s history repeating itself. In the midst of the COVID-19 pandemic –– as Pennsylvania’s long-term care providers were pleading for the resources necessary to protect their residents and staff –– the Department of Health found an opportune time to draft new regulations, without stakeholder input, for 700 nursing homes throughout the commonwealth.
“And this, after the Department of Health disbanded a stakeholder workgroup, which was established to guide this regulatory process and offer suggestions,” Shamberg continued.
“Once again, the experiences of long-term care providers were disregarded. Rather than include input from the front lines of the pandemic, Department of Health officials chose to draft regulations with unachievable mandates that will do nothing to improve the quality of care in Pennsylvania. In fact, the Centers for Medicare and Medicaid Services (CMS) does not believe in a ‘one size fits all’ approach to staffing ratios, which is why there is no federal recommendation that requires minimum staffing ratios,” he concluded.
The first package of proposed regulations will be published in the Pennsylvania Bulletin by July 31. This will begin a 30-day public comment period on the proposed regulations. Each of the five rulemaking packages will follow the same process.
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