Gov. Wolf’s administration vows ‘historic’ increase in care for nursing home residents

Gov. Tom Wolf’s administration said Wednesday it plans to add more than an hour to the amount of daily care required for skilled nursing home residents.

The state presently requires a minimum of 2.7 hours per day, a number that hasn’t increased in nearly 25 years, even as the typical nursing home resident has become sicker and frailer. The minimum would rise to 4.1 hours.

“Outdated regulations have ignored industry changes and best practices related to patient care,” said Pennsylvania Acting Secretary of Health Alison Beam.

Beam said the minimum level of care is the first part of a package of reforms intended to improve nursing home care. Each much be advertised and be subject to public comment. A state regulatory review board will ultimately decide whether they become law.

Beam said the administration’s goal is for the new standards to take effect by late 2022.

Nursing home operators in Pennsylvania immediately objected to the proposals, saying the state is ignoring the financial cost to nursing homes as well as a historic shortage of workers.

Adam Marles, the CEO of LeadingAge PA, which represents non-profit long-term care providers, said the state isn’t providing enough financial support.

“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,” Marles said in a statement. “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.”

Industry officials also said they are still reeling from the COVID-19 pandemic and all the extra costs including protective equipment, which are ongoing.

However, state officials said they expect to direct more funding to the facilities, including increasing the daily reimbursement from Medicaid, the state-federal program that covers the majority of the 72,000 nursing home residents in Pennsylvania.

Meg Snead, Pennsylvania Acting Secretary of Human Services, said the state expects it will cost $366 million per year to ensure a minimum of 4.1 hours of care per day for each resident.

Beam also pledged additional funds to nursing homes.

“We’re confident that the state’s nursing home industry can withstand the improvements,” said Beam.

National experts and advocates have long said 4.1 hours of care is the minimum level needed to ensure that skilled nursing home residents have adequate care and quality of life. Unionized nursing home workers in Pennsylvania have long pushed for that level as well as a state-mandated minimum staffing levels.

Advocates implored state officials to require more hours of care in a PennLive investigation published in 2018, “Still Failing the Frail.”

Beam said minimum staffing levels are another part of the package the administration will introduce. She said state officials along with nursing home industry representatives and others will have to decide what level of staffing is needed to make sure staffers can provide a minimum of 4.1 hours without being overworked.

Pennsylvania has 692 skilled nursing facilities, which care for people with the greatest medical needs. They are distinct from assisted living facilities and personal care homes. The 4.1 hour minimum and other parts of the package would apply only to skilled nursing facilities.

State officials announced the reforms at the Homeland Center in Harrisburg, where the director expressed support for the reforms, and which officials said already provides more than 4.1 hours.

In fact, Beam said 125 Pennsylvania facilities already provide at least 4.1 hours, and well over 400 others provide at least three hours.

Kim Jackson, a licensed practical nurse and a veteran of working in nursing homes, told of a time when she and co-workers had time for things like painting female residents’ nails and keeping them free of facial year.

But she said her work evolved into a situation of worrying that someone would have time to feed residents while food was still hot or even feed them at all. She told of working without breaks or going to the bathroom.

“We go into this work because we want to help people, to ease their suffering,” she said. “But at the end of the shift you know that you didn’t have time and your staff didn’t have time to do everything that needed to be done. You know that you didn’t do enough for the people that are counting on you.”

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