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Wolf Administration introduces first of five proposed regulations of nursing homes
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Pennsylvania

Wolf Administration introduces first of five proposed regulations of nursing homes

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Alison Beam

Acting Secretary of Health Alison Beam talks about proposed nursing home regulations during a news conference Wednesday at Homeland Center in Harrisburg.

The Wolf Administration on Wednesday announced that it is looking at five packages that will be the first to update Pennsylvania’s nursing home regulations in nearly 25 years.

The state Department of Health unveiled only the first package of proposed regulations, which focuses on increasing the minimum standard of required hours of direct care for residents each day from 2.7 to 4.1 hours within a 24-hour period.

SEIU Healthcare Pennsylvania, a union of nurses and health care workers, said Pennsylvania would be the first state to regulate a minimum of 4.1 hours of direct care, if the regulations are approved.

“COVID made clear that we need to reform our long-term care system,” said Matthew Yarnell, president of SEIU Healthcare Pennsylvania. “It’s time to focus on solutions that protect residents and those who care for them.”

“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. “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.”

The package also requires skilled nursing facilities to comply with the U.S. Centers for Medicare & Medicaid Services (CMS) regulations and requirements, which the Wolf Administration said will make the state Department of Health’s oversight process more efficient, create consistency and eliminate confusion in the application of standards.

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LeadingAge PA, an association representing service providers, took issue with the first set of regulations.

“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,” association president and CEO Adam 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. 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.”

Review process

This first set of proposed regulations and the four after it, if approved, would apply to only the 692 licensed skilled nursing facilities that are regulated by the DOH. Personal care homes and assisted living homes are regulated by the state Department of Human Services, which is under separate regulations.

With Wednesday’s announcement, the DOH submitted the first installment of proposed regulations to the General Assembly, the Independent Regulatory Review Commission and the Legislative Reference Bureau. The next step is to have the proposed regulations published in the PA Bulletin by the end of July, which will start a 30-day public comment period, with comments submitted to the DOH via email at RA-DHLTCRegs@pa.gov.

The department will submit the final-form regulations once all five packages of regulations move through the state’s regulatory review process. The department is currently working on the other four packages of proposed regulations that will include updates to other critical topics, including change of ownership, staff development, staffing ratios and infection control and prevention.

“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,” said Acting Secretary of Health Alison Beam, during a news conference at Homeland Center in Harrisburg Wednesday.

“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 added. “Lessons learned during the pandemic are being incorporated into the new regulations.”

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