Acting Secretary of Health Alison Beam announces reforms related to nursing home care.

The Wolf administration has proposed new staffing requirements for nursing homes, a measure that industry groups say is simply unattainable.

Acting Secretary of Health Alison Beam said the administration is proposing regulations focused on increasing the quality of care received by residents by increasing the minimum direct care hours by 1.4 more hours each day. The current skilled nursing facility regulations have not been updated since 1999.

LeadingAge PA, an association representing more than 380 providers of service for seniors, released a statement from President and CEO Adam Marles.

“Today’s announcement by the Wolf administration is disappointing, but hardly surprising given its record on Medicaid funding. 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.

“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,” he continued. “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.”

Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, voiced his displeasure as well.

“The Department of Health’s newly-proposed staffing requirement illustrates just how out-of-touch this regulatory agency is regarding the providers, workers and residents they oversee,” he said.

“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,” Shamberg continued. “This announcement is not ‘historic’. 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.”

This won’t work, he said, adding that even the federal government knows it won’t.

“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 said.

He, too, spoke of the staffing crisis.

“Today’s announcement to raise staffing levels in nursing homes comes at a time when Pennsylvania is facing a statewide workforce shortage. To meet a 4.1 staffing standard statewide, nursing homes will need to hire an additional 7,000 direct care workers –– who, at this moment, do not exist.”

With that new staff would come a serious price tag — more than $300 million a year — with no new funding attached, Shamberg said.

The health department has submitted the first installment of the proposed regulations to the General Assembly, the Independent Regulatory Review Commission and the Legislative Reference Bureau. The next step is for the first package of proposed regulations to be published in the PA Bulletin by the end of July which starts a 30-day public comment period. The department encourages all interested stakeholders, including industry groups, resident advocates, and the general public to comment on the proposed regulations. Once published, comments may be submitted to the Department of Health via email:

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