Pennsylvania offers first nursing home regulatory updates in 20 years

More than 72,000 skilled nursing home residents in Pennsylvania would see an increase in the direct care hours they receive daily under proposed regulatory changes, the first updates in more than 20 years.

Acting Department of Health Secretary Alison Beam on Wednesday said the changes would increase the minimum number of hours of direct care for residents from 2.7 to 4.1 hours per day, which is more in line with Medicare recommendations.

“The review of nursing home regulations is part of the administration’s continued efforts to improve resident care and working conditions for nursing home staff,” Beam said at a press conference. in Harrisburg.

The Wolf administration on Wednesday announced a series of proposed changes to nursing home regulations, including increasing the number of hours staff spend caring for residents.

The announcement took place at the Homeland Center, which Beam says is one of 125 nursing homes in the state that already meet the proposed level of direct care. The facility provides 5.8 hours of direct care per day, according to the Centers for Medicare & Medicaid.

The deployment is the first of five sets of proposed changes to state nursing home regulations, which were last revised in 1999. The proposals are based on the latest research, expert input and ” insightful lessons ”learned during the COVID-19 pandemic, which disproportionately affected residents of nursing homes, state officials said.

More than 13,000 long-term care residents who have tested positive for COVID-19 have died since the start of the pandemic, about half of the more than 27,000 deaths in the state. More than 72,000 long-term care residents have tested positive since the start of the pandemic.

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“Lessons learned during the pandemic are being incorporated into new regulations,” Beam said.

The first set of proposed regulations focus on adding 1.4 hours of direct care required for residents each day.

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Nursing home worker Aaron Crow, who works at the Harborview Rehabilitation Care Center in Doylestown, and union leader Alana Bennett protested on Tuesday, calling for fair wages and benefits for all employees.  Similar protests took place at 41 nursing homes across the state.

More than 100 national studies and reports have shown that the current minimum staffing requirement in the state does not meet quality of care and quality of life needs.

Increasing the minimum number of hours of direct care could greatly improve the quality of care for residents, Beam said. She cited studies that show that 4.1 hours of direct care is the minimum level needed to prevent infections, dehydration, falls and malnutrition.

She added that many skilled nursing facilities already provide at least three hours of direct care to each resident per day.

The first package also includes requirements for operators to comply with the regulations and requirements of the Centers for Medicare & Medicaid Services. This will make the state surveillance process more efficient, create consistency and eliminate confusion in the application of standards.

Chief Long-Term Care Ombudsman Margaret Barajas said the state has an “ethical imperative” to ensure its most vulnerable residents are taken care of.

“Just like you and me, they want to live in a house where they feel safe, loved and well cared for,” she said.

But when staffing meets minimum requirements, residents suffer mentally, physically and emotionally, she said. Residents tell him and other ombudsmen that their caregivers are overworked.

“Residents, their families and their advocates have long expressed concerns about the quality of care and, ultimately, the quality of life offered under existing care mandates,” said Barajas. “We are delighted that our collective voice has been heard. ”

Beam added that the department understands that these changes will not only impact residents and staff, but the industry as well, and they want to partner with the industry to see how this can increase sustainability.

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the hands of the elderly by pixabay

But the long-term care industry’s pullback began before the press conference ended.

In a press release, a state trading organization claimed the change would do nothing to improve the quality of care and would have a direct impact on staffing levels at a time when the state faces a labor shortage. -work.

“The new staffing requirements proposed by the Department of Health illustrate just how disconnected this regulator is from the providers, workers and residents it oversees,” said Zach Shamberg, President and CEO of the Pennsylvania Health Care Association, which represents 400 long-term care operators. “Today’s announcement, unfortunately, is a step in the wrong direction.”

In the current operating environment, the proposed increase in direct care hours is “impossible,” unfunded “and” impossible “and would cripple a critical component of long-term care in the state, Shamberg said.

To meet the 4.1-hour staffing standard, nursing homes will need to hire an additional 7,000 direct care workers, which could cost operators $ 6 million per week in new wages, Shamberg said.

“No new proposed funding is attached,” he added. “For an industry so dependent on a Medicaid reimbursement system that has not kept up with rising healthcare costs since 2014, this is simply unrealistic.”

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The first set of proposed regulations will be published in the Pennsylvania Bulletin next week, marking the start of a 30-day public comment period.

There was no discussion on Wednesday when the next round of proposals is announced. Beam said the ministry wanted to stagger the publication of each proposed section of the regulatory changes so that it provides the opportunity for appropriate public comment.

The proposed additional regulatory packages will involve a change in ownership, staff development, staff ratios and infection control. These packages will follow the same process for public comments.

The department also submitted the first installment of proposed regulations to the General Assembly, the Independent Regulatory Review Commission and the Legislative Reference Office for review.

The Wolf administration wants the five proposed sets of regulations to go through the regulatory review process before the end of next year.

The department plans to submit the final regulations once all five update packages have passed the state’s regulatory review process.

At the end of each public comment period, the Department of Health will review the comments and draft the final regulations, which will be sent to the Independent Regulatory Review Board.

The commission will review the proposed regulations and ultimately decide whether the proposed regulations will be implemented. The changes will only apply to the state’s 692 licensed skilled nursing facilities.

How you can comment on new nursing home regulations

Stakeholders, industry groups, resident advocates and the general public can comment on the Department of Health’s proposal to increase the minimum number of daily hours of direct resident care starting July 31.

Comments can be submitted to the Department of Health by email to [email protected]

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