Wolf Administration proposes to increase hours of direct care in nursing homes

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Nursing home visitation guidelines have been adjusted from 28 days being COVID free to 14.

HARRISBURG — On Wednesday, Wolf Administration officials shared proposed nursing home regulations to increase the number of hours of care received by residents by 1.4 more hours each day.

The regulations currently in place have not been updated since 1999. The first package of proposals focuses on increasing the minimum standard from 2.7 to 4.1 hours of care within a 24-hour period. 

“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.

Beam, standing alongside leaders of four cabinet agencies as well as a nursing home worker and resident, said this is the first in a series of five packages of proposals based on the latest research, input from subject matter experts and industry stakeholders and informed by lessons learned during the COVID-19 global pandemic. 

With the announcement, the department has submitted the first installment of proposed nursing home 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, people can submit their comments to the Department of Health via email: RA-DHLTCRegs@pa.gov.

“The Wolf Administration is looking at long-term care in a comprehensive manner and we are committed to getting the proposed updated regulations through the regulatory review process by the end of 2022,” added Beam. “Nursing home regulations have not been updated in nearly 25 years. Given the magnitude and importance of the regulations for more than 72,000 nursing home residents and their families, publishing the proposed updates in packages will allow each section the opportunity for appropriate feedback during the public comment period.”

The department plans to submit the final-form regulations once all five packages of updates move through the state’s review process. These regulations will apply only to the 692 licensed skilled nursing facilities regulated by the Department of Health. Personal care homes and assisted living homes typically housing residents with less acute health care needs are regulated by the Department of Human Services under separate regulations. 

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

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

During the pandemic, the Department of Health supported facilities with the provision of personal protective equipment (PPE), infection prevention and control technical support, staffing support, outbreak response, and ongoing testing.

The Department of Health is also working on the other four packages of proposed regulations that will include proposed updates to other critical topics including change of ownership, staff development, staffing ratios and infection control and prevention. These packages will follow the same process for public comment as this first package of proposed updates.

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