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New nursing home money, staff ratios will end ‘someone taking care of 20 residents’

Patriot-News - 7/11/2022

A $515 million infusion from the new Pennsylvania budget will allow nursing homes to hire more staff and pay and train them better. It will allow better care for nursing home residents and a better career for the people who provide the care, an array of leaders said Monday.

A contingent including the nursing home industry, unionized employees and elected officials of both parties called the measures “historic.” They predicted they will go far toward reversing problems including stagnant funding, poor wages and, during the COVID-19 pandemic, a labor shortage that threatened to cause homes to stop accepting new residents or even close.

“It is truly an investment that could save senior care in this state. It is a long-term investment in long-term care,” said Zach Shamberg, the CEO of the Pennsylvania Health Care Association, which represents for-profit facilities.

New staffing ratios finalized Monday will be gradually implemented over several years. When fully in place, certified nursing assistants will care for no more than 10 residents during day shifts, 11 during evening shifts and 15 during overnight shifts. There also will be ratios to limit the number of residents each licensed practical nurse must care for.

“We’re going to be able to end the days of someone taking care of 20 residents,” said Matthew Yarnell, the president of SEIU Healthcare Pennsylvania, a union.

The nursing home industry has historically pushed back against so-called mandatory staffing levels, in recent months suggesting they are impossible for financial reasons and because of the worker shortage.

However, Shamberg said the new Pennsylvania ratios are fair and doable given the new funding, which includes both state and federal money. He further said his industry embraces the ratios because of the positive impact on residents.

Gov. Tom Wolf said the ratios are part of Pennsylvania’s first updated nursing home regulations in 25 years, calling the old regulations “too outdated to support the needs of today’s nursing home staff and nursing home residents.”

The new budget increases the daily reimbursements nursing homes receive from Medicaid, which pays for the care of nearly 70% of nursing home residents. The figure, which varies by region, will increase from about $200 per day to about $235, the first increase in a decade.

At least 70% of the daily reimbursement must be spent on direct care.

Yarnell said he believes the new money will allow a $20 an hour starting wage for CNAs; the present statewide average rate is about $16.50. Officials said such a starting wage will allow homes to attract a sufficient number of quality workers, prevent them from losing workers to other industries, and ensure consistency of care for nursing home residents.

The new budget also directs more money to assisted living and personal care facilities and to nursing homes that care for a high proportion of people who need breathing ventilators.

On Monday, the various groups — nursing home industry representatives, the union and elected leaders of both parties — gathered for an uncommon round of credit-sharing.

Shamberg credited Wolf for months ago asking the various groups to seek common ground, and the Republican-controlled legislature for supporting their requests.

House Speaker Bryan Cutler, R-Lancaster County, said “these are not issues that come with a party affiliation.”

“It shows that we all have an interest in taking care of people … that we recognize that people need help and that we as policymakers can do our part. That’s why we were sent to Harrisburg in the first place — to find solutions to improve people’s lives,” he said.

READ MORE FROM PENNLIVE:

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