New Pa. nursing home staffing requirements in effect, with more changes slated for 2024

New regulations require more direct care hours for residents and tighter staffing ratios at nearly 700 long-term care facilities statewide.

Close up hands of caregiver doctor helping old woman at clinic.

A caregiver helps an older adult.(Rido81/Bigstock)

Pennsylvania state agencies will begin enforcing new staffing requirements at long-term care facilities across the Commonwealth, which took effect July 1.

The new rules set a minimum number of hours each resident should get in direct care and caps the maximum number of people assigned to each skilled worker at nursing homes.

State officials, labor organizers, and patient advocates say the new regulations are part of larger efforts to improve long-term care services statewide, especially in the aftermath of the COVID-19 pandemic and Pennsylvania’s growing aging population.

“Data clearly shows that increases in staffing standards saves countless lives and results in better health outcomes for all nursing home residents,” said Becky Fortenbaugh, program manager at the state Long-Term Care Ombudsman Office. “More direct care hours means that residents will be more likely to receive the individualized and personal care they deserve.”

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Facilities are required to provide each resident with at least 2.87 hours of direct care per day. That will increase to 3.2 hours on July 1, 2024.

The regulations also set stricter staffing ratios for certified nursing assistants or aids and licensed practical nurses. For example, there must be a minimum of one CNA per every 12 residents and one LPN per every 25 residents during day shifts.

Even tighter staffing ratios are scheduled for next year.

The Pennsylvania Independent Regulatory Review Commission approved the new regulations in October.

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Matt Yarnell, president of the labor union SEIU Healthcare Pennsylvania, which represents thousands of long-term care workers across the state, said the new requirements should create safer environments for everyone.

He said the regulation changes could also help retain and recruit professionals in the industry.

“The staffing ratio itself is about creating the kind of conditions that allow caregivers to focus on providing good care,” Yarnell said, “and not being in positions where they’re taking care of way too many people and not being able to do their job, and do it well.”

The Pennsylvania Department of Health will oversee and enforce the new requirements.

Jeanne Parisi, Deputy Secretary for Quality Assurance, said the department has been working to prepare nearly 700 long-term care facilities across the state for new staffing levels.

Parisi said the department conducts a site visit and inspection at each facility every 15 months or more frequently if reported issues or complaints occur.

At that time, state officials will verify that staffing ratios are being met. The state will cite facilities that are not complying with the new regulations and require them to submit and implement a plan of correction. If they fail to do that, facilities risk penalties.

To meet even tighter staffing ratios and direct care time limits scheduled for next year, Parisi said the state and its partners would work toward improving the workforce pipeline by increasing training and education opportunities.

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