Changes needed in PA to fix a neglectful nursing home system

Pennsylvania, like most other states in the U.S., has a long, ugly history of sub-standard nursing home care. Bed sores, falls, and wrongful death are common occurrences when a for-profit nursing home industry is left under-regulated. We have learned that in the absence of oversight, the industry will put its profits ahead of resident safety. The downstream effect of this is chronic understaffing and resident harm. This was tragically amplified during the COVID pandemic. The take home message is this – we need stronger agency involvement and better regulation to ensure appropriate care for our society’s most vulnerable. 

To fix this systemic problem, the Pennsylvania Department of Health recently unveiled proposed changes to Pennsylvania’s nursing home regulations. This is the first major overhaul of Pennsylvania’s nursing home regulations in nearly 25 years. 

The recently proposed regulations would amend standards relating to the closure of a skilled nursing facility, delete duplicative state and federal requirements and regulate construction on new facilities, as well as renovation of older facilities. Future revisions are expected to include proposed revisions on facility licensure, hurricane and storm preparedness, residents’ rights, and what kind of services are offered at Pennsylvania’s 688 nursing homes.

This regulatory overhaul presents an opportunity for real change in an industry that has been plagued with poor performance and preventable casualties. 

We need to demand more from the skilled nursing home industry. Nearly one in four residents experience at least one instance of abuse while residing in a long-term care facility. Nearly one in three staff members admitted to emotionally abusing residents. These numbers are wholly unacceptable. Especially when the victims oftentimes cannot advocate for themselves.

Increased regulation and government oversight offer a solution to a broken nursing home system. After all, the lifeblood of these facilities is federal dollars in the form of Medicare and Medicaid. It is not a big ask that nursing homes comply with state and federal regulations. 

Any attention paid to this issue is a step in the right direction. While the Commonwealth has not yet unveiled plans to revamp the Residents’ Rights Bill, this can be instrumental in ensuring that every nursing home resident is afforded basic human rights and protections under Pennsylvania law. A strong Resident’s Rights Bill gives voice to the voiceless and allows third parties like agency inspectors, civil litigators, or legal guardians, to bring legal action to enforce those rights. This ensures accountability if a nursing home does not provide residents with adequate care.

We deserve to know who owns the nursing homes that house our parents. If we can determine who owns a facility, frequent offenders will be identifiable and precluded from getting a skilled nursing license. A clear, transparent ownership disclosure requirement should be included in the proposed improvement of Pennsylvania’s nursing home regulations. 

Lastly, more frequent unannounced inspections, and increased civil fines for deficiencies, would go a long way in keeping facilities on their toes. It is known in the industry that facilities clean up, staff up and shine around survey time. More frequent random inspections would maintain the element of surprise. This would translate to better resident care.

The recently released proposed regulations were published in the Pennsylvania Bulletin on Oct. 9. We are now at the tail end of the 30-day comment period. Contact your lawmaker and demand accountability, transparency and decency from the nursing home industry that is caring for our greatest generation. 

Michael Brevda is licensed to practice law in Florida, New York, and Washington DC, and is the managing partner of Senior Justice Law Firm, a national nursing home abuse law firm. Senior Justice Law Firm has a Pennsylvania office in Philadelphia. Brevda has consulted with lawmakers in Florida and New York when those states were proposing changes to laws governing nursing homes and assisted living facilities.