New Pennsylvania Nursing Home Regulations Being Implemented in 2023 and 2024

In October 2022, Pennsylvania’s Independent Regulatory Review Commission approved a range of new nursing home regulations governing the state’s nearly 700 nursing homes. This was the first time these regulations were updated since 1997, and it represents the beginning of a new era in nursing care that is more focused on the comfort and safety of residents. These new regulations were to be implemented in phases, with the first two phases being implemented in February and July of 2023. With the next phase scheduled to be implemented at the end of October, the team at Slutsky Elder Law thought this would be the perfect time to review the main aspects of these new regulations and explain how they will result in more transparency and better patient care in Pennsylvania’s nursing homes and long term care facilities.

Phase 1: February 1, 2023

In past years, state regulations have been severely lacking in transparency regarding changes of ownership at nursing facilities. Advocates for the new regulations argued that residents and their families deserve to know who is responsible for the care being provided and to be notified when nursing homes change hands. Now, new applicants for licensure must provide notice to the State Long Term Care Ombudsman when applying, and applicants for a change of ownership licensure must provide notice to facility staff and residents.

Phase 2: July 1, 2023

Staffing shortages at nursing facilities have continued to be an issue in the aftermath of the COVID-19 pandemic. The second phase of PA’s new nursing home regulations is aimed at addressing those shortages and encouraging additional hiring by setting minimum staffing levels. In phase two, all nursing facilities in the state will be required to provide at least 2.87 hours of direct patient care for each patient, up from the previous requirement of 2.7 hours. It will also limit the number of residents each nurse aide is allowed to see in one day.

To help cover the costs of hiring more staff, Medicaid rates were increased and $159 million in American Rescue Plan Act funds were authorized to be delivered to Pennsylvania’s nursing homes by June 30th, 2023.

“Adequate staffing means the difference between a resident receiving assistance walking to and using the bathroom rather than falling trying to ambulate by themselves or being left lying in their own waste for long periods,” wrote Pamela Walz, a supervising attorney at Community Legal Services of Philadelphia, one group that strongly advocated for these changes to be made.

Phase 3: October 31, 2023

Additional changes to the application and licensure process will be implemented at the end of October. More information and documentation will be required, including posting the application to the state Department of Health website and providing audited annual financial reports for license renewal. A public comment period will also be established for new license applications and change of ownership license applications.

Phase 4: July 1, 2024

In the final implementation phase, minimum staffing levels will be further increased. At the beginning of July 2024, nursing facilities will be required to provide at least 3.2 hours per day of direct patient care and no individual nurse aide will be allowed to care for more than 10 residents during the day, 11 in the evening, and 15 overnight, down from 12 residents during the day and evening and 20 overnight established in phase 2.

At Slutsky Elder Law, we applaud Pennsylvania’s efforts to set a higher standard of care for the state’s nursing home residents. Although more work needs to be done, we believe these new regulations will go a long way toward improving the quality of life for the more than 80,000 people living in Pennsylvania’s long-term care facilities. In the future, we hope that advocacy groups and members of Congress will continue to fight for these people, who are some of the most vulnerable in the state.

Elder Law Attorneys in Pennsylvania

One of the most important steps you can take to ensure your wishes will be respected as you get older and you will be well cared for is to speak with an attorney specializing in elder law. As one of the first elder law attorneys in Pennsylvania, Robert Slutsky has been advocating for older Pennsylvanians since 1992. If you need advice about Medicaid asset protection, powers of attorney, guardianships, or anything else related to elder law, Rob is the elder law attorney to contact in Bucks County, PA and neighboring counties. Call (610) 940-0650 or visit our contact page to request a consultation today.


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