Pennsylvania's oversight of nursing homes will get another look

Two years after an audit found big holes in the Pennsylvania Department of Health’s oversight of nursing homes that care for thousands of vulnerable residents, the oversight system is getting another look.

Pennsylvania Auditor General Eugene DePasquale said his office will follow up on its 2016 audit “to measure just how much progress the Department of Health has made” on its recommendations.

The department moved quickly to address two key criticisms, reversing a 2012 decision to stop accepting anonymous complaints and stepping up use of financial penalties and other sanctions.

Less clear is how the department is addressing what DePasquale said in 2016: that the root of the problem “likely is that some facilities may lack sufficient nursing staff.”

Response to review

Russ McDaid is president of the Pennsylvania Health Care Association, which represents more than 500 providers among the approximately 700 nursing homes in the state.

He said scrutiny on nursing homes has intensified since 2016 and the way to improve conditions is not to step it up even more, but to address the “gross underfunding” of the industry.

About two-thirds of residents in the typical Pennsylvania nursing home rely on Medicaid, he said, and in the past seven years the shortfall between what Medicaid pays and what their care costs has roughly doubled to about $18,000 per resident per year.

“I don’t know what other solution government is looking for,” he said. “They can expect more of the same if we don’t reverse this funding course.”

Adam Marles, president and CEO of nonprofit senior services association LeadingAge PA, said in an email that its members “generally operate with well over the minimum staffing required” by the department, but the industry is “in the middle of the most significant work force crisis in recent memory."

LeadingAge looks forward to working with authorities "not only on the regulatory requirements for nursing facilities, but also on improving and enhancing care for Pennsylvania’s older adults," he wrote.

Since 2016, operators of three Lancaster County nursing homes have declared bankruptcy, with the Health Department stepping in to install temporary management at one — and that home and another one have changed hands and management twice.

The department requested the initial audit in 2015, when the Pennsylvania attorney general’s office sued Texas-based Golden Living, alleging it failed to meet basic human needs at 25 facilities in Pennsylvania, including one at 425 N. Duke St. in Lancaster city that is now being run by a different company.

The lawsuit is still in process.

Health Department spokesman Nate Wardle said in an email that it welcomes the review and chance to discuss next steps.

Improvements have been made, he wrote, “and we are continuing to work to ensure safe care is provided to those living in nursing homes in Pennsylvania.”

Credit: HEATHER STAUFFER | Staff Writer