Something is rotten in the city of Philadelphia, and it isn’t coming from Sansom Street. For years, nursing homes in the area have been running understaffed and underfunded, and without drastic changes in how we deal with underperforming nursing homes in the area, we’re destined to experience more cases of rampant neglect like those recently discovered at St. Francis Center for Rehabilitation. In that case, the nursing home was cited and its license revoked but was still able to appeal and receive a provisional license to stay open.

An Influx Of Citations For Area Centers

Over the past few years, the Department of Health in Pennsylvania has received a reputation as lackadaisical for allowing nursing homes across the state to get by with inadequate care. As a result, the agency has ramped up its efforts to uncover improper care. In 2015, the Health Department changed its policies to allow people to call in anonymously to complain about nursing home care. For Philadelphia nursing homes, the increased scrutiny has led to many local facilities being cited for everything from safety violations to inadequate staffing.

Problems With Limited Access To Nursing

One of the biggest problems Philadelphia area nursing homes have been cited for is a lack of nursing care for residents. According to the official Pennsylvania Code, nursing homes in the state must have at least two nursing personnel on duty at all times, with one nurse for every 20 residents. In addition, nurses must spend at least 2.7 hours per day (24 hr) providing direct care to each resident.  This is far below the 4.1 hours per day recommended by a recent study conducted by health care researchers (associated with the Centers for Medicare and Medicaid) and lower than the 2.8 hours per day reported as the least amount of time a CNA should spend with residents to provide the minimum threshold of care.

The Problem With Pennsylvania

The Pennsylvania Department of Health, which licenses 99% of the state’s nursing homes,  performed a performance audit of state nursing homes in 2016 to determine potential areas of concern. During its investigation the department recognized many areas of low performance, including the following:

1. Staffing levels throughout the state remain woefully lacking. Not only is there a shortage of qualified nurses working in nursing homes, they are not spending nearly the time necessary to provide adequate care to residents. In addition, although the DOH has the ability to increase quality hours, it has not done so.
2. Complaints are received but not dealt with in a timely manner. Until recently, those who chose to complain could not do so anonymously; therefore, many problems were not addressed.
3. The Department of Health has been hesitant to issue civil penalties to nursing homes that are providing inadequate care. This becomes blatant when considering that over the same audit period, DoH has fined nursing homes a scant $172,350 compared to CMS, which fined Pennsylvania nursing homes more than $2 million in the same period.

The Light At The End Of The Tunnel

While the Department of Health still feels correction and education is more important to ensure nursing home improvements than civil fines and punishments, the organization has increased the number of citations delivered two-fold since the audit of 2016. The major problem cited involves staffing, whether the complaint is under-staffing or under-qualified staffing. Unfortunately, this isn’t likely to change until leaders of the senior communities can figure out why so few qualified nurses are working in nursing homes across the state.

If you have a loved one living in one of Pennsylvania’s many nursing homes, you can help change the level of care he or she receives by speaking up when you notice conditions that need improvements. Contact the Pennsylvania Department of Health or your local long-term-care ombudsman and let them know the changes you would like to see throughout the state’s residential facilities.