Department of Health

PA Department of Health Regulations for Nursing Facilities

Nursing facilities in Pennsylvania are licensed by the Department of Health, Division of Nursing Care Facilities (DNCF). The DNCF conducts surveys of nursing facilities to ensure compliance with federal and state regulations. These include licensure and certification surveys, follow-up surveys and complaint investigations. The survey process, protocols and guidance are contained in the Center for Medicare & Medicaid Services (CMS), State Operations Manual. The DNCF provides resources and guidance to nursing facilities through its website, the Message Board and the issuance of Provider Bulletins. The Department also operates and maintains the federally mandated Nurse Aide Registry.

DOH Posts Guidance for Calculating Direct Nursing Care Hours

The Department of Health (DOH) posted guidance on the DOH Message Board regarding the calculation of hours of direct nursing care provided for during each 24 hour period. The guidance includes a table that nursing facilities will be requested to complete by DOH surveyors. The table is designed to document the actual number of hours each nursing staff worked for the identified period.

The guidance also provides examples of staff that should NOT be included in the calculation and hours that MAY be included. The guidance reiterates that a nursing facility’s daily number of hours of care per resident/day (PPD) must be at least 2.7 to meet §211.12(i)(relating to nursing services), if this PPD is not met a citation will be issued. Additionally, nursing facilities are reminded that the direct care hours must be adequate to meet the needs of the residents being served in the facility, this may necessitate staffing that exceeds the minimum requirement of 2.7 PPD.

A copy of the guidance can be found here.

If you have questions regarding the guidance, please contact Dawn Murr-Davidson at dmurrdavidson@phca.org or Gail Weidman at gweidman@phca.org.

Resources

Department of Health Message Board

The Department of Health uses the Message Board to provide information on new initiatives, updates and reminders for the providers they license, which includes, among others, nursing facilities.

Department of Health Monthly Newsletter

The PA Department of Health issues a monthly e-newsletter. The newsletter is a vehicle through which DOH informs health care facilities, public health professionals, and all Pennsylvanians about Departmental activities, projects, emerging health threats and more.

Division of Nursing Care Facilities Homepage

Information on this page is for individuals associated with the operation of a nursing facility.

Guidance for Calculating Direct Nursing Care Hours

December 2016

Nursing Facility Inspection Reports

The Department of Health, as state licensing agency and state survey agency for CMS, conducts both routine and special inspections of skilled nursing facilities and issues inspection reports, which can be found here.

Pennsylvania Code 28 Pa. Code Part IV, Subpart C: Long-Term Care Facilities

Regulatory Chapters within the Pennsylvania Code that nursing facilities must comply with

Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and A/V Recordings by Nursing Home Staff

This memorandum discusses the facility and State responsibilities related to the protection of residents. Specifically, at the time of the next standard survey for both the Traditional survey and QIS, the survey team will request and review facility policies and procedures that prohibit staff from taking, keeping and/or distributing photographs and recordings that demean or humiliate a resident(s).

State Operations Manual

CMS Complete State Operations Manual Website

The Centers for Medicare & Medicaid Services’ (CMS) State Operations Manual (SOM) is widely followed in interpreting the meaning of CMS regulations. It provides direction to surveyors on how to conduct surveys and most likely surveyors will have it with them when they arrive, unannounced, to do a survey in the nursing facility.

State Operations Manual Appendix P – Survey Protocol for Long-Term Care Facilities – Part I

Appendix P of the State Operations manual outlines the survey protocols to be used by surveyors when conducting surveys of long-term care nursing facilities.

State Operations Manual Appendix PP – Guidance to Surveyors for Long-Term Care Facilities

Appendix PP of the State Operations manual provides guidance to long-term care nursing facility surveyors related to survey procedures and the determination of compliance.

State Operations Manual Appendix Q – Guidelines for Determining Immediate Jeopardy

Appendix Q of the State Operations manual provides a detailed analysis of the steps surveyors should follow to assist them in accurately identifying those circumstances which constitute Immediate Jeopardy: preparation, investigation, decision-making and implementation.

State Operations Manual Chapter 5 – Complaint Procedures

Chapter 5 of the State Operations manual Sections 5300 to 5390 provide guidance regarding the Investigation of Complaints for Nursing Homes

State Operations Manual Chapter 7 – Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities

Chapter 7 of the State Operations manual implements the federal nursing home survey, certification, and enforcement regulations contained in the federal rules at 42 CFR Part 488.

Dementia Care Survey Tools

In response to feedback from stakeholders and partners of the National Partnership to Improve Dementia Care in Nursing Homes, CMS shared the revised survey materials that were developed for the 2014 Focused Dementia Care Survey Pilot and 2015 expansion effort. The intent is that facilities would use these tools to assess their own practices in providing resident care.

Carbon Monoxide Alarms

Care Facility Carbon Monoxide Alarms Standards Act – Act 48 of 2016

Effective September 21, 2016, this Act provides standards for carbon monoxide alarms in care facilities.

May 2017

Partner spotlight

Our focus is on relationships. On forging rock-solid partnerships with successful regional and local firms who are as fervent as we are about providing clients with best-in-class asset protection and unparalleled service. That commitment has empowered us to be the fastest-growing independent insurance agency in the U.S. Founded in 2011 as a national partnership of leading independent property and casualty and employee benefits brokerage firms, we're now one of the largest brokers in the nation with offices in 30 states and two countries.

Learn more about our business partners