November 08, 2023
Contact: Eric Heisler,
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PHCA Issues Critical Response of Pennsylvania US Senators for Supporting a Misguided Federal Regulatory Proposal

Sens. Casey and Fetterman ignore warnings and concerns from states, stakeholders and US Senate Democrat counterparts about an unattainable, unfunded and undermining mandate

Harrisburg, Pa. (November 8, 2023) –– The Pennsylvania Health Care Association –– a statewide long-term care advocacy organization for Pennsylvania’s most vulnerable residents and their providers of care –– has issued the following statement in response to a letter signed by Pennsylvania’s U.S. Sens. Bob Casey and John Fetterman that supports the Centers for Medicare and Medicaid Services (CMS) proposal of a federal staffing mandate that will negatively impact Pennsylvania seniors and adults with disabilities in need of care. The following statement can be attributed to Zach Shamberg, president and CEO of the Pennsylvania Health Care Association (PHCA).

“Senators Casey and Fetterman are clearly out of touch with the realities facing health care in Pennsylvania, and their misguided support of the Centers for Medicare and Medicaid Services self-contradicting nursing home staffing proposal will have a far greater negative impact than anything they think they are trying to improve.

“Pennsylvanians need advocates who support access to care, rather than nationwide policies, structured by oblivious viewpoints, that undermine state regulations. 

“CMS has proposed a staffing mandate that suggests every person across the country has identical care needs in a long-term care setting –– this, after previously stating that a ‘one-size-fits-all’ approach to care is not best. And Pennsylvania’s two U.S. senators are now suddenly agreeing with this notion.

“Moreover, our federal officials are ignoring the warnings and concerns of Pennsylvania’s elected leaders, health care stakeholders and even the state’s Independent Fiscal Office, who have all sounded the alarm regarding an access to care crisis that will be far greater than what we are currently facing if this mandate is implemented. In an October report, the Independent Fiscal Office stated that numerous factors, including this proposed mandate, could create ‘more stress on long-term care capacity and further exacerbate hospital discharge delays.’ The Hospital and Healthsystem Association of Pennsylvania, in conjunction with PHCA, submitted comments to CMS warning that after recently experiencing a capacity crisis, ‘this federal staffing proposal will only lead us further down a path of catastrophe.’ And five Pennsylvania state Senate leaders asked CMS not to ‘hand Pennsylvania yet another unfunded federal mandate,’ particularly one that will undermine the increased staffing regulations Pennsylvania put into place in July.

“Looking beyond Pennsylvania, 14 governors have signed a letter opposing the mandate, and 28 of Senator Casey’s and Fetterman’s colleagues –– led by fellow Democrat Jon Tester –– submitted their concerns with the proposal.

“Elected officials stump for increased wages for workers, but they have failed to support funding for states to recruit and train new caregivers, let alone pay them higher wages. Perhaps they don’t realize that state and federal governments own the responsibility of paying for Medicaid care, which is the payor source for more than 70 percent of all nursing home care. 

“If our elected leaders want to take a stance to support senior care, they should fund it.

“Where are the caregivers necessary to meet this mandate? Where is the funding –– the more than $500 million additional dollars per year needed to support this mandate just in Pennsylvania? And where will the people of Pennsylvania go when nursing homes –– and subsequently hospitals –– are at capacity? 

“Nursing homes provide the next level of care when patients are ready to be discharged from a hospital. Many patients need skilled care and can’t go home, not to mention that you can’t receive home care –– a far less regulated health care service, with limited oversight –– if you don’t have a home. 

“We are issuing a warning to state governments across the country, and especially in Pennsylvania: start planning now for the negative ramifications of this bad federal policy that will ultimately destroy a critical component of the health care continuum. Start thinking now about who is going to care for your state’s ventilator patients, adults with physical and mental health disabilities, dementia residents, adults in need of physical rehabilitation, and our rapidly increasing senior population.

“We are asking all elected leaders and regulators to stop working in a vacuum and collaborate with health care providers to better support, sustain and enhance care. Drop the talking points and engage in real conversations. Be the advocates for long-term care our aging population needs right now.”

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