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Pennsylvania Proposes Second Round of Ongoing Regulatory Changes for Long-Term Nursing Facilities | Ballard Spahr srl


The Pennsylvania Department of Health recently released the second of five expected sets of proposed changes to the regulation of Commonwealth long-term care facilities. The regulatory overhaul began over the summer with the publication of the first set of proposed revisions.

The result

  • Pennsylvania this month proposed the second of five expected sets of changes to Commonwealth nursing home regulations.
  • The second set includes the proposed changes to the regulations governing the closure of facilities, the applicability of the Personal Safety Code and standards relating to the physical environment and equipment.
  • In addition, the Pennsylvania Department of Health tentatively describes the scope of regulatory changes to be stated in each of the remaining packages. Future packages will likely concern the licensing of facilities, disaster preparedness, the multitude of services offered in regulated facilities, and residents’ rights.

The bottom line

The second set of proposed regulations seek to revise or remove duplicative or conflicting requirements between state and federal standards applicable to long-term nursing facilities. The proposed regulations would amend the standards for closing a long-term care facility, remove certain physical storage standards and standards from the Personal Safety Code as duplicating federal requirements, and clarify certain requirements for the renovation or construction of new establishments compared to existing establishments.

Governor Wolf’s administration continued to release regulations as part of the Commonwealth’s first overhaul of long-term care facility regulations since 1999. On October 9, 2021, the Pennsylvania Department of Health (the Department) published the second set (out of five sets) of regulations proposed in the Pennsylvania Bulletin. The ministry is still finalizing three more sets, but has released draft proposals for the content of each. Future revisions are expected to include proposed revisions to regulations related to licensing of facilities, disaster preparedness, resident rights, and the range of professional services offered at regulated facilities.

The second round of proposed regulatory revisions focuses on standards related to the construction, alteration or closure of facilities. Primarily, the Department aims to eliminate provisions of relevant Pennsylvania law that conflict or duplicate federal standards.

Concretely, the Ministry proposes:

  • Reduce or eliminate state requirements (to the extent that they conflict with federal law) to notify the ministry or residents of the impending facility closure;
  • Remove the requirement for licensed establishments to file proof of financial accountability with the Ministry (as federal law already requires certain plans for the continued payment of salaries and other expenses throughout a facility closure process) ;
  • Remove regulations related to the application of the Personal Safety Code (as it is incorporated by reference into the federal requirements that the Commonwealth intends to adopt for all long-term care facilities); and
  • Separate regulations pertaining to alterations, renovations and construction to clarify which standards apply to alterations, renovations or new and existing construction.

The Department is proposing a number of changes in the latter category. These proposed changes relate to regulations governing building plans, residents’ rooms, locks, utility room, utility rooms, bathrooms and bath facilities, linens, supplies, windows, meals, lounges , plumbing and other aspects of buildings and grounds.

In addition, the Department will maintain the current restrictions on the requirement for residents to leave within 30 days of receipt of the applicable notice. Finally, the Department is proposing to modify housekeeping and maintenance standards by removing certain requirements relating to ice containers and storage.

The Department does not expect the second round of proposed changes to increase costs for various stakeholders. For the Department, consistency between state and federal laws should streamline the Department’s investigative processes and clarify the applicability of the standards to new modifications or constructions compared to those applicable to existing facilities. The ministry expects little to no financial impact on the 689 licensed long-term nursing facilities in the Commonwealth. Only three of these facilities do not participate in Medicare or Medicaid, and all the others must already be in compliance with federal regulations. For the Commonwealth in particular, the department does not expect the proposed settlement to increase the costs of Pennsylvania County-owned facilities (of which there are 20, accounting for about 8% of total beds). The Department does not expect increased costs to the general public.

Comments on the draft regulation can be submitted within 30 days of posting. The Ministry prefers to receive comments by email at [email protected]. Ballard Spahr’s health attorneys in Pennsylvania will continue to provide updates on the rollout of these proposed rule sets as they become available.

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