HARRISBURG — A state lawmaker has introduced legislation that would require state inspectors to make at least one unannounced inspection at nursing homes each year.

State Rep. Anthony DeLuca (D-Allegheny County) said Friday that the need for greater oversight of long-term care facilities predated the pandemic.

The facilities need stricter oversight because families may be afraid to complain if they believe there are problems, he said.

“I don’t think families say anything sometimes because they’re worried about what will happen to their relatives. If they don’t think they can take their relative out of the facility, they worry that if they complain that it will be taken out on their relative,” DeLuca said.

DeLuca said he was drawn to the issue when he learned about problems involving the care of one of his own relatives.

When he then began to research the issue, he decided legislation was needed, DeLuca said.

He said he’s heard concerns about things like facilities employing inadequate staffing levels during the week when relatives are less likely to visit and then boosting staffing levels for the weekend when visits are more likely.

His legislation would focus on nursing homes, but would not cover personal care homes, which are not required to provide the same level of nursing care.

On Thursday, Acting Secretary of Health Alison Beam said that the department encourages people with concerns about nursing home care to notify the department, adding that anonymous complaints are allowed.

“If you see something wrong happening in a nursing home, please speak up. We are listening,” Beam said. “The department investigates all complaints and takes further action if necessary to ensure out-of-compliance actions are corrected to better protect and provide the best support for our most vulnerable Pennsylvanians.”

Individuals with complaints about a nursing home can file that complaint with the department in several ways. Complaints can be made anonymously by calling 1-800-254-5164, filling out the online complaint form (health.pa.gov) or emailing c-ncomplai@pa.gov.

In January, Department of Health nursing home surveyors conducted 712 inspections, including 351 complaint investigations, of 472 separate nursing homes. Of these, 222 were COVID-19-specific investigations. However, there were no new sanctions finalized against a nursing care facility in the month. The department oversees 692 nursing homes and more than 88,000 beds within nursing homes in Pennsylvania.

“The Department of Health investigates all complaints made to the department regarding nursing homes,” said Maggi Barton, a Department of Health spokeswoman. “These complaints can be regarding a number of factors, including but not limited to, building safety, COVID-19 compliance, etc.” 

The state stopped doing annual inspections of nursing homes last spring but resumed them on June 1, she said.

There were 5,033 total nursing home inspections completed between March 1, 2020, and Thursday, she said. Those surveys revealed 2,246 violations. More than half, 2,693 of the inspections were triggered by COVID-19 concerns, and those COVID-19 inspections revealed 845 violations, Barton said.

In Pennsylvania assisted living facilities and personal care homes are regulated by the Department of Human Services. Nursing homes are regulated by the Department of Health.

There are approximately 1,200 licensed personal care homes in Pennsylvania and nearly 35 licensed assisted living residences according to the Pennsylvania Health Care Association, the trade group representing long-term care facilities.

On Feb. 14, inspectors from the Department of Human Services helped relocate 21 residents of Sunshine Corners, a personal care home in Sunbury, after officials investigating a COVID outbreak there discovered other code problems.

DeLuca said he thinks families are typically in a better position when dealing with concerns about personal care homes because they are more likely to be directly involved in paying for the care, compared to nursing home residents whose care is often covered by Medicaid.

A personal care home is a facility where the resident will receive some assistance eating, with personal hygiene and cleaning but don’t require nursing care, according to the Department of Human Services. The Department inspects each PCH annually and conducts investigations into complaints and unusual incidents.

Personal care homes and assisted living facilities are similar. Assisted living residences are required to offer living units with kitchenettes and private bathrooms while personal care homes may offer a variety of living arrangements. The level of care provided in an assisted living facility can be higher than that in a personal care home, according to the PHCA.

The state stopped conducting annual in-person inspections last March when the COVID-19 pandemic erupted, said Erin James, a Department of Human Services spokeswoman.

“On-site annual licensing inspections resumed in October at personal care homes and assisted living facilities. Onsite incident investigations and complaint monitoring never stopped,” she said.

When inspectors weren’t physically visiting facilities for the licensing inspections, they continued to conduct those inspections remotely, she said.

“Regulatory compliance is measured through observation via real-time audio/video communication with provider staff who are physically present at the facility and via file-sharing methods that allow records and other documentation to be reviewed at an offsite location,” she said.

James said that inspectors conducted 1,272 complaints or “incident” driven inspections of personal care homes last year. In addition, there were 273 renewal inspections.

There were 67 complaint or incident-triggered inspections at assisted living facilities, and 13 renewal inspections of assisted living facilities. 

John Finnerty reports from the Harrisburg Bureau for The Meadville Tribune and other Pennsylvania newspapers owned by CNHI. Email him at jfinnerty@cnhi.com and follow him on Twitter @cnhipa.

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