Department of Health Announces Public Comment Period for Final Package of Proposed Regulations to Improve Skilled Nursing Facility Care

The Pennsylvania Department of Health today provided an update on the fourth and final package of proposed skilled nursing facility regulations that includes updates to align with federal regulations; increases per-shift staffing minimums for registered nurses and licensed practical nurses and establishes per-shift minimums for nurse aides. This package of proposed regulations was published in the Pennsylvania Bulletin on May 28. At that time, a 30-day public comment period started.

“It is important to establish these per-shift minimum staffing requirements to help ensure that appropriate care is provided around the clock,” said Department of Health Acting Secretary and Physician General Dr. Denise Johnson. “This package addresses residents’ rights and care plans, bringing us further in line with federal requirements and placing an emphasis on person-centered care.”

Regulations of Pennsylvania’s 685 skilled nursing facilities, where more than 72,000 people live, have not been updated in nearly 25 years.

The department encourages all interested stakeholders, including industry groups, resident advocates and the general public to read and comment on the proposed regulations within this time period. The regulations are published both on the Pennsylvania Bulletin website and the IRRC website and comments may be submitted to the Department of Health via email:

This is the final package of proposed regulations that are based on the latest research, input from subject matter experts and industry stakeholders and informed by lessons learned during the COVID-19 global pandemic. In addition to addressing nursing staff requirements, the proposed package establishes protections against discrimination on the basis of gender identity or expression, modernizes the language and requirements related to the use of restraints, and aligns with federal requirements related to resident care plans and resident rights.

The department is concurrently working on the final-form regulations for the first three packages of regulations and will consider comments on all four packages before submitting final-form regulations. The regulations will apply only to the 685 skilled nursing facilities licensed by the Department of Health. Personal care homes and assisted living homes typically housing residents with less acute health care needs are regulated by the Department of Human Services under separate regulations.

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