House Co-Sponsorship Memoranda

In the near future, I plan to offer legislation that would require nursing homes meet a minimum level for nurse aide (CNA) staffing.

In Pennsylvania, the staffing standard of 2.7 hours of care per resident day includes Registered Nurses (RN), Licensed Practical Nurses (LPN), and Certified Nurse Aides (CNA). The Department of Health posts staffing levels but does not break this out by RNs, LPNs, or CNAs nor is there a minimum requirement for CNA staffing.

Numerous studies point to the relationship between nursing home staffing and quality care. In particular, CNA hours per resident day are strongly associated with better scores on certain quality measures and lower hospitalization of residents. Staffing levels have been documented to be related to both the process and the outcomes of nursing home care such as fewer pressure sores, improved functional status, better mortality rates, and fewer deficiencies for poor quality.

Given the importance of CNA staffing to the quality of resident care, any increase in direct care provided by CNAs will improve the quality of care and quality of life for residents.

My proposal will help ensure a minimum level of quality care by requiring all nursing homes meet the current median CNA staffing level of 2.15 hours of care per resident day. If a DOH inspector finds a home with a CNA staffing level below the current median, DOH would cite the home for failure to meet state staffing standards and require a plan of action to increase staffing levels to meet the state median.