Pennsylvania Nursing Home Oversight Lacking, Will Suffer As Elderly Population Increases: Report

A new report warns that Pennsylvania nursing homes may not be ready for a coming influx of residents as Baby Boomers age, raising concerns about the risk of nursing home neglect and the quality of care that will be provided at facilities throughout the state as the population ages.

Pennsylvania Auditor General Eugene DePasquale issued a special report (PDF) last week, which outlines the condition of the state’s nursing homes. The report contains nine observations and 30 recommendations, which investigators said the state should adopt to prevent neglect and abuse problems in Pennsylvania.

Chief among those recommendations are calls for clear policies for vetting nursing home operators, a call for better data to be able to tell which facilities are improving, stronger collaboration between state agencies, and that there should be efforts to bolster the elder care workforce in the state as well.

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The report is a follow-up to a 2016 audit, which found that the state’s Department of Health had failed to adequately review nurse staffing levels, complaints and sanctions against facilities.

DePasquale determined that the state is currently not ready to deal with the coming growth in the elderly population.

“Right now, there are nearly 90,000 Pennsylvanians living in more than 700 nursing homes,” DePasquale said in a press release. “Not only can Pennsylvania do a better job in ensuring the safety of today’s older adults, but we must also get ready for the huge numbers of people who will need care in the not-so-distant future.”

The report estimates that by 2030, there will be 38 dependent older adults for every working-age resident, and that by 2040, nearly a quarter of Pennsylvania’s residents will be 65 or older.

The report also found that since the 2016 report, the state has come to rely more on direct monetary fines than provisional licenses, which are temporary licenses indicating a facility is under review and must improve to continue operations. In 2017, the ratio of fines to provisional licenses was 3-to-1. By 2018, that ratio had changed to 55-to-1.

While the state Department of Health claimed the shift was just an issue of the types of deficiencies, and not reflective of any policy shift, reviewers questioned whether the agency is just relying on them too heavily.

The report also noted that in many areas of the state, quality older adult healthcare is either difficult to find or expensive, and that public and private systems are ill-prepared for handling and preventing cases of nursing home abuse as the number of nursing home residents begins to rise dramatically in the coming years.

DePasquale and the report note that it is up to state legislators to put policies in place to address these problems.


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