Pennsylvania needs to immediately bolster its ranks of registered nurses, home-care workers and other professionals, or risk a “crisis” shortage of those workers as the state’s senior citizen population further swells in the coming years, Auditor General Eugene DePasquale warned Tuesday.

“By 2040, nearly a quarter of Pennsylvania’s population will be 65 or older,” DePasquale said in a statement released by his office. “That’s over 3 million Pennsylvanians who will likely need some kind of care, many of whom may lack personal financial resources or family support, and end up relying on taxpayer-funded programs like Medicaid.”

Meanwhile, officials at the Pennsylvania Department of Health, who have oversight of some 700 nursing homes across the state, say they’re still working to come into compliance with staffing issues, the handling of complaints, and other problems raised in a 2016 audit by DePasquale’s office.

That comes as the agency prepares its first rewrite of Pennsylvania’s nursing home regulations in two decades.

At a joint news conference Tuesday, DePasquale and state Health Secretary Rachel Levine discussed the agency’s current efforts as well as its attempts to address recommendations for additional improvements included in a follow-up report released by DePasquale’s office.

“There’s always more work to be done,” Levine said Tuesday.

.@PAAuditorGen and Health Secretary Rachel Levine talk about audit of Pa. nursing homes. pic.twitter.com/CDqebZ3mbb — Pennsylvania Capital-Star (@PennCapitalStar) July 23, 2019

Among the report’s recommendations:

The Dept. of Health needs to “adopt thorough, clearly outlined policies for vetting nursing home operators,” after DePasquale’s office found that one “financially unstable” operator had been granted a license after racking up a poor track record “in another jurisdiction.”

Pennsylvania needs to “develop stronger collaboration” between agencies to prepare for that wave of older Pennsylvanians, and to improve training and wages for the workers who will be charged with taking care of them. That effort should include the State System of Higher Education and Pennsylvania’s community colleges.

Levine said the Health Department has stepped up its enforcement actions, levying $1.9 million in civil penalties against violators since June. The agency has tried to “make sure that [we’re] fixing problems faster,” but that violators “are implementing solutions faster.”

The agency also hopes to have its first rewrite of Pennsylvania’s nursing home regulations since 1999 ready for public comment by year’s end. Levine could not say why the rules governing the care of tens of thousands of older Pennsylvanians had not been overhauled since the administration of former Republican Gov. Tom Ridge.

Asked whether the failure to update those regulations was a dereliction of responsibility by her predecessors, Levine said “I would think they would be updated more than once a generation.”

Thru June, DoH has hit nursing homes with $1.9m in civil penalties. Hope to update nursing home regs by year’s end. First such update since 1999, Levine says pic.twitter.com/RnPooaydq4 — ByJohnLMicek (@ByJohnLMicek) July 23, 2019

Improving wages for such lower-wage workers as nurses aides is a slightly tricker business, Levine and DePasquale acknowledged, saying it’s a task for the Legislature to work out.

According to industry data, those workers make between $11.14 an hour and $17.31 an hour depending on whether they work in a nonprofit or a for-profit facility.

Levine suggested Tuesday that legislative authorization of Gov. Tom Wolf’s proposal to increase Pennsylvania’s minimum wage from $7.25 an hour to $15 an hour by 2025 would go some distance to helping those workers. DePasquale further suggested that a higher wage would boost the economic fortunes of workers across the sector.

In a statement, LeadingAge Pa., an industry trade group that represents nonprofit nursing homes, said staffing issues in the industry “are directly tied to the continued lack of Medicaid funding provided by the administration and state lawmakers.”

“Not only are we losing some of our best employees, but gross underfunding makes it difficult to compete for new hires. Last year alone, providers lost more than $630 million serving Pennsylvania’s poorest older adults because Pennsylvania will not increase Medicaid funding,” the trade group’s president and CEO Adam Marles said in that statement.

“During 2019-20 state budget deliberations, LeadingAge PA aggressively advocated for a modest 2.8-percent funding increase to start addressing the problem but none was included.”

Read the full report below:

‘Who Will Care for Mom & Dad’ Audit of Pa. Nursing Home Staffing by jmicek on Scribd