Zach Shamberg headshot
Zach Shamberg

The Pennsylvania Legislature is working on legislation to ease workforce shortages in the senior living industry and create a permanent pathway to employment as the state’s older adult population climbs.

During a call with the media on Thursday, Pennsylvania Health Care Association President Zach Shamberg shared information on two companion bills in the state Senate and House of Representatives that seek to address those workforce challenges.

SB1268, introduced by Sen. Judy Ward (R-Hollidaysburg), and HB2380, introduced by Rep. Curt Sonney (R-Erie), seek to amend current state law, allowing temporary nurse aides (TNAs) hired during the COVID-19 pandemic to be placed on the state’s Certified Nurse Aide Registry and be eligible for permanent employment at long-term care facilities, including assisted living communities.

During the pandemic, federal and state regulatory and statutory provisions were waived by the Centers for Medicare & Medicaid Services and Pennsylvania Gov. Tom Wolf to assist in the hiring of TNAs in senior living and care facilities. 

“While this has resulted in many temporary nurse aides being hired, these individuals will have to leave their job once the waivers expire, because they will not be deemed qualified or eligible for the state Certified Nurse Aide Registry, which is necessary for all nurse aides to work in a long-term care facility,” Ward said.

SB1268 has 16 bipartisan co-sponsors and recently was referred to the state Senate Education Committee. HB2830 has 12 co-sponsors and was referred to the state House Committee on Aging and Older Adult Services.

Pennsylvania is the third oldest state in the nation in terms of population, Shamberg said, and is three to five years away from the “silver wave,” when baby boomers will age into the demographic of needing long-term care services.

“Various studies show that we don’t have the workforce available to ensure quality care for our senior citizens,” Shamberg said, adding that PHCA has partnered with local and state groups to address workforce challenges facing providers, including improving training, retention and career investment. “The challenges in long-term care were exacerbated by COVID-19, none more than the workforce crisis,” he said.

To help alleviate some of these challenges, Shamberg said, CMS suspended many regulatory and statutory provisions, including a waiver giving providers the ability to recruit and hire TNAs to provide aspects of resident care, including activities of daily living support, infection control and prevention and nutrition. TNAs were required to complete an eight-hour online training course and go through hands-on training at long-term care facilities. 

Since the TNA program was formally approved in Pennsylvania in April, more than 2,500 individuals completed the training and were hired at assisted living communities, personal care homes and nursing homes in response to COVID-19. 

“At a time when tens of thousands of Pennsylvanians were losing jobs, long-term care was hiring,” Shamberg said, adding that nearly 70% of PHCA members have hired TNAs. “When these waivers expire and state emergency declarations end, these TNAs will be forced to vacate their jobs because they are not deemed qualified or eligible for the state nurse aide registry. Thousands of jobs created will all be lost in an instant.”

PHCA worked with Ward, a former nurse and chair of the state Senate Aging and Youth Committee, and Sonney, chair of the state House Education Committee, to draft legislation to amend current state law to allow TNAs to be placed on the state registry and continue to provide care in Pennsylvania long-term care facilities.

“The legislation would provide a path to full-time employment as a certified nurse aide for those who have served admirably and compassionately as a nurse aide during the severe challenges of caring for our most vulnerable during the COVID-19 pandemic,” Ward said, adding that she hopes to “get something done” by the end of the year. “After everything TNAs have done, it just seems very common sense to be able to do this.”  

“One of the good things that can come out of COVID-19 is the ability for TNAs to be able to continue to do what they have been doing and continue to work and serve our elderly residents,” Sonney said. “They are absolutely an essential function in our healthcare community, no matter what setting.”

Shamberg said this legislation is a way of “building the workforce pipeline” and getting younger Pennsylvania residents interested in careers in long-term care.

“Think about the jobs that are going to be here not just in two to three years, but in 10 to 20 years — long-term care is it,” Shamberg said. “The more interest we can garner for a position like this, with online training and easy access to learning, is a home run for providers across the state.”