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PRINTER'S NO. 1558
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE RESOLUTION
No. 238
Session of
2026
INTRODUCED BY FARRY, PENNYCUICK, KEARNEY, FONTANA, J. WARD AND
VOGEL, APRIL 1, 2026
REFERRED TO HEALTH AND HUMAN SERVICES, APRIL 1, 2026
A RESOLUTION
Directing the Legislative Budget and Finance Committee to
conduct a study and issue a report on reimbursement rates and
workforce issues for shift nursing services provided to
individuals under Pennsylvania's Medical Assistance program.
WHEREAS, Shift nursing services are a critical component of
care for medically fragile individuals, including children and
adults with complex health needs who require extended skilled
nursing support in home settings; and
WHEREAS, The availability of qualified shift nurses to
provide care has been significantly impacted by workforce
shortages, missed shifts, rising cost to care, reimbursement
disparities, including rates in surrounding states, differences
in reimbursement rates across the medical assistance system and
rising operational costs; and
WHEREAS, Current reimbursement rates for shift nurse services
under Pennsylvania's Medical Assistance program does not reflect
the true cost of care delivery, contributing to shift nurse
attrition and reduced access for vulnerable populations; and
WHEREAS, Families and providers across this Commonwealth have
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reported increasing difficulty securing consistent nursing
coverage, resulting in hospital readmissions, caregiver burnout,
underemployment and unemployment, out-of-home placements of
children and disruptions to patient stability and safety; and
WHEREAS, A data-driven rate study is necessary to evaluate
the adequacy of existing reimbursement structures, assess
regional and acuity-based cost variations, wages and benefits
and inform future policy and funding decisions to stabilize and
strengthen the skilled nursing workforce for the families who
rely on it; therefore be it
RESOLVED, That the Senate direct the Legislative Budget and
Finance Committee to conduct a study and issue a report on
reimbursement rates for shift nursing services provided to:
(1) individuals under 21 years of age who are eligible
for Medicaid-paid in-home shift nursing services; and
(2) individuals over 21 years of age who are eligible
for Medicaid-paid in-home shift nursing services;
and be it further
RESOLVED, That the study shall determine appropriate
reimbursement rate ranges for shift nursing services and include
consideration of the following:
(1) Analysis of the current pediatric and adult nursing
and home health aide reimbursement rates and methodologies in
each Medical Assistance funded program, including
HealthChoices, Community HealthChoices, fee-for-service and
waivers offered by the Office of Developmental Programs and
Office of Long Term Living.
(2) Review of current rates in bordering states and
additional comparable states, as appropriate.
(3) Evaluation of potential cost savings from in-home
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nursing care versus inpatient settings, including hospital
and long-term care facilities for children and adults, taking
into consideration the cost to hospitals of unreimbursed
care.
(4) Assessment of authorized versus filled hours
separately for children and adults receiving services in each
Medical Assistance funded program, including HealthChoices,
Community HealthChoices, fee-for-service and waivers offered
through the Office of Developmental Programs and the Office
of Long Term Living, and the potential impact of rate changes
on unfilled and missed shift percentages and on network
adequacy, with analysis on urban, suburban and rural areas.
(5) Engagement with providers who offer home health care
and skilled nursing to this population, Medicaid recipients
of skilled nursing services, including their families,
caregivers and advocacy groups.
(6) Review of industry standards, provider and other
relevant data and publicly available sources such as
applicable Bureau of Labor Statistics occupation wage
studies;
and be it further
RESOLVED, That the Legislative Budget and Finance Committee
prepare a report of its findings and recommendations and submit
the report to the Senate no later than 12 months after the
adoption of this resolution.
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