Ensuring medically fragile children and their families have nursing care in their homes makes a critical difference in their daily lives. It is where they want to receive care and it’s a cost savings to the Commonwealth.

We need an accurate picture of the reimbursement landscape to better address gaps in care. I will be introducing a resolution requiring the Pennsylvania Department of Human Services (DHS) to conduct a comprehensive rate study of Medicaid-funded skilled nursing services—specifically Shift Nursing, also known as Private Duty Nursing (PDN). The study shall include both pediatric and adult Shift Nursing services.

The study would mirror the Department’s previous study of Personal Assistance Services (PAS) and other Home and Community Based Services (HCBS) reimbursement rates and costs of care, which provided critical insights to the rate structure and its effect on the rest of the system. PDN services face similar pressures, with providers struggling to retain nurses and families left without adequate help in a time of need.

Why this study is needed:

• Family and Patient Impact: Adequate Shift Nursing staffing allows medically fragile individuals—both children and adults— to remain out of more costly and less desirable institutional settings. Pediatric and adult patients and their families overwhelmingly prefer care at home, which results in better health outcomes.
• Reimbursement Rate Disparities: Current Medicaid fee-for-service rates for   Shift Nursing are significantly lower than those in neighboring states.

A formal rate study would provide transparency and ensure that Pennsylvania’s Medicaid program supports both the skilled nursing workforce and the families who rely on it to care for a vulnerable population.

I invite you to join me in co-sponsoring this resolution to advance access to care, sustainability, and accountability in our healthcare system.