President Joe Biden's administration has proposed nationwide minimum staffing requirements for nursing homes that would raise the bar higher than Pennsylvania just did with its first state-level update in decades. 

Per The Inquirer: Biden said other types of workers also provide essential care in nursing homes, and estimates that when they are accounted for residents will receive roughly four hours of care daily under his plan. That's more than the 3.2 hours Pennsylvania will require under its own expanded rules.

Patient safety advocates have long equated more direct care hours with better patient outcomes, and SEIU Pennsylvania, a union representing nursing home workers here, has applauded efforts to raise them. Nursing home owners, meanwhile, are calling this another "unfunded mandate." 

Find The Inquirer's paywalled report here: White House staffing requirements for nursing homes: What would they mean for Pa.?

THE CONTEXT: As Spotlight PA previously reported, COVID-19 highlighted the failure to improve nursing home oversight in Pennsylvania, one of the most elderly states in the nation, and the dangerously low staffing requirements noted by former state Auditor General Eugene DePasquale.

Here's a 2019 map of the best-staffed nursing homes in the state.

New staffing requirements followed under former Democratic Gov. Tom Wolf and began to take effect this summer; it was estimated that nursing homes would need to hire 1,400 nursing aides to meet the quota.

But care providers argued that the money wasn't there and that the state’s low Medicaid reimbursement rate remained a major roadblock. While Wolf signed legislation upping those state reimbursement rates, the rates change annually, and Biden's more stringent proposal has no funding attached. Providers say there's another angle to consider as well: An ongoing industrywide shortage of interested applicants.