Pennsylvania’s Home Care Crisis: Families, Seniors, and People with Disabilities at Risk

Pennsylvania is facing a growing crisis in home care—a system designed to allow seniors and people with disabilities to live safely and independently in their own communities. According to the Pennsylvania Homecare Association, the situation has reached a breaking point, with 112,000 missed shifts per month and families increasingly left without the support they need.

For many Pennsylvanians, home care is not a luxury. It is the lifeline that keeps them out of hospitals and nursing facilities. Yet as reimbursement rates stagnate and workers leave for better-paying jobs in retail, hospitality, or nursing homes, the entire industry is buckling. The consequences for vulnerable residents are devastating.

The Financial Strain Behind the Crisis

At the heart of the problem are Pennsylvania’s Medicaid reimbursement rates. Currently set at $20.63 per hour, these payments are significantly lower than those in neighboring states. Operational costs, insurance, and taxes are deducted. Therefore, home care workers are left with wages that cannot compete with other job markets.

The impact is stark. Agencies cannot hire or retain enough staff. Families are left waiting for care that never comes. And the very individuals home care was meant to serve—seniors, people with disabilities, and children with complex medical needs—are left at risk.

By contrast, states like West Virginia have increased rates to over $25 per hour, and New Jersey has implemented incremental raises tied to the cost of living. Pennsylvania, however, has lagged behind—leaving it 23% below the baseline identified in its own state-commissioned study.

Human Consequences of Missed Shifts

The statistics are alarming: more than 112,000 missed shifts every month. But behind each number is a real person.

That could mean an elderly woman left in bed for hours because no caregiver arrived to help her up. A child with medical needs left vulnerable when a nurse or aide isn’t available. A senior who misses a meal or vital medication.

As Mia Haney, President of the Pennsylvania Homecare Association, explained to The Center Square:

“That’s 112,000 plus times a senior, an individual with disabilities is sitting there, waiting for someone to show up, and no one’s coming. Frankly, that’s just unacceptable, and Pennsylvania needs to do better.”

For families, the uncertainty is exhausting. Many must choose between stepping in themselves—at great personal and financial sacrifice—or sending their loved ones to nursing homes or emergency rooms. Ironically, both of those settings cost the state significantly more than home care.

An “Institutional Bias”

Part of the crisis lies in how Medicaid categorizes care. Nursing home care is treated as a mandatory benefit, while home care remains optional. This reflects what advocates call an “antiquated institutional bias”—a mindset that prioritizes facilities over home- and community-based solutions.

Yet, research shows that aging in place produces better health outcomes and quality of life. Home care also functions as preventative care: caregivers notice small changes in condition and alert doctors before issues escalate into emergencies. Without these safeguards, patients often end up in hospitals, where costs and risks are higher.

The Legislative Battle

Despite bipartisan recognition of the problem, meaningful reform has stalled. Advocates pushed for at least a 10% rate increase in the upcoming budget, far short of the full 23% needed, but even that seems unlikely.

Haney described the stalemate in stark terms:

“We hit the iceberg and it’s just whether we’re gonna let the ship sink. We’re taking on water actively… this is only going to take us so far, and we really needed our legislators to do more than just verbally tell us they support us.”

Without action, more agencies will close their doors to Medicaid patients, leaving thousands on waiting lists and pushing them into costly institutional care.

Why This Matters for Families

For Pennsylvania families, the crisis is personal. It’s about whether parents, grandparents, and children with special needs can stay at home with dignity—or whether they will be forced into facilities against their wishes.

The situation also raises questions of accountability. When a state knowingly underfunds home care to the point where basic services cannot be delivered, vulnerable residents bear the brunt of systemic neglect.

KBD Attorneys’ Perspective

At Ketterer, Browne & Davani (KBD Attorneys), we have seen firsthand what happens when health systems and care providers fail to protect vulnerable populations. Many of our cases involve nursing home neglect, wrongful death, and abuse—tragedies that could have been prevented if adequate care and oversight were in place.

This home care crisis is another dimension of the same problem: systemic underinvestment in the people and services that protect our most vulnerable citizens. Whether in a nursing home or at home, patients deserve safe, consistent, and compassionate care.

Families who suffer because of missed care, neglect, or preventable harm have legal rights. While raising reimbursement rates is a legislative battle, holding providers accountable when they cut corners or abandon patients is a fight that can and must happen in the courts.

Moving Forward

Pennsylvania cannot afford to ignore its home care crisis. Advocates are right: investing in home care saves money in the long run while preserving dignity and independence for residents. Failure to act only shifts costs to hospitals, nursing homes, and grieving families.

At KBD Attorneys, we stand with families navigating these challenges. Whether through legal action against negligent providers or advocacy for systemic change, we are committed to protecting the rights of seniors, people with disabilities, and all those who depend on care to live safely at home. Contact us if you want to take legal action for your loved one.

Source: the center square