Testimony on Nursing Home Stability and Costs
Thursday, April 9, 2026
Louise Santee, SEIU Healthcare PA member at Phoebe Home
My name is Louise Santee, and I am a certified nursing assistant and medication technician at Phoebe Home. I want to first thank Senator Miller for inviting me to speak. This year, August 4th, marks 30 years that I’ve been at this nursing home.
I’m very proud of Phoebe. I don’t see this as “just a job.” This is work from the heart. But it’s beginning to be a little tough sometimes. That is why I’m speaking to you all today.
When I first applied to Phoebe, there was a waiting list to get in the door. Can you imagine that? I was so happy when I got the call to come in. That was the place to work. We had an excellent reputation. Why isn’t there a waiting list anymore? It’s not just Phoebe. It’s this way at every nursing home and across the whole system.
Today, there is a higher acuity of care in residents. People are staying at home longer because they cannot afford to come to the facility. People live their lives without receiving the care they should because they cannot afford healthcare. This means by the time our patients arrive at the facility, it takes more staff and more supplies to care for them properly.
If acuity is getting higher, there should be more staffing. But we are seeing the opposite. When I first came to Phoebe, we were fully staffed. We had 5 aides on a floor caring for 48 to 50 residents, and we had a bath person – just for baths! Now there are usually no more than 4 aides. Short staffing leads to turnover. New people with no experience are less likely to stay when they are thrown to the deep end, overwhelmed, and undercompensated. Caregivers who have been in this for decades are doing more with less.
We rush to provide basic care. We have a saying: Face, hands, bottom. I’ll do my damndest to get everything done, but it is a struggle. I will circle back and do it if I have to, but not everyone does that. Residents say the pullups are different and don’t hold anything. Families ask “what’s going on with mom’s hair? The soap is not as good.”
I buy my own Dove bodywash for residents, because it’s gentle and smells nice. Every year, I go nuts for the Bath & Bodyworks sale at Christmas. I get every single resident, man or woman, a bodywash and a spray. One lady loves cucumber melon. I love going around with my cart giving it out.
This is not just a job, and it shouldn’t just be a business. Phoebe was always resident-centered. We have something called the Phoebe Mission. It didn’t matter where you worked before. What you learned, forget it. You had to learn the Phoebe Mission: “Honoring God and relying on God’s grace, we strive to have these values govern our behaviors and actions within the communities we serve.”
- Faith in Action Values
- Accountability
- Compassion
- Ethical Conduct
- Fruits of the Spirit
- Integrity
- Respect
- Stewardship
When companies and owners treat this more like a business and less like a mission, it trickles down. We have to pay and respect the care and the workers providing it. These have to be valued jobs.
We need funding to increase staffing and supplies. People will not be overwhelmed, able to do a good job, and keep up their morale. This is the key to recruitment and retention. I support updating the Budget Adjustment Factor this year with a bottom floor of 90%. I don’t think it makes sense to keep following an unpredictable formula. It will also allow us to invest more funds into staffing now.
We also need accountability. When care-cutting owners are allowed into Pennsylvania, it taints the whole ecosystem. It makes all other owners think it’s okay to begin cutting small corners, big corners.
I’m lucky to be a part of a union. As union members, we discuss with management how we can invest funds into the workforce – training bonuses, shift differentials, and longevity. I know that there is also an existing positive model between the Pennsylvania Health Care Association, responsible owners, and union caregivers where we work together to improve staffing.
People entrust their most precious people to us to take care of to the best of our ability. We need the funding, staffing, and accountability to do that.
When residents come to my nursing home, I tell them: “I know this place is not home to you. But I will try to make it the absolute best that I can.” Because they deserve that. The elderly are the backbone of our country. They didn’t have electronics. They didn’t have computers. They did hard manual labor, even the women. They deserve the best ends of their lives that we can give them.
There has been so much change in nursing homes, including Phoebe. But we have the power to intervene and change the course. Thank you for this opportunity to speak.