Mark Pinsley, the Democratic nominee for Pennsylvania Senate District 16, believes people should age with dignity, not debt.
A semi-private nursing home room in Pennsylvania costs about $142,000 a year. The average Pennsylvanian 65 or older has an income of about $56,000. (AARP Pennsylvania, via Central Penn Business Journal) At one of the hardest moments in a family’s life, the math pushes people to drain their savings, or their parents’ savings, just to pay for care.
Pinsley would:
- Protect home care, nursing homes and rural hospitals in the state budget.
- Make sure no one loses coverage over a missed form or a confusing system.
- Raise wages for home care and nursing home workers, so the care actually exists.
- Tighten the rules on who can own a nursing home, so facilities aren’t gutted by absentee investors. His Private Equity Accountability Act would let the state block those deals. More: What is Mark Pinsley’s position on private equity buying up hospitals, nursing homes, and housing?
What Medicaid cuts would mean for Cedarbrook
In May 2025, before Congress passed its Medicaid cuts, Pinsley’s office published a special report on what they could do to the county’s nursing home. (Special Report, The DOGE Effect, May 14, 2025 — a special report, not an audit)
Medicaid already doesn’t cover the cost of care. Cedarbrook spends about $12,700 a month per resident. Medicaid pays about $8,300. The county fills a gap of about $36 million a year with other state and federal grants that aren’t guaranteed.
A 10% Medicaid cut would cost Cedarbrook about $7 million a year on top of that.
And families could be handed the bill. Pennsylvania’s filial responsibility law lets a nursing home sue a resident’s adult children, spouse or parents for unpaid care, even if they never signed anything. In 2012, a Pennsylvania court ordered a son to pay $93,000 for his mother’s nursing home care. Most people don’t know the law exists.
The report recommended that the county commit never to use the law against Cedarbrook families, and that the General Assembly end or reform it before Medicaid cuts take hold. As a state senator, Pinsley could take up that reform. More: What is Mark Pinsley’s plan to lower healthcare and prescription drug costs?
Three audits, until it was fixed
- 2020: His office found more than $450,000 in unpaid bills from residents’ private payments that were likely to be written off, plus weak controls over billing. (Report 20-01)
- 2021: It went back. Nothing had been fixed. First-month payments were weeks late, two residents never paid at all, and two were admitted without a signed agreement. (Report 21-12)
- 2023: It went back a third time and found real progress on billing and collections, with some areas still needing work. (Report 23-08)
To be clear: the old $450,000 wasn’t recovered. What got fixed was the process that caused the loss. A nursing home that collects what it bills isn’t quietly using taxpayer money to cover unpaid care.
This is the part of long-term care nobody campaigns on. Staffing and wages get the attention. Whether the billing office collects the first month’s payment on move-in day doesn’t — but it’s the difference between a nursing home that stays solvent and one that doesn’t.
His priorities
Protect the care. Home care, nursing homes and rural hospitals are the first things cut when budgets get tight, because the people who rely on them have the hardest time fighting back. Pinsley would use the state budget to protect them.
No one should lose care over paperwork. People often lose coverage not because they stopped qualifying, but because a notice went to an old address, a form was confusing, or they couldn’t get through on the phone. The fix is cheap compared with what it prevents.
Raise wages. The shortage of care workers is a pay problem. When a nursing assistant can earn more in retail, with less physical and emotional strain, the shortage isn’t a mystery.
Tighten ownership rules. Nursing homes have been a favorite target of investment firms that load them with debt and cut staff. Pinsley’s proposed Private Equity Accountability Act would require public hearings, review by the Attorney General and approval by the Department of Health before an investor could buy a nursing home, so a deal that would cut care could be blocked. More: What is Mark Pinsley’s position on private equity buying up hospitals, nursing homes, and housing?
Common questions
“Can the state afford it?” Good care keeps people out of the emergency room. Preventing a fall at home costs far less than treating a broken hip.
“Shouldn’t families, especially spouses, take care of their own?” They already do most of it, unpaid, at real cost to their jobs and savings. Public support helps them keep going. Today, a spouse can’t be paid as a personal care assistant, even after giving up a job to provide care.
“Shouldn’t the market set caregiver pay?” It has — and the result is a constant shortage.
District 16 covers parts of Lehigh and Bucks counties. The general election is November 3, 2026.
