EAST PENNSBORO TWP, Pa. (WHTM) — Usually, whoever’s picketing outside a business is upset at whoever’s inside running the business. But Liz Wright, a certified nursing assistant (CNA) picketing Wednesday outside The Gardens at West Shore, a Camp Hill-area nursing home, says that’s not necessarily the case in this instance.

“It’s not management against the union,” said Wright, a member of SEIU Healthcare PA. “It’s not us against them. It’s all of us as one, as a whole — the whole building.”

The union’s demands are familiar: better pay, benefits, and working conditions. But rather than demanding that from management at the dozens of nursing homes where workers picketed simultaneously across Pennsylvania, the union is asking this of government — the Republican-controlled legislature and Gov. Tom Wolf, a Democrat, alike.

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The reason? Because nursing home funding comes mostly from government — fully 70%, largely from Medicaid, according to figures cited by both the union and the Pennsylvania Health Care Association (PHCA), which represents long-term care facilities. Historically, the two have been on different sides of issues.

To be sure, it’s not as though they now see completely eye to eye.

“There’s got to be accountability,” said Matthew Yarnell, president of SEIU Healthcare PA. “If there’s going to be more public dollars moved into the industry, then the industry has got to be willing to be accountable to spend those public dollars on bedside care” — on frontline worker salaries and benefits and on reducing patient caseloads, for example, rather than shareholder dividends and management salaries.

But most of the problem, he said, is there’s simply not enough money to go around.

“Years ago, long-term care competed against hospitals and other healthcare services,” said Zach Shamberg, president and CEO of PHCA. “Today we’re competing with Sheetz and Walmart and Wawa.”

And not only them.

“My daughter went to McDonald’s making $16” an hour to start, Wright said. “I’ve been doing this job for over 25 years and she’s making almost just as much as I am.”

A job she said she’s proud to do, but not an easy one: “I’m only 50 years old, and my back hurts.”

Yarnell said the union wants CNAs like Wright to start at $20 per hour, licensed practical nurses (LPNs) to start at $25, and no one working in nursing homes to start at less than $16.

And as for worker caseloads?

“The days of one caregiver trying to take care of 16 to 20 residents have got to be over,” he said. Eight to 10, he said, would be more reasonable.

Shamberg wouldn’t commit to those targets but again said the main barrier is funding — hundreds of millions of dollars annually, he said, to make up for the fact that Medicaid reimbursement rates haven’t increased since 2014 even though the cost of nearly everything else has increased.

“That can’t happen anymore, especially after the last two years” of the COVID-19 pandemic, Shamberg said.