Part 3: Writing their own rules

Kenney said he was amazed at the number and intensity of calls and visits he got from rural legislators who were concerned about the new rules.

"There were legislators coming to the committee saying, 'Look, here's Joe Blow who operates a little nine-bedroom home in my district, and he's upset, and I want to make sure he's protected,' " said Kenney, who replaced O'Brien in 2002 as chairman of the health committee.

Personal-care homes also pushed their residents to start a letter-writing campaign - with great success. Legislative offices were bombarded with handwritten, desperately-worded pleas from residents of the homes who believed the new rules would end up pushing them out on the street.

"There were a lot of letters. This was the hottest issue that legislators have brought to me in the sense of constituents on their backs," Kenney said.

In the end, he said, he believed the rules were a reasonable compromise that better protected residents.

Industry representatives made their arguments easy to digest.

"You can't regulate bad people from doing the wrong thing," said W. Russ McDaid, chief public policy officer of PANPHA, a trade and lobbying group that represents nonprofit personal-care and nursing homes.

In a newsletter, PANPHA said it had succeeded in making the final rules "much more workable." Among other things, PANPHA took credit for knocking out the requirement that a fire drill be conducted within five days of a new hire, saying it would be cumbersome.

Asked about the 55 fire deaths in personal-care homes, McDaid said: "I don't want to sound glib about this, but there are 1,700 personal-care homes. I don't know what that statistic means or doesn't mean. . . . I don't know whether that's high or not."

It's about three times the fire-death rate for the general Pennsylvania population, according to figures from the U.S. Fire Administration.

To demonstrate how flexible the Rendell administration had been, Richman testified before a state commission that she had "worked with the legislature" and the industry "to negotiate over 30 substantive changes" to the rules.

When the dust settled, part of the industry - mostly the larger, better-funded homes - had signed off on the regulations. But large segments remained opposed.

One group sued to overturn the regulations, arguing that they were illegal. Ultimately, the lawsuit was unsuccessful, and the rules are now in effect.

O'Brien, who often bucked his fellow Republicans on health-care issues, said they do not go nearly far enough.

"After what happened to William Neff, it's inexplicable to me," said O'Brien, referring to the Bucks County resident who was murdered in a poorly regulated personal-care home in 2000. "My position was, they should either operate under the same rules as nursing homes or they should be gone."

Rendell's chief regulator of personal-care homes called the rules a fair compromise.

"I actually think the providers were not as effective as they think they were in getting the stuff reduced," said Karen Kroh, who wrote the regulations.

"Our job was to balance business needs and costs with health and safety protections for residents, and we believe that we hit just the right balance."

Critics say the new regulations don't solve a fundamental problem: a shortage of inspectors.