newsPa’s home healthcare crisis: Low Medicaid rates drive nursing shortage Stagnant state reimbursement rates have left thousands of shifts unfilled, forcing families of medically fragile children to fight for life-sustaining care. 9 Min Re

Zayva McCachren is one of the oldest living children in the world with a rare terminal condition known as sphingomyelin phosphodiesterase-4, or SMPD4. She is 7. SMPD4 is a gene in the human body, and deficiencies cause severe neurodevelopmental disorders, including a significantly smaller head and stiff or fixed joints.