Current Nursing Home Staffing Rules in Virginia

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Despite numerous pandemic deaths, Virginia still has no rules dictating minimum nursing home staffing requirements. According to recent AARP statistics, Virginia’s nursing home COVID-19 death rate is the country’s second-highest.

However, the state’s nursing home staffing issues began long before the pandemic. Some of Virginia’s nursing homes consistently receive low marks year after year, with several facilities garnering federal attention for immediate corrective action.

The lack of proper Virginia nursing home staffing requirements has contributed to many of the ongoing issues multiple facilities have encountered in recent years.

When there is a lack of staff, the residents are the ones who suffer. There tends to be a direct link between understaffing in a nursing home and increased neglect and abuse cases.

In 2019, Richmond Times-Dispatch published an expose on the problems plaguing some of Virginia’s nursing homes. The title tells you all you need to know: “Bedsores, burns and a maggot: 5 Va. nursing homes on federal list of persistent underperformers.”

Legislation to Establish Minimum Staffing Ratios Died

Despite the increase in deaths due to the pandemic, there’s still no current Virginia legislation addressing minimum staffing requirements for nursing homes.

2020 marked the 16th time a proposal to set minimum staffing requirements was brushed off, even though Virginia nursing homes continue to be ranked so low.

The proposal came from state Senator Jennifer Kiggans, R-Virginia Beach, who wants nursing homes to provide a minimum of one direct-care staffer per six patients.

The current reality is that some caregivers are assigned three to seven times that number. Some nurses have reported they are typically assigned anywhere between 20 and 40 patients every shift.

Nurses being overworked means they can’t adequately care for residents, ensure high-risk patients are appropriately monitored, etc. That is why neglect and abuse are rampant within the Virginia nursing home system.

Even though the proposal was shot down in 2020, legislators ordered the Department of Health to create a workgroup that would review and share recommendations on how to increase the Virginia nursing home workforce. 

Updates to the Proposal in 2021

Fast forward to 2021, and it’s now the 17th time this proposal was killed.

The workgroup held meetings, but when the final list came out, the top three recommendations out of 34 were focused on creating optional service-learning credits for students who were volunteering in these long-term care facilities.

Further down on the list were proposals that would pay facilities a higher Medicaid reimbursement amount if they achieved specific nursing home staffing ratios.

The first suggestion was to start at 12 patients to one caregiver and eventually reach the desired six-to-one ratio over the following four budget cycles.

Lobbyists for nursing homes voted against both of these recommendations. The Virginia Health Care Association—Virginia Association of Assisted Living, was against instituting any type of staff-to-resident ratio.

They argue that there needs to be more credentialed health care professionals in Virginia and that establishing staff-to-resident ratios isn’t going to work without having certified nurses who want to be there.

How Nursing Home Staff Ratios Contributed to COVID-19 Deaths

While staffing shortages existed long before the pandemic, COVID-19 exacerbated them, further contributing to the virus’s spread.

According to the Virginia Department of Health, long-term care facilities are the second biggest source of outbreaks. There have been over 31,000 cases of COVID-19 in long-term care facilities, resulting in nearly 4,000 deaths.

The next highest source of cases is at correctional facilities, with just over 18,000 cases and only 61 deaths. Those are significantly lower numbers than in nursing homes.  

One of the reasons COVID-19 spread so rapidly through nursing homes is due to the shortage of staff. Many of the low-paid staff work at multiple facilities. If they contracted the virus and worked in two to three facilities in the same week, imagine all the people they exposed.

Staffing shortages also led to not isolating positive COVID-19 patients from the negative ones. For nursing home residents, nursing home staffing issues literally mean the difference between life and death right now.

Virginia Nursing Homes Continue to Rank Low

Virginia nursing homes consistently fall to the bottom of the charts on various ranking criteria.

For example, Families for Better Care has ranked Virginia as 36 overall with an overall grade of “D” for the third consecutive time.

The report card shows residents receive less than two hours and 17 minutes of direct care daily. Three out of four nursing homes didn’t reach an above-average rating in the inspection.

Overall, nursing home care in Virginia is second to the bottom for the Mid-Atlantic Region, barely squeezing above Pennsylvania as the worst state. 

What to Do If You Suspect Nursing Home Neglect or Abuse

Deciding to move a loved one to a long-term care facility is complicated enough in normal times. Having to do it during the pandemic is even worse.

It’s crucial to do your research to find the best long-term care facility for your family member. However, even if you choose the best one, there’s no guarantee that residents are fully protected against neglect and abuse.

To help protect your loved ones, you must monitor your family member’s condition and watch for red flags of abuse and neglect. If you suspect something is amiss, speak with a skilled Virginia nursing home abuse attorney right away.

At Lantz & Robins, P.C., we have decades of combined experience handling nursing home abuse cases. Contact our office to schedule an initial consultation. Let us review your situation and explain the best course of legal action.

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W. RANDOLPH ROBINS, JR.

Mr. Robins is an active member of the Virginia Trial Lawyers Association and the American Association for Justice, groups that are dedicated to making transportation, healthcare, and workplaces safer for average people. Born and raised in Richmond, Mr. Robins graduated from the University of North Carolina and earned his law degree from the Washington College of Law at American University.

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