Who Regulates Nursing Homes in Virginia

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Are you faced with the need to decide whether to send a loved one to a nursing home, or is a family member already a resident? Understandably, it’s a very serious matter and a decision that should not be taken lightly.

You may have many questions related to the process, the nursing home’s record, what your family member can expect, what to do if you suspect neglect or abuse, etc.

If you already have a loved one in a nursing home, it’s crucial to familiarize yourself with who regulates nursing homes in Virginia and where to report any issues. 

You can also contact the experienced team of Virginia nursing home neglect lawyers at Lantz & Robins, P.C., to discuss your concerns. We will review your circumstances and advise you on the best course of action.

Who Is Responsible for Regulating Nursing Homes in Virginia?

The Office of Licensure and Certification (OLC) operates under the Virginia Department of Health. They administer the state licensing programs for all medical facilities, including hospitals, nursing homes, outpatient surgical centers, hospice programs, and home care organizations.

They are also responsible for conducting inspections and monitoring complaints to verify nursing homes are complying with all state requirements.

The Centers for Medicare and Medicaid Services (CMS) oversee things on a national level. They contract with state-level agencies like the OLC to certify that the nursing homes and suppliers who participate in Medicare and Medicaid programs comply with the minimum health and safety standards.

Under their regular certification process, they ensure nursing homes adhere to all federal certification requirements.

The Joint Commission Accreditation

Nursing homes can also apply for voluntary accreditation through The Joint Commission. This accreditation lets people know the nursing home is committed to excellence throughout all aspects of care. Some potential benefits of Joint Commission accreditation include:

  • Strengthens people’s confidence in the quality and safety of care, services, and treatment their family members will receive;
  • Helps maintain and organize patient safety efforts;
  • Could reduce liability costs for the nursing home;
  • Reduces risk and improves risk management;
  • Recognized by insurance companies and third parties;
  • Provides deeming authority for certification from Medicare;
  • Fulfills regulatory requirement in some states;
  • Provides professional advice and counsel, including educating staff; and
  • Aligns a nursing home with the most respected names in healthcare.

Although there are many benefits for nursing homes to pursue voluntary accreditation, not everyone will go the extra mile. You can search for accredited nursing homes in Virginia by searching the Quality Check website. Currently, there are less than 100 certified nursing home facilities in Virginia.

Nursing Home Reform Act

Under the 1987 Nursing Home Reform Act, nursing homes across the country are legally required to provide services and activities that achieve or maintain the highest levels of physical, psychosocial, and mental well-being of all residents per the written care plan.

Before a nursing home can qualify to participate in Medicaid and Medicare, it must adhere to all federal requirements applicable to long-term care facilities. Examples of some federal regulations require nursing homes to:

  • Conduct an initial accurate and comprehensive assessment of every nursing home resident’s functional capacity;
  • Have an appropriate number of nursing home staff members;
  • Assist with activities of daily living, such as grooming or personal oral hygiene, if the resident is unable to carry out these activities on their own;
  • Develop a comprehensive care plan for all residents of the nursing home;
  • Promote every resident’s quality of life;
  • Complete and maintain accurate clinical records on every resident that are easily accessible;
  • Verify all residents receive satisfactory supervision and assistive devices that will prevent accidents;
  • Promote every resident’s quality of life;
  • Verify residents are free from any significant medication errors;
  • Keep residents from developing pressure sores or, if a patient has one, treat them so they heal and new ones do not form; and
  • Provide all residents with enough fluids, so they do not become dehydrated.

Before a nursing home is eligible to receive funds from Medicare or Medicaid, it must comply with all aspects of the Nursing Home Reform Act.

Elder Justice Act

The Elder Justice Act was passed in 2010 to address neglect, abuse, and exploitation of older adults on a federal level. New initiatives and programs emerged that have helped promote elder justice research, coordinate better federal response to issues surrounding elder abuse, increase protections for nursing home residents, and support Adult Protective Services systems.

The Elder Justice Coordinating Committee was also formed under the new act, coordinating activities across the federal government related to elder neglect, abuse, and exploitation.

What to Do If You Suspect Nursing Home Neglect or Abuse in Virginia?

If your loved one is already in a nursing home and you suspect abuse or neglect, it’s crucial you take immediate action. The first thing you should do is file a nursing home complaint with the Virginia Department of Health’s Office of Licensure and Certification.

The OLC has a comprehensive nursing home complaint form that you can use to detail what is going on. If the abuse is serious, you can call the hotline number at 800-955-1819. You can return the form via mail or fax as well.

Once you file a complaint, the OLC will open an investigation and send out inspectors to review your family member’s chart. These visits are unannounced, so the nursing home doesn’t have time to alter any records or cover up anything.

Contact a Virginia Nursing Home Abuse and Neglect Lawyer

Did your loved one suffer serious harm or injuries due to a nursing home’s negligent or intentional acts? You may be considering legal action. To learn the best course of action, you should speak with an experienced Virginia nursing home neglect and abuse attorney.

At Lantz & Robins, P.C., our attorneys have over 50 years of combined experience with personal injury matters, including nursing home neglect and abuse. Contact our office today to schedule an initial consultation. Let us review your circumstances and see how we can help.

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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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