By: Tyler Layne
RICHMOND, Va. — A state legislator is
attempting to create some new laws to address concerns surrounding
transparency and staffing in Virginia nursing homes, as the
commonwealth's facilities rank among the bottom in the country for
average staffing levels, according to federal data.
Del. Rodney
Willett, a democrat representing parts of Henrico County, has brought
forth two bills in an effort to "maintain the highest quality that we
can" in nursing facilities. It's an issue CBS 6 has extensively covered over the past year and a half, as families have complained about care and conditions in record numbers.
“The theme here is trying to take care of our loved ones," Del.
Willett said. “The stories are incredibly troubling, and I think we
shouldn’t need stories like that to take more action, but unfortunately
what we learned is we did not have adequate oversight.”
Minimum staffing standard
One bill would establish a minimum staffing standard in nursing homes.
The
General Assembly previously passed one in 2023, which Governor Youngkin
signed into law and was supposed to take effect July 2025, but it has never actually taken effect.
That's because the 2023 law included a provision that would repeal the
state staffing standard if the federal government enacted its own
staffing standard. The federal government did later adopt a more
stringent staffing standard, but it was eventually overturned. The legal
and regulatory challenges ultimately left the state without its own
staffing standard.
“Bottom line is we need to have a staffing ratio in Virginia. We have been behind on that for years," Willett said.
Willett's
bill, as is, would require nursing homes to provide at least 3.25
hours, adjusted based on the needs of the residents, of nurse staffing
per resident per day. That's higher than the 3.08 hours initially
adopted in the 2023 legislation.
“Why did you want to change the number?” reporter Tyler Layne asked.
“Well,
that number I will tell you, that’s [to be determined]. We are going to
have a number, and as the finer point on that, stay tuned. We will have
that. But the most important thing is that we will have a staffing
ratio," Willett responded.
“So it may not land on 3.25?” Layne asked.
“We will see. It could, but we will see," Willett said.
When asked what number Willett would prefer, he said he would "defer to the greater experts."
According
to data from the Centers for Medicare and Medicaid Services (CMS),
which regulates nursing homes at the federal level, Viginia facilities
provide an average of 3 hours and 47 minutes of total nurse staff hours
per resident per day. That's below the national average of 3 hours and
54 minutes.
Virginia has a statewide CMS staffing rating average
of 2.5-out-of-5 stars, as of December 2025. Only seven other states in
the country have a lower staffing rating. CMS calculates the ratings
using facilities' reported staffing levels and staff turnover rates.
Higher staffing levels and lower staff turnover "may mean higher quality
of care for residents," according to CMS.
AARP Virginia, which advocates for seniors, supports Willett's bill.
"For
decades, too many nursing home residents have suffered due to chronic
understaffing. Yet despite repeated efforts by advocates, Virginia
remains one of a small number of states without minimum staffing
standards in place," said Jim Dau, AARP Virginia State Director. "This
legislation will better ensure that nursing homes can provide timely and
much-needed care to some of our most vulnerable Virginians."
However,
the Virginia Health Care Association (VHCA), which represents the
industry, refrained from saying it supported the bill. Instead,
spokesperson Amy Hewett said VHCA "strongly supported" the lower 3.08
staffing standard passed in 2023, which she noted is still going through
the regulatory process.
"The Youngkin administration has a
regulatory package in process that has yet to be finalized that would
make Virginia’s staffing standard effective upon completion of the
regulations. Additionally, the legislation passed in 2023 required that
the costs of that standard be funded in the Medicaid base rate. To date,
the Commonwealth has not appropriated funds for the additional direct
care staff costs at the level needed to meet the staffing standard
through the Medicaid payment rate," Hewett said. "We know that a strong,
stable nursing workforce is critical to high quality resident care in
nursing homes. It is imperative that nursing homes have the resources
they need to appropriately staff facilities and provide their residents
with the high-quality care they deserve."
When asked whether
Willett was expecting industry pushback to the proposed staffing
minimum, he said, “We’re in discussions on that.”
Ownership disclosure requirements
Willett's other bill would require nursing home owners to disclose to
the state much more information about who they actually are and their
history of running other facilities.
The
move comes months after Governor Youngkin's health commissioner, Dr.
Karen Shelton, told lawmakers the department of health collected
inadequate ownership and performance insights during the licensure
process.
“We’ve also noted that there's been a noticeable increase
in the number and changes of ownership in nursing homes over the past
few years. Unfortunately, we have relatively little information on
these," Shelton said during a July 2025 presentation to lawmakers.
“When she gave you that testimony, did that concern you and prompt you into action?” Layne asked.
“Absolutely,
I mean, you could say this is about accountability, and that certainly
can be the case, but we should just know who we're dealing with, and
especially with a vulnerable population like this," Willett said.
Anytime
a facility changes hands, the bill would require the new operator to
disclose all direct and indirect owners, the owner of the building, the
owner of the operating entity, and related parties that will provide
services to the nursing home.
Further, the owners would have to
disclose a record of certain financial, regulatory, licensing, and/or
criminal trouble for nursing homes they operated or owned within the
past five years. The owners would also be required to disclose whether
the nursing homes they ran appeared on the federal government's list of
the nation's worst-performing facilities.
According
to the bill, the health commissioner would be directed to deny a change
of ownership application if the owners' previous nursing facilities
closed due to licensing or certification action, had bankruptcy or
receivership proceedings that weren't dismissed within 60 days, or had
its license suspended, denied, or revoked.
Hewett said the VHCA supports this bill and helped develop it.
“This
is another one where the nursing homes themselves have said, 'We don't
want bad actors here either.' And I think there's this uniform agreement
that, yes, in the exceptional time where there [is] someone who really
should not be operating these facilities, we need to know that, and this
will make that clear. And then we've given the commissioner now the
authority to do something about that," Willett said.
Full Article & Source:
Virginia lawmaker pushing for nursing home minimum staffing standard, ownership disclosure requirements
