Bill could set minimum staffing requirements for Virginia nursing facilities

RICHMOND, Va. (WRIC) — A newly introduced bill could set minimum staffing requirements and consequences for certified nursing facilities that don’t comply — if it passes in Virginia’s upcoming legislative session.

HB 1446, introduced by Del. Robert Dr. Orrock, Sr. (R-54) at the end of December, sets nursing staff mandates for these facilities, and imposes administrative sanctions on those out of compliance. The bill has a delayed effective date of July 1, 2026.

A similar measure was presented by Del. Betsey Carr (D-69) during the 2022 legislative session, but was continued to 2023.

“These facilities are making a profit,” Joanna Heiskill with Justice and Change for Victims of Nursing Facilities said. “Why is there a staffing shortage? Why aren’t the CNAs [certified nursing assistants] and nurses being paid enough, and why isn’t there enough staff to pay to facilitate quality care?”

Heiskill and Tracey Pompey formed the group after each woman lost a loved one in a Virginia nursing facility. Pompey also used to work in the industry.

“There’s no way you can give quality care if you have 25 patients, and all of them, you still have showers to give,” she said. “Everybody still has to get up. So, you’re asking crazy demands with a little staff, and these companies, these corporations are making a profit off of the backs of these seniors is nursing facilities.”

According to Dec. 2022 survey results from the Virginia Health Care Association’s (VHCA) Virginia Center for Assisted Living (VCAL), long-term care providers are still experiencing a “severe workforce crisis,” exacerbated by the coronavirus pandemic. The data revealed that even though 2020 was the height of the clinical challenges of COVID-19, 86% of Virginia’s nursing homes and assisted living facilities reported that their workforce situation worsened throughout 2022.

VHCA VCAL data also showed that nearly every such facility in the commonwealth has asked staff to work overtime or take extra shifts, and that 82% reported having a shortage of staff to fill all shifts.

“I’ve had it — 25 patients to take care of, and then the next day, you’re so burned out that, at the end of your eight hours, you’re so burned out,” Pompey said. “The next day, you have to come back and do it all over again.”

If passed, the bill would require each facility to provide an average of at least 3.08 hours of case mix-adjusted total nurse staffing hours per resident per day. As drafted, it also mandates that certified nursing facilities provide at least one physician who is licensed to practice medicine in the commonwealth to be on-call at all times, though not necessarily physically present on the premises. Facilities that do not comply could be fined.

“The problem is, who’s monitoring that?” Heiskill said. “Who’s going to pay attention and hold them accountable if they don’t adhere to those policies?”

She and Pompey said they are hopeful that this measure will pass in the upcoming legislative session, but that regardless of what happens in state government, they will continue their advocacy efforts.

“I don’t want to ever think that we didn’t make an effort to do or cause some level of change for families, so they don’t have to go through what we went through,” Heiskill said. “It’s horrendous. If you hear some of the stories, it’s horrendous. You can’t imagine.”

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