With a fifth of Virginia’s nursing homes failing to meet staffing standards, stakeholders split on solutions

Virginia

RICHMOND, Va. (WRIC)-One fifth of Virginia’s nursing homes are failing to meet expected staffing levels under federal standards. It’s increasing the risk of low quality care, especially for low-income and black Virginians. 

That’s according to a new study presented to the General Assembly’s Joint Commission on Healthcare. Lawmakers are looking into various legislative solutions ahead of the 2022 session. 

That report also found that Virginia has more nursing homes with low staff ratings than other states. 

“Facilities with low staffing are more likely to have poor quality measures in health inspection ratings,” said Associate Health Policy Analyst Kyu Kang. “Low staffing negatively impacts care quality as well as staff and resident well being.” 

Among the possible fixes being considered are mandatory staffing standards. Currently, Virginia is in the minority as one of 16 states that doesn’t require a minimum ratio, according to Kang. 

Dignity for the Aged Executive Director Sam Kukich said her mother in law lost 65 pounds and had more than four dozen falls in a short-staffed nursing home. Her story was detailed in an investigation two years ago. 

“Family members have spent many years waiting and hoping for change and their family members die. We keep saying the same things over and over and nobody hears us,” Kukich said. “Please do not wait another year to mandate ratios.” 

Industry leaders are opposed to the push for requirements. 

It comes as a new survey from the Virginia Health Care Association— which represents roughly 350 long-term care facilities statewide–suggests staff burnout from COVID-19 is exacerbating long-standing workforce shortages.

It found 81% of long-term care providers believe the situation has gotten worse in 2021 compared to 2020, which they consider “the height of the clinical nightmare.” 

Nearly all respondents reported vacancies in critical positions, with 96% looking for CNA’s, 92% missing LPN’s and 75% trying to fill RN positions. 

When asked about their current staffing situation, 59% indicated there were few to no applicants to fill their needs for additional staff. That’s the case despite widespread pay increases and bonuses. 

“We want to hire staff. The truth is the workforce is just not there right now. We have seen people exiting healthcare. They’re not coming to work in our facilities and this could not be a worse time quite frankly to consider a staffing mandate,” said Deborah L. Petrine, Chairman and CEO of Commonwealth Care of Roanoke.    

The Virginia Department of Health said the work group needs to take into consideration how to compel compliance with any new standards it sets, pointing out that the agency is limited to issuing a plan of correction, revoking a license or suspending new admissions. 

“VDH does not want a policy’s good intention to be frustrated by a lack of viable enforcement,” said Rebekah Allen, a senior policy analyst at VDH. 

As an alternative to a mandate, a provider from Virginia Beach suggested establishing a timeline to comply with the federal standard followed by a reassessment after which those who continue to fall below expected staffing levels may see new admissions suspended or have their license revoked. Meanwhile, he said the state could review ownership changes for possible issues and provide targeted funding to assist the 21 percent of homes struggling the most. 

The nursing home industry is also urging the General Assembly to increase Medicaid reimbursement rates. Multiple speakers said the current rate doesn’t cover the cost of care and makes it difficult for facilities to manage their finances, which has an adverse impact on staffing. 

Meanwhile, the Virginia Community College System is requesting nearly $53 million over two years to hire more teachers and build out nursing labs, which will allow them to increase their enrollment. VCCS is projecting that, by 2028, the investment will allow them to graduate 3,500 licensed nurses each year, up from the current annual rate of 2,000. 

The work group is set to meet again on Nov. 9 to endorse various policy options. The full commission is expected to vote on those options on Dec. 7. The proposals will then be considered by the entire General Assembly in 2022.

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