Virginia sets clearer triggers for nursing home sanctions

The Virginia Department of Health is setting clearer guidelines for when serious or repeated problems at nursing homes should prompt state sanctions.

Why it matters: MultipleRichmond-area nursing homes have faced serious — and at times, deadly — deficiencies involving staffing, neglect and resident safety, as families and advocates urge the state to do more.

The big picture: VDH licenses privately operated facilities and conducts federal inspections for the Centers for Medicare & Medicaid Services.

  • And it already has the power to restrict admissions, suspend or revoke licenses, and pursue other sanctions againstVirginia’s nearly 300 nursing homes.
  • But April Dovel, who began leading VDH’s nursing home oversight office in November, told Axios regulators lacked a consistent framework for decidingwhen to use state enforcement powers rather than rely on the federal process.
  • Now, Dovel said, when facilities repeatedly fail to correct systemic problems, “we’re going to take action against your license, or restrict new admissions.”

The latest: VDH guidance released Monday, with public comment open through Sept. 9, lays out triggers for considering state sanctions.

  • They include the same or similar violation on two consecutive inspections, the same violation three times within 18 months, and repeated failures to correct deficiencies.
  • Multiple deficiencies in areas like quality of care can also prompt review, though enforcement decisions will remain case-specific.

Why now: Dovel said VDH’s oversight operation became “very reactionary, putting out fires” after pandemic-era staffing losses as complaints rose, inspections accumulated and inspector vacancies hit 40%.

  • Then news coverage put a spotlight on the issues, she told Axios, helping build General Assembly support for more oversight resources “to prevent these things from occurring again.”
  • That means more staff to find problems, and more capacity to create guidance for what to do about them.

Stunning stat: As of July, 58% of Virginia nursing homes hadn’t received a standard inspection in at least two years, the nation’s second-highest percentage, per ProPublica…

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