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AARP urges General Assembly to protect nursing home residents

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A Virginia General Assembly committee will take up legislation that could improve the lives of the Commonwealth’s nearly 30,000 nursing home residents, make facilities safer, and protect those who live and work there.

“People who live in nursing homes deserve to have enough staff taking care of them and making sure they’re safe,” said AARP Virginia Advocacy Director Natalie Snider. “For two decades the Virginia General Assembly has been asked to establish minimum staffing standards in Virginia nursing homes; however, no action has been taken.”

The House of Delegates Committee on Health, Welfare and Institutions has been assigned House Bill 646, which addresses nursing home staffing. The bill, sponsored by Del. Betsy Carr (D-Richmond) and co-sponsored by Del. Kaye Kory (D-Falls Church), has been sent to an HWI subcommittee for consideration.

Inadequate staffing, minimal training, and poor infection control leads to falls, pressure wounds, and the spread of disease in nursing homes. Virginia is one of only 18 states that does not require nursing homes to maintain a minimum number of staff hours per resident per day. Nursing home residents need assistance with at least some of the activities of daily living, including bathing, dressing, getting in and out of bed, getting to the restroom or help with incontinence, and feeding themselves. Some are wheelchair- or bed-bound and are completely dependent upon the staff for their quality of life.

“The COVID 19 pandemic exacerbated and exposed long-standing issues in Virginia nursing homes related to a lack of staffing and care standards,” added Snider. “The General Assembly needs to act now and prevent the tragic loss of any more lives, now and after the pandemic.”

Nearly 30,000 people live in Virginia’s 287 nursing homes. According to the Centers for Medicare and Medicaid Services, 155 Virginia facilities are rated as “much below average” (1 star) and “below average” (2 stars) in staffing. More than 100 Virginia nursing homes have overall quality ratings of 1 or 2 stars, and 121 received 1 or 2 stars due to poor health inspections.

“Currently, Virginia has no established standards, so staffing ratios are left up to individual care facilities. Some nursing homes perform well in this area, but others do not. This legislation would establish statewide hourly standards for all nursing homes to ensure quality care for residents,” Snider said.

The Nursing Homes Abuse Advocate tracks problems in nursing homes and maintains a watchlist of facilities where harm has occurred to residents. Currently 117 Virginia facilities are on the list. Virginia is one of four states with the most facilities on the list.

“It is unconscionable that 40 percent of Virginia’s nursing homes are on a watchlist for causing harm to residents,” Snider said. “That indicates that potentially thousands of people are in danger, and lawmakers must act now to protect them.”

AARP Virginia urges the General Assembly to enact common-sense policies immediately that ensure quality care for residents through improved staff-to-resident ratios and standards of care.

CMS has identified, and AARP policy supports, nursing home staffing with minimum hourly thresholds of:

  • 2.8 hours for nurse aides per resident per day
  • 1.3 hours for registered nurses and licensed practical nurses, combined, per resident per day
  • 0.75 hours for RNs per resident per day
  • For a combined total of 4.1 hours of nursing care per resident per day – including RN, LPN, and CNA

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