Richmond, VA — Efforts to set a minimum staffing standard for Virginia’s nearly 300 nursing homes have stalled, leaving advocates and families disheartened after lawmakers scaled back a once-promising bill to a new study.
Del. Rodney Willett (D-Henrico) initially proposed legislation that would have required nursing homes to meet a minimum average of 3.25 acuity-adjusted nurse staffing hours per resident per day. The measure drew bipartisan support and moved through the General Assembly. But by the time it cleared the House, the mandate had been stripped out and replaced with a directive to study the workforce in Virginia nursing facilities.
For resident advocate Joanna Heiskill, the change was painful.
“It’s very hurtful,” she said, arguing that years of studies have produced little action. A 2021 review by the Joint Commission on Health Care had already recommended the 3.25-hour benchmark.
Budget Pressures Stall Mandate
Willett said the shift reflects budget realities. Implementing a staffing minimum would require higher Medicaid reimbursement rates, and he estimated the annual cost would be well under $20 million. Still, he acknowledged there is no way to impose a mandate without increasing state spending.
Lawmakers also lowered the proposed standard to 3.08 hours to align with a 2023 effort before ultimately converting the bill into a study in committee.
Virginia remains one of the few states without a staffing minimum and ranks in the bottom 20% nationally for federal staffing ratings.
Industry Divided Over Standards
The Virginia Health Care Association, which represents mostly for-profit facilities, said lawmakers were right to ensure any mandate is fully funded, noting workforce recovery since the pandemic but ongoing competition for nurses.
LeadingAge Virginia, which represents nonprofit providers, urged senators to restore a standard. Its members average 4.3 staffing hours per resident daily, well above the proposed minimum.
Meanwhile, state health officials are reviewing whether previously paused regulations establishing a 3.08-hour standard can move forward.
For families like Heiskill’s, the delay feels all too familiar. “They need their government to step in,” she said. “Straighten up and get it done.”
