Richmond, Virginia — Virginia just took a closer look at its nursing home industry — and the order came straight from the governor’s pen.
Gov. Abigail Spanberger signed a bill into law that requires the state’s Joint Commission on Healthcare to study how nursing homes operate, how they spend public money, and how well they actually care for residents, according to industry reports. The measure was driven by Del. Delores McQuinn, a Henrico Democrat whose district includes a facility federal regulators flagged as Virginia’s worst-performing nursing home.
“The expectation was that if you owned the nursing home, that you were going to be providing the kind of care that people deserve,” McQuinn said. “And what we found out — it was not happening.”
The new law tells the commission to dig into a long list of operational practices. Quality outcomes. Staffing levels. Inspections and enforcement. Resident rights. Emergency preparedness. Ownership structures. Real estate arrangements. Related-party transactions. And a question that’s been dogging the industry for years: how much Medicaid money actually reaches the bedside.
Why this is different
SCJ readers may remember McQuinn’s bill won unanimous backing in committee after she described Virginia’s oversight record as “shameful.” That hearing was the warm-up. Spanberger’s signature is the finish line — for now.
Lawmakers in this same session also passed a separate bill ordering a study of staffing standards and another that forces nursing home operators to disclose more during ownership changes. Several tougher proposals didn’t make it. Bills that would have penalized homes paying excessive rent to related-party landlords, set an enforceable staffing floor, and required more frequent doctor visits all stalled.
That mix has frustrated some advocates who wanted faster action.
“Why they show to want to try and do this and do that, nothing is actually getting done,” advocate Joanna Heiskill said.
McQuinn pushed back gently. “We had to start somewhere,” she said, noting the commission will deliver recommendations alongside its findings, giving lawmakers material to act on later.
What operators should watch
The commission’s report is due by December 2027. That’s a long runway, but the topics on the list are exactly the ones operators have been quiet about — particularly real estate arrangements and related-party deals, which have drawn growing attention in Virginia after a string of complaints, federal certification cuts, and record consumer filings to the state health department last year.
Non-profit operators publicly endorsed the measure during legislative hearings. For-profit groups offered no public opposition.
Industry watchers say findings from a study like this rarely sit on a shelf. Once a state commission documents how Medicaid dollars move through related-party companies and into real estate, lawmakers tend to take a second look at the bills that didn’t pass the first time.
For now, Virginia operators have about 18 months before the state shows its work — and uses it to decide what comes next.
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