Category: Health Care
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New Virginia Nursing Home Law Appears to Violate Federal Statute
by James C. Sherlock In addition to the General Assembly embarrassing themselves in the way they passed a law on nursing homes in this year’s session, they did it in an unseemly rush. There was no pre-filing, a near-immediate and disgraceful floor “debate” led by the nursing industry’s lobbyist, and a rushed vote in the…
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The Ongoing Tragedy of Virginia’s Nursing Homes
by James C. Sherlock Virginia’s Health Commissioners have a job that is broad and deep in its responsibilities and authorities.By statute, appointees must be physicians. Each is the chief executive of the Virginia Department of Health (VDH): a central office in Richmond and 35 local health districts. By Virginia statutes and regulations, they are also…
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The Virginia Board of Health and Nursing Homes – A Strange Appointment
by James C. Sherlock I am starting to lose my sense of humor about the whole Virginia nursing home thing. The Virginia Board of Health (VBOH) writes state regulations for every health facility and health services provider in Virginia, including nursing homes. There is a statutory seat on the VBOH for a nursing home representative.…
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How Did VCU Miss the Red Flags?
by Jon Baliles The unravelling saga of a failed development proposal downtown a block from City Hall that was supposed to rise out of the ashes of the failed Navy Hill project is still smoldering. The failed deal has come with a price tag of about $80 million so far (and growing) for VCU Health.…
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Lost Kids of Southwest Virginia
Kingsolver, Barbara. Demon Copperhead. Harper, 2022 A review by Dick Hall-Sizemore Barbara Kingsolver is an award-winning author who lives on a farm in Washington County, Virginia. Her latest novel, Demon Copperhead, is what she calls her “great Appalachian novel.” It was awarded a Pulitzer Prize for Fiction this year. Kingsolver grew up in Appalachia, in…
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Nurse Staffing in Virginia Nursing Homes in July Ranked 49th in the Nation
by James C. Sherlock The Centers for Medicare & Medicaid Services (CMS) has released its national nursing home quality data for July. It provides summaries of nursing home performance for each state, the District of Columbia and three U.S. territories. I sorted it for Reported Total Nurse Staffing Per Resident Per Day. I did that…
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New CMS Hospital Quality Rankings – Virginia Facilities Ranked Exceptionally High
by James C. Sherlock The Centers for Medicare & Medicaid Services (CMS) on Wednesday released its latest annual hospital quality rankings . Only 10.4% of the rated hospitals in the country were awarded the top ranking of five stars. Of Virginia’s 74 rated hospitals, 13 received that top ranking. Almost 18%. Nationally, 28% received one…
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Nursing Homes – What Could Go Wrong?
by James C. Sherlock I have written a lot recently about staffing shortages in Virginia nursing homes and the Commonwealth’s national ranking near the bottom of the states for staffing measures. It is appropriate to ask why that matters. Federal analyses of Centers for Medicare & Medicaid Services (CMS) data offer the answer. In proposing…
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Staffing Has Collapsed in Many Virginia Nursing Homes, Creating a Health Crisis for Our Most Vulnerable Citizens
by James C. Sherlock I am seldom surprised by Virginia’s nursing home staffing problems, but new government data show no progress on staffing since October of last year. Data from the Centers for Medicare & Medicaid Services show that the number of significantly understaffed facilities has not budged in seven months. The numbers don’t lie.…
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Understaffed Nursing Homes and the False Claims Act
by James C. Sherlock Nursing home operators, paid by government insurance programs on a per diem basis for caring for their patients, make higher profits if they understaff than otherwise. The less staff they have, the higher their operating margins. The federal government, with much experience in such situations, tries to offset those incentives with…
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An Utter (and Videotaped) Disgrace of the Virginia General Assembly
by James C. Sherlock Whatever the Virginia Health Care Association (VHCA), the state’s nursing home lobbying organization, pays its General Counsel, Scott Johnson, it is not enough. He has been representing them for 20 years, and he owns the General Assembly. This is going to sound boring as I frame the background that is the…
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Corruption, Ignorance Turn Deadly in the General Assembly
by James C. Sherlock Virginia Department of Health inspectors, on page 11 of 66 of a statement of deficiencies dated June 21, 2021, wrote of a gut-wrenching discovery. They found an incontinent patient at Autumn Care of Suffolk, a stroke victim unable to talk, tied to her bed by a staffer. She was terrified and…
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Nurse Staffing Laws Bringing Big Changes are On the Horizon
by James C. Sherlock In my lengthy series on Virginia’s nursing homes, I pointed out that many of them are understaffed with nurses, RNs in particular. I also pointed to a nationwide nurse shortage, due in part to burnout, that the training pipelines are not poised to fill. New York, Pennsylvania and Oregon are poised…
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Private Equity in Medicine
To add to those revealed in James Sherlock’s excellent posts about nursing homes and the health care industry generally, here is another culprit–private equity firms. They buy up medical practices in an area, creating great bargaining power with insurance companies, and begin raising prices. The fight is between giant, merged insurance companies and giant, merged…
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Nursing Shortages Require Better Oversight of Virginia Nursing Homes – Part Two – State Action Required
by James C. Sherlock Patterns of understaffing, medical harm and abuse in nursing homes are traceable: in some cases to a business model of understaffing to increase profits. Federal fines are built into the business models of the bad actors. Some of the worst post double-digit annual operating margins; in some to other systemic chain-wide…