Category: Long Term Care and Nursing Homes
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National Academy of Sciences Offers Superb Recommendations for Fixing Virginia’s Nursing Home Crisis
by James C. Sherlock Sometimes, we need to listen. I just finished the 806-page 2022 report “The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff” by the National Academy of Sciences (NAS). It is downloadable at the link. That study and report were utterly professional and thorough, as…
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The Virginia State Budget and the Rising Costs of Registered Nurses
by James C. Sherlock I was asked yesterday by a reader about the relationship between nursing homes, rising registered nurse salaries and the new Virginia budget agreement. Good questions. Virginia’s workforce includes nearly 70,000 registered nurses. The state pays its workers, but it also pays its Medicaid share for private sector nurses. Pay for private…
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Virginia Has an Opportunity to Take the Lead in Nursing Home Technology Insertion to Improve Care with Existing Staff
by James C. Sherlock A pending new federal rule defining strong nursing home staffing minimums has finally accomplished something that I thought unlikely in my lifetime. It has in a single stroke aligned the interests of patients and their loved ones, nurses, nursing homes, state and federal governments, and taxpayers in finding ways to make…
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Virginia’s Certificate of Public Need Program – A New Sheriff in Town
by James C. Sherlock Everywhere counterproductive to competition, innovation and cost, Virginia’s Certificate of Public Need (COPN) program also has proven antithetical to quality and safety in nursing homes. A thorough 2022 report by the National Academies of Sciences, Engineering and Medicine on improving nursing home quality had this to say about state Certificate of…
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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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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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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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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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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…
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Nursing Shortages Require Better Oversight of Virginia Nursing Homes – Part One – The Problem
By James C Sherlock We have some great nursing facilities in Virginia. We also have far more than our share of bad ones. Virginia has a decision to make about the latter. The federal government sets standards for those that are paid with federal funds. It both levies fines and denies payments as it feels…
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Profound Registered Nurse Shortages in a Virginia Beach Nursing Home
By James C. Sherlock Registered nurses (RNs) both supervise medical treatment and are the primary medical care providers in nursing homes. Physicians are on call but generally are not present. One Virginia nursing home is currently advertising: RN’s Now hiring All Shifts! Pick your shift. Perhaps not good news for those patients. Some of the…