Virginia nursing homes say they’re limiting admissions due to a lack of staff

Industry survey finds 44% of facilities have had to enact holds or wait lists

By: - October 30, 2023 3:10 pm

(Getty Images)

A recent survey of Virginia nursing homes found that nearly half have limited new admissions because they don’t have enough workers to accommodate everyone seeking care.

The survey of 170 facilities conducted this fall found that 44% had put a hold on new admissions at least once since June 1, and 39% had implemented waiting lists for new admissions. Most facilities that responded to the survey said they’re having trouble finding enough nurses and caregivers to fill shifts, and 31% said they’ve listed job postings that have drawn few or no applicants. More than 90% of the facilities said they’ve had to ask their employees to work overtime or take extra shifts.

The poll was conducted by the Virginia Health Care Association-Virginia Center for Assisted Living, the state’s largest organization representing the interests of the long-term care industry. The group says it can’t solve its staffing problems alone without more assistance through improved workforce development efforts and changes to government-set reimbursement rates under Medicaid, which covers the care for most residents of Virginia nursing homes.

In an interview, VHCA-VCAL President and CEO Keith Hare said many nursing home caregivers have left the field due to the exhaustion and relentlessness of the COVID-19 pandemic. The latest survey results, he said, point to a “crisis” in health care for the elderly.

“I don’t say this lightly. I think it’s the biggest public policy issue that is not just facing the state but facing our country,” Hare said.

Nursing home operations have been a recurring challenge for state policymakers. This year, the General Assembly passed a bipartisan bill creating minimum nurse staffing requirements for the facilities, the culmination of a long push to improve the quality of care provided for lower-income people. 

The industry has at times resisted those efforts, arguing it can’t hire enough people to comply with the proposed rules. 

“You just can’t magically produce thousands of nurses just because you pass a regulatory requirement,” Hare said.

The specifics of Virginia’s new staffing rules, which call for facilities to provide a daily average of at least 3.08 hours of nursing time per resident, are still being worked out in the regulatory process and won’t take effect until 2025. The legislation that passed acknowledged the workforce shortage problem by including carve-outs for facilities that remain understaffed despite diligent efforts to hire more nurses.

“I think advocates for this bill would tell you it is not as much as they would like,” Del. Bobby Orrock, R-Caroline, said of the legislation he sponsored while presenting it to the House of Delegates earlier this year. “But it is far more than anything we have had in the past.”

Del. Vivian Watts, D-Fairfax, who has also worked on the issue for many years, called this year’s legislation a step toward accountability. But she also said policymakers have to start thinking about ways to address the problem through the state budget.

“We can’t have more staffing if we don’t have more funding,” Watts said on the House floor.

President Joe Biden’s administration is also taking aim at the issue by announcing new federal rules on nursing home staffing last month.

“The nursing home industry receives nearly $100 billion annually from American taxpayers, yet too many nursing homes chronically understaff their facilities — resulting in poor, substandard care that endangers residents,” the White House said in a news release. “When nursing homes stretch workers too thin, residents may be forced to go without basic necessities like hot meals and regular baths, or even forced to lie in wet and soiled diapers for hours.”

Hare, the head of VHCA-VCAL, said the federal rules don’t have the same type of “protections” designed to prevent penalties from being assessed on facilities “doing everything they possibly can to hire.”

“Until we get enough caregivers in the system as a whole, then we won’t get anywhere near trying to solve this problem,” Hare said.


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Graham Moomaw
Graham Moomaw

A veteran Virginia politics reporter, Graham grew up in Hillsville and Lynchburg, graduating from James Madison University and earning a master's degree in journalism from the University of Maryland. Before joining the Mercury in 2019, he spent six years at the Richmond Times-Dispatch, most of that time covering the governor's office, the General Assembly and state politics. He also covered city hall and politics at The Daily Progress in Charlottesville.