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Virginia's nursing home residents deserve better

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Contact your lawmaker to demand nursing home reform for Virginia's vulnerable nursing home residents. The time for action is now, tell your legislator to pass House Bill 646. Use this link to email your legislator.

AARP wants to hear from people who have loved ones in nursing homes. Please use this link to contact us.

House Bill 646: Improved Staffing Ratios and Standards of Care

Bill status: HB 646 will be heard in House Health, Welfare, and Institutions Subcommittee 3 on Tuesday, Feb. 8. Members of the committee are: Chairman Del. Chris Head (R-Roanoke), Del. Wendell Walker (R-Lynchburg), Del. Robert Orrock (R-Thornburg), Del. Roxann Robinson (R-Midlothian), Del Cliff Hayes (D-Portsmouth), and Del. Kathy Tran (D-Springfield).

House Bill 646 would establish nursing home staffing hourly minimum thresholds of:

  • A minimum of 2.8 direct care hours must be provided by a certified nurse aide (CNA) per resident, per day;  
  • A minimum of 1.3 direct care hours must be provided by a registered nurse (RN) or licensed practical nurse (LPN) per resident, per day; and
  • A minimum of 0.75 hours of the total direct care hour requirements above (4.1 hours) must be provided by a RN per resident, per day.

Currently, Virginia has no established standards, so staffing ratios are left up to individual care facilities. Some nursing homes perform well in this area, but others do not. This legislation would establish statewide standards for all nursing homes to ensure quality care for residents.

This legislation also establishes quarterly training for nursing home staff on the following items:

  • First aid
  • Medication administration
  • Compliance with nursing home policies and procedures

Ensuring Quality Care in Nursing Homes

For two decades the Virginia General Assembly has been asked to establish minimum staffing standards in Virginia nursing homes; however, no action has been taken. Now, due to the state not adequately addressing this issue, more than 2,000 residents and staff in nursing homes and other long-term care facilities have died due to COVID-19.

The pandemic only exacerbated long-standing issues in Virginia nursing homes related to a lack of staffing and care standards. Virginia is one of only 18 states with no established staffing minimums. AARP Virginia urges the General Assembly to enact common-sense policies immediately that ensure quality care for residents through improved staff-to-resident ratios and standards of care.

What This Means for Nursing Home Residents

Minimum staffing standards can improve health outcomes. Numerous studies have found a direct correlation between the quality of resident care and the number of nursing staff. Better staff to resident ratios improve care as seen in reduced incidence of pressure sores, lower use of physical restraints, and fewer hospital admissions. Staff ratios below those identified by CMS noted above means basic resident care needs cannot be met and residents could suffer harm.

Our nursing home residents deserve better than subpar conditions. That’s why AARP is fighting to put the safety and well-being of nursing home residents first.

It’s time to hold nursing homes accountable for providing safe environments and high-quality care for residents.

For more information, contact Natalie Snider at or (804) 344-3063.

AARP wants to hear from people who have loved ones in nursing homes. Please use this link to contact us.

Virginia voters want nursing home reform

With the coronavirus pandemic exposing problems in our long-term care system, strong majorities of Virginia voters support proposals that would improve the quality of care that nursing home residents receive, according to results of an AARP Virginia voter survey

AARP Virginia asked likely voters age 18 and older about their concerns about nursing home safety. The survey was conducted in August by the Wason Center for Civic Leadership at Christopher Newport University.

Read the full survey here.

Track COVID-19 cases and vaccination rates in Virginia's nursing homes

The COVID-19 pandemic has swept the nation, killing more than 186,000 residents and staff of nursing homes and other long-term care facilities. The AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner. 

Track resident and staff case rates, death rates, vaccination rates, staff shortages and supplies of personal protective equipment at the AARP Nursing Home COVID-19 Dashboard.

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