8 comments
I understand there is a lot of work still to do. A ton of work, in fact. But thank you for continuing to work towards a better way. In our rural area of Virginia, nursing homes are abysmal. We are slowly seeing some improvements but progress is incremental. They get dinged by licensure but very little changes. I'm talking about neglect. Insects. Rodents. Floors sticky with urine. Broken heat &/or air conditioning. Unchanged bandages, unaddressed fractures. You wouldn't put a stray dog in some of these places, but many times the choice is a lousy nursing home close by or a better one that you can't afford to visit. And unvisited people are prime candidates for the worst neglect. So, again, THANK YOU for tightening regs, decreasing backlogs, & increasing inspectors and please don't give up, just push harder & ask for more help. Those are people living in these places, and they don't deserve what they are getting.
Any tightening of oversight on nursing homes would be welcome. My husband died in January after contracting flu at Lee Health & Rehab in Pennington Gap, where the staff masking requirements were not being enforced.
Re: Nursing Home Administrative Sanctions Guidance Document
There have been plenty of news stories about inadequate or abusive nursing home care. I live in the Richmond area have been witness to multiple instances of poor care, inadequate staffing, and lack of education on the part of the people actually providing care in three nursing facilities. In spite of the fact I was visiting 3-4 times a week, and communicating regularly with nursing home staff, there were issues I was unaware of until outside hospice staff alerted me. I was helped to problem-solve some issues by the ombudsman for my region, but little changed, and ultimately without nursing homes knowing that trained observers are coming in, enforcement for infractions is inconsistent and can easily be hidden. Without regular oversight, we rely on nursing homes self-policing, and it is obvious that is not an effective strategy to protect vulnerable people, especially in light of the fact that most facilities are owned by for profit corporations. Nursing home work is undeniably physically and emotionally hard, but it is also work that requires trust, which regular inspection and oversight will help provide, along with actual consequences for repeated infractions. Our healthcare system is no doubt under great strain (or even broken) now. The patients in these facilities suffer a host of indignities and it is our responsibility to advocate for them, to say nothing of the money being paid for inadequate care. Good health care providers in these facilities are just as tired and burned out as the patients by the bad actors, and thus would benefit too from standard enforcement.
I was certified as a Medication Technician back in 2011 and began working at a new facility in Stafford County. What I witnessed during my short 8 months was tragic and ended a career before it had barely started. Staffing was the issue. CNA's that sleep during their shift, LPNs that leave controled substances on nightstands. Med Techs that sabotage med charts to deflect blame for improper dosing of patients. Memory care patients that fall out of bed multiple times on the same shift with the same staff members in charge. Stealing from patients, workers that come in late or not at all. All under the noses of so called directors whos only worry is filling the shift at the most cost effective method possible. Nursing homes and Assisted Living facilities need to hold their staff to higher standards and concequences must be severe when infractions are made. I lived it, I watched it happen and I left the field. If you have good qualified staff, you don't have issues. Hold your staff to a higher standard and your facility will run efficently.
The conditions of Loudoun Rehabilitation and Nursing in Leesburg, VA are atrocious. They are very poorly managed with administrators rarely lasting more than 6 months. They have run off many of the caring staff members and are short-staffed. They often do not order diagnostic tests and blood work timely, and it can take days to get results that are needed stat. They must have incentives not to call 911 when residents need it because they rarely seem to call 911 until it's too late, and residents and families hesitate to call 911 because the facility shames them for doing so. Residents are not changed for hours at a time, ones who want to get up are often left in bed all day, and residents are sometimes left alone in the dining room well after the others have been put to bed. Many residents don't receive a balanced and varied diet, and the dietician is not doing her job. Meal tickets often don't agree to what's served. Many residents aren't offered sufficient hydration. Management doesn't know how many Hoyer slings they have, but there aren't enough for the number of residents who require them. Hoyer slings are often not cleaned and are used again once the urine dries. Residents are put into urine-soaked beds. Call buttons for some residents are often unplugged so that residents can't ring for emergency assistance and can't watch TV. They have been running out of supplies, such as diapers (especially 3X size which means they put residents into diapers that are too small), gloves, masks, soap, etc. which has had a direct correlation to an increase in infections that have resulted in sepsis and death. The Resident Council was taken over by management despite protests of residents and families. The facility can't effectively control the heating, air conditioning, and humidity levels. If you join and read the Loudoun Aging Parents site on FaceBook, you'll see that our community is well aware of the neglect and abuse that goes on there, and some of the positive comments have been from staff and management at this or a related facility without any acknowledgement that it's a biased comment. Yet, when OLC finally came out a couple of months ago after over a year of not showing up despite numerous and serious complaints being submitted, they only chose to investigate one death. They gave this nursing home a "deficiency free survey," which the facility celebrated and bragged about on their Facebook site. Did the inspectors actively seek out staff, visitors, etc. who witnessed the decline of the deceased? Did they verify in the system if the medical records/notes had been updated after the fact to make it look like care was given when it wasn't? Something seems very wrong as to why the inspector could come to this conclusion based on eye witness accounts. Because retaliation is very real, why don't the inspectors change how they audit to pay more attention to anonymous complaints? Why aren't the inspectors looking for patterns and trends related to the complaints, especially when suspicious deaths have occurred? Why don't inspectors walk randomly into residents' rooms and take a detailed look for the conditions related to the above complaints? As soon as an inspector shows up, additional staff is called in and the facility sweeps through the rooms to do their best to ensure they are in compliance so why don't inspectors stop this from happening? There have been allegations of serious fraud so why aren't the financials being investigated? Why aren't the staff protected when they take their mandated reporter duties seriously? When residents are sent to the hospital, why aren't the hospitals taking their mandated reporter duties seriously, and if they are, then why does it take over a year for inspectors to show up only to look at 1 incident and find nothing? In May 2025, OLC issued many pages of violations for this facility, yet they subsequently cleared all of them even though many of the same conditions were still occurring so the re-audit process failed. Your entire inspection process needs to be revamped. Why do the Ombudmen in Virginia have so little power to get nursing homes to change their bad behavior and no ability to assess fines since they are at the facilities much more often than OLC? Unless there are serious financial consequences to the gross neglect and lack of care, changes will never occur.