by James C. Sherlock
The Virginia Department of Health (VDH) inspectors regularly report instances of resident abuse, including battery, occasionally resulting in death. That has persisted for decades and appears undeterred by current enforcement efforts.
The Code of Virginia (Code) is partially at fault. It makes it challenging for the state, its citizens, and local law enforcement to address dangerous deficiencies.
Long-term residents of nursing homes are expected to die there. Many short-term residents in skilled nursing beds are supposed to get better, but often do not. They instead return to the hospital or transition to long-term care or hospice.
Virginia law appears almost fatalistic in the face of those facts.
Multiple Code provisions governing the reporting and investigation of potential crimes in nursing homes are rendered incoherent by the proliferation of federal and state programs and sanctions.
- VDH personnel conduct federal and state inspections and investigate tips received on its complaints hotline and portal. The reports often cite violations of federal law that include evidence of crimes, including abuse, battery, or even manslaughter.
- The Centers for Medicare & Medicaid Services (CMS) has long been authorized by federal law to respond to those citations by sanctioning violators through administrative actions, such as fines or suspensions of new admissions. As of July 1, 2025, VDH also has sanctioning authorities.
- The Virginia Department of Social Services (VDSS) operates an Adult Protective Services (APS) program. APS investigates reports of abuse, neglect, or exploitation of adults aged 60 and older or incapacitated adults ages 18 to 59 submitted on its own hotline and portal .
Those parallel programs have not proven sufficient to mitigate recurring dangers to nursing home residents and, indeed, appear to be part of the problem.
