by James C. Sherlock
Disclaimer. The author is a member of the Virginia Nursing Home Oversight and Accountability Advisory Board established under Governor Youngkinโs Executive Order 52. ย Nothing in this series should be taken to represent the opinions of the Commonwealth or that Board.
This series will explore the dreadful and dangerous choices faced by many who seek nursing homes in Virginia. It will illuminate those choices in various regions of the state in consecutive articles.
Too many facilities should be avoided, but there are simply not enough decent choices in many areas to support local nursing home demand. Those choices and competition generally are limited purposely by Virginiaโs Certificate of Public Need (COPN) law.
For years I have offered testimony in this space based upon excellent Virginia Department of Health (VDH) reports of inspections. Many describe terrible conditions and the resulting human tragedies. Those conditions are cited by VDH inspectors in the reports as violations of the federal Social Security Act and federal regulations for its enforcement. Virginia law and regulations for nursing homes are in every case less demanding than federal counterparts, so are in practice useless. Federal money and therefore federal supremacy are involved.
The widespread negative publicity generated by the results of the December 2024 raid on Colonial Heights Rehabilitation and Nursing Center raised public awareness of the problem. That in turn resulted in the 2025 General Assembly passing decades-needed additional regulatory authority and funding for hiring of additional inspectors by the Virginia Department of Health (VDH).
The highly accelerating trend of individual complaints to VDH on nursing homes is another result of that publicity. Both are welcome.
The dilemma for Virginians is posed mostly by out-of-state for-profit chains whose breakneck growth since early 2000 has led to their dominance in many geographic areas. That growth continued with the closing in September 2025 on the purchase of seven nursing facilities from Newport News-based Virginia Health Services (VHS) by Brick, New Jersey-based Marquis Health Services.
Rapid discharges of patients from hospitals to skilled nursing beds are driven by government and private insurers to lower the total cost of treatment. That treatment is underwritten by Medicare. That policy makes good sense as policy. ย It bends the overall insurance cost curve downwards.
The long-term care beds are paid for primarily by Medicaid reimbursements.
The unwritten assumption of government policies is that there are sufficient capably staffed beds to accept them. That assumption is demonstrably untrue in many communities in Virginia and elsewhere.
The methodology described below will be used in this series for assessment of the options for seekers of nursing homes in several Virginia locations.
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