Category Archives: Long Term Care and Nursing Homes

Virginia’s Self-Inflicted Nursing Home Crisis — Part 2, the Business

Posted on October 1, 2021 by | 8 comments

by James C. Sherlock

Nursing homes are businesses.

Seventy percent of those in Virginia are for profit. They are run not by doctors but registered nurses with physicians on call. 

Nursing facilities very widely in size in Virginia, from the 300-bed Mulberry Creek Nursing and Rehab center in Martinsville to facilities of less than 30 beds, especially the long-term care units of a few mostly rural hospitals.

They include facilities designated as skilled nursing facilities (SNF), often post-op care and rehabilitation, and others designated as long-term-care nursing facilities (NF). Most nursing homes in Virginia have facilities and certified beds for each.

Insurer mix and staffing costs are keys to profitability.

Many of these businesses are worth what they get paid, but many are not. Continue reading →

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Posted in Children and Families, Consumer Protection, Efficiency in Government, Ethics, General Assembly, Governance, Health Care, Long Term Care and Nursing Homes, Money in politics, Public safety & health, Regulations and Government Oversight

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Virginia’s Self-Inflicted Nursing Home Crisis – Part 1

Posted on October 1, 2021 by | 15 comments

by James C. Sherlock

None of us ever knows when we will need a nursing home for ourselves, our parents or our kids. Yes, kids.

While long-term nursing care is mostly for older patients, skilled nursing facilities are needed for patients of all ages, including children, for shorter term post-op treatment and recovery.

The patients in many of Virginia’s nursing homes suffer greatly from a combination of known bad facilities and a lack of government inspections. The health and safety of patients in those facilities are very poorly protected by the state.  

In this series of reports I am going to point out some nursing homes (and chains) whose records will anger you. Government data show some have been horrible for a very long time in virtually every region in the state.

Those same records show that Virginia is years behind on important, federally mandated health and safety inspections.

VDH’s Office of Licensure and Certification doesn’t have enough inspectors — not even close. And the government of Virginia — officially based on budget data — not only does not care but is directly and consciously responsible.

When I am done reporting on my research I suspect you will demand more inspectors.

You will also  reasonably ask why the worst of them are still in business when the Health Commissioner has the authority to shut them down.

Good question. Continue reading →

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Posted in Children and Families, Efficiency in Government, Ethics, General Assembly, Governance, Health Care, Long Term Care and Nursing Homes, Money in politics, Public safety & health, Regulations and Government Oversight, Uncategorized

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The Accelerating Scale of the Legislate-Regulate-Spend-and-Repeat Cycle Has Broken Government

Posted on August 4, 2021 by | 23 comments

by James C. Sherlock

Virginians – the state and individual citizens – have received over $81 billion in COVID-related federal funding. That comes to $9,507 for every man, woman and child in the Commonwealth.  Big money. 

That was Virginia’s share of $5.3 trillion in federal spending just on the pandemic (so far). A trillion dollars is a million million dollars. A thousand billion dollars.

For comparison, GDP was about $21 trillion in 2020  It is projected to total just short of $23 trillion this year.  The national debt is $29 trillion and growing. A little over $86,000 for every American. That figure does not include the $5 trillion in additional spending pending in the Congress.

Every day we spend $1 billion on interest with interest on the 10-year treasuries at 1.18% today. The Congressional budget office predicts 3.6% before 2027. Do the math. That is $3 billion a day — well over a trillion dollars a year — in interest. 

Relax. If you thought I was about to launch off on a discussion of drunken sailors, writing checks that our grandkids will have to make good, and the fact that inflation will drive interest payments ever upward, be reassured I am not.

This is about the demonstrated inability of many government agencies at every level to regulate, administer, oversee, spend and repeat with anything approaching efficiency or effectiveness.  Continue reading →

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Posted in Corruption and Scandals, Disasters and Disaster Preparedness, Education (K-12), Efficiency in Government, General Assembly, Governance, Government Finance, Health Care, Housing, Long Term Care and Nursing Homes, Mental illness and substance abuse, Money in politics, Politics, Public safety & health, Regulations and Government Oversight, Social Services and Entitlements

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The Business and Politics of Senior Care in Virginia

Posted on March 24, 2021 by | 2 comments

by James C. Sherlock

We write here often about senior care, the companies that provide it and the politics around that business.

It is useful to understand the continuum of care to make sure we also understand the different financial situations which companies in different parts of that industry find themselves and the way they are overseen and paid in Virginia.

The larger corporations that offer these services often offer both facility and in-home care.

The basic descriptions below are offered for considering the business interests and therefore the lobbying efforts of the companies that provide the services. They are not meant for personal counseling. Continue reading →

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Posted in Government Finance, Health Care, Insurance, Long Term Care and Nursing Homes, Regulations and Government Oversight

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The Real Nursing Home Scandal in Virginia

Posted on March 23, 2021 by | 5 comments

Canterbury Rehabilitation and Healthcare Richmond

by James C. Sherlock

Mike Martz has written three excellent columns that have appeared in the Richmond Times Dispatch starting March 19.  Headline of one: “Virginia tries to move ahead of national ‘reform agenda’ for nursing homes.”

The gist of it was that a couple of national nursing home industry organizations have taken advantage of the public consciousness of the COVID tragedies to produce a “reform agenda” centered around significantly higher Medicaid payments.

Unreported so far is that they also want weaker inspections. More about that below.

We all applaud any attempt to “improve operating standards for nursing homes, initiatives to boost the facilities’ workforce, and efforts to give residents more privacy and protect them from poor-performing nursing homes” as Martz wrote. Who could oppose that?

The financials of nursing homes lead me to agree that higher Medicaid payments will be required to accomplish those goals. But the higher payments need to be accompanied by better oversight to make sure that the money brings the desired outcomes.  Continue reading →

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Posted in Consumer Protection, General Assembly, Governance, Health Care, Long Term Care and Nursing Homes, Political Influence, Regulations and Government Oversight

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