Personnel Shortages that Plague Virginia’s Health Facilities Inspection Staff in the Hands of Budget Negotiators

UVa Hospital

by James C. Sherlock

One of the most important responsibilities of Virginia state government is to inspect medical facilities and home care providers to ensure we are safe when we enter their care.

It continues to fail in that responsibility thanks to years of Virginia budgets that have consciously ignored the need for increased inspector staff and increased salaries with which to competitively hire that staff.

I have reported for a long time that the staffing of the Virginia Department of Health (VDH) Office of Licensing and Certification (OLC) is scandalously deficient. Based upon an update today from OLC, it remains so.

That organization has only half of the inspectors it needs to carry out its defined responsibilities.

Those highly skilled and very dedicated people, largely registered nurses, are asked to do every day for Virginians what we cannot do for ourselves and what our elected representatives have refused for decades to properly fund them to do.

Think of that next time you use the facilities and home providers they are required for your safety to inspect.

We hope the current General Assembly budget negotiators keep it in mind for themselves and their families.

Or the Governor sends the budget back until they do.

Because of below-market salaries and benefits, OLC is unable to fill the 78 Medical Facility Inspector (MFI) positions they are authorized.  Nineteen of those, a quarter of the total, are vacant today.

That is the tip of the iceberg. I asked VDH whether

If fully staffed to authorized positions, you would be short of the numbers of inspectors to make the program work the way it should.  If that is the case, please estimate the shortfall between needed positions and authorized positions.

In response to my query, they responded:

Our most recent estimate of additional positions needed for required state licensure responsibilities included: home care organizations (14 MFIs, 2 Supervisors, and 2 Admin Support Staff) and Acute Care/Long Term Care (13 MFIs, 3 Supervisors, and 1 Admin Support Staff).

Funding for the additional positions could be covered by revenue from licensing fees that are collected. However, repeated attempts to increase licensing fees have been unsuccessful.

In addition, a request was also included in the CMS budget for an additional ten long term care MFIs to accomplish the required federal responsibilities. (emphasis included in response)

Doing the math, the OLC requires 115 MFIs to accomplish its state and federal missions. It has 59 onboard.

Next time you use a medical facility or a home health organization, consider that.

What to do? Perhaps the current budget negotiators can consider that they and their families too will some day soon use a Virginia medical facility or home health organization and fix the entire problem.

Use budget language to increase the fees to the inspected organizations to fund the need and authorize the additional inspectors needed. Those fees have not been raised in 40 years.

Given that the industry does not like to be inspected, they will need to fight that headwind. Saddle up and do it.

The Governor should send the budget back if it does not solve the problem.