Profound Registered Nurse Shortages in a Virginia Beach Nursing Home

By James C. Sherlock

Registered nurses (RNs) both supervise medical treatment and are the primary medical care providers in nursing homes.

Physicians are on call but generally are not present.

One Virginia nursing home is currently advertising:

RN’s Now hiring All Shifts! Pick your shift.

Perhaps not good news for those patients.

Some of the worst nursing homes are just bad places to work.  Others don’t pay their nurses enough.

Some both.

I will describe with Centers for Medicare & Medicaid Services (CMS) information a Virginia Beach nursing home that:

  • is grossly understaffed; and
  • has been cited in its most recent inspection both for abuse of patients and for failure to provide appropriate treatment and care.

Yet it is open and soliciting new residents.

Virginia nursing homes and RNs.  The last Bureau of Labor Statistics report offers results from May of 2022.

Virginia at that point had 69,510 working RN’s, paid an average hourly mean wage of $39.36 and an annual mean wage of $81,860, calculated for 2080 hours.

It is perhaps illustrative of the extent of the national problem with nursing home staffing that staffing is a characteristic rated by CMS for nursing homes but not for hospitals.

Despite that, some Virginia facilities are currently offering RN jobs at well below comparable RN wages last year.

  • One RN job at Heritage Hall in Front Royal is being solicited for $58.9k – $74.6k per year*. That nursing home is currently rated by CMS at one star for staffing. That converts to an hourly wage range of $28.32 to $35.87.
  • The same RN job at the Leesburg Heritage Hall, rated two stars for staffing, is offered for the same $28.32 to $35.87 hourly range.
  • Glenburnie Rehabilitation and Nursing Center in Richmond is offering two RN jobs at $62k – $78.6k per year which converts to $29.81 to$37.79 per hour.  Glenburnie has a one-star CMS rating for staffing.

All job offerings and salary ranges in this story are quoted from yesterday unless otherwise noted.  Maybe they will fill those jobs, maybe not. But doing so does not appear to be a strategic priority.

RN turnover in nursing homes is very high, averaging 56% annually in Virginia and 54% nationally over the past twelve months.  That is also a statistic published only for nursing homes.

For that reason there appears to be an industry-wide nursing home sign-on bonus in Virginia of $5,000 – $7,500, paid out in two increments at 90 days and 6 months of employment.

But hospital sign-on bonuses for RNs here range from $7,500 to $10,000 and above.

A Virginia Beach example. A charge nurse is an RN who is in charge of a ward in a healthcare facility during his or her shift.   They will generally need a minimum of 3-5 years of experience in a clinical setting before they can get hired as a charge nurse.

A charge nurse job at UVa Health System is offered at $39.39 – $64.98 an hour.

Saber Healthcare Group advertises for an RN charge nurse who can “earn up to $40 per hour” at its Colonial Health & Rehab Center LLC (Colonial) in Virginia Beach.

Let’s see how RN staffing has been going at Colonial over the past three months, as reported by CMS:

  • RN hours per resident per day in CMS data represents each facility’s daily average over the last reported three-month quarter as verified with its payroll system.
  • Registered nurse staffing at Colonial over the last quarter was, on weekdays, 13 minutes per resident per day.  Nationally the average figure was 39 minutes.  Both figures are adjusted for patient load and individual patient nursing requirements.
  • But even 13 minutes was far better than on weekends, when the average RN hours per resident per day at Colonial was three minutes per resident per day vs. a national average of 36 minutes.  You read that right.
  • CMS notes that Colonial submitted data that did not meet the criteria required to calculate RN turnover.  We can only imagine.

Inspections and federal sanctions. The same job advertisement linked above offers as a benefit of Colonial:

Culture of employees creating an IMPACT!

So let’s look at impacts.

Federal fines in the last three years: 4

    • $74,419  07/08/2021
    • $2,293. 01/11/2021
    • $9,750. 12/11/2020
    • $9,750. 09/25/2020

Payment denials by Medicare in the last 3 years: one on 07/08/2021.

Most recent health inspection 07/08/2021. Total number of health citations in that inspection: 17.  Average number health citations in U.S. nursing homes 8.8.

Last complaint inspection, 06/23/2022, resulted in two citations: one for abuse and one for failure to provide appropriate treatment and care.  The level of harm for each was actual.  We note no federal fines after that inspection.

Bottom Line. Colonial Health & Rehab Center is still open and soliciting new patients.

It’s just a few miles from me.  I can even pre-register.

I’ll tell my friends.