Tag Archives: James Sherlock

Virginia’s Self-Inflicted Nursing Home Crisis – Part 4 – the Worst Facilities in Virginia

by James C. Sherlock

Today we are going to take a look today at a snapshot of Virginia’s worst nursing homes as rated by the Centers for Medicare/Medicaid services.

Medicare rates 54 of the total of 386 nursing facilities in Virginia as overall one star out of five.  By definition of the way that Medicare compiles records and assigns scores, they have been bad for a long time.

Don’t use them. If you have any friend or loved one in one of these places encourage them to re-locate if they can. Either way, visit them often. It helps.

The ratings are established in considerable part by the inspections conducted by the Virginia Department of Health Office of Licensure and Inspection.

Continue reading

Virginia’s Self-Inflicted Nursing Home Crisis – Part 3 – McAuliffe & Herring

by James C. Sherlock

In the first two parts of this series, I wrote about the shortage of state inspectors for nursing homes in the Virginia Department of Health Office of Licensure and Certification (OLC)  and the continuing danger it poses to Virginia patients.

The problem, unfortunately, is much wider than just nursing homes.  So is the scandal.

That same office inspects every type of medical facility including home care agencies as well as managed care plans. Except it cannot meet the statutory requirements because it does not have sufficient personnel or money. And it have been telling the world about it for years.

Terence Richard McAuliffe was the 72nd governor of Virginia from 2014 to 2018. Mark Herring has been Attorney General since 2014.

We will trace below that they can reasonably be called the founding fathers of overdue inspections of medical facilities in Virginia.

VDH has been short of health inspectors since McAuliffe and Herring took office and still is .

Both of them know it. And they know that lack of inspections demonstrably causes unnecessary suffering and death.

Continue reading

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

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

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

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

The Economics of Flood Control in Virginia

Hampton Roads base flood – 1% annual risk

by James C. Sherlock

We have work to do, and need to do it quickly and well.

  • If we want to get storm defenses built before major storm damage rather than after; and
  • if we want the federal government to pay 65% of the costs.

Let’s assume we do.

The “Virginia Coastal Resilience Master Planning Framework” appears to be heading in a direction that may miss important pieces of any benefit/cost assessment. And those assessments drive federal interest.

The assumption in Framework going forward appears to be that the value of flood protection is in loss avoidance. Exclusively. 

Indeed, all of the work that I can find in flooding assessments Virginia is put towards the goal of understanding the costs of such losses.

Not sufficient, but fixable. Continue reading

Louisiana Shows How Flood Control Can Work at Massive Scale

by James C. Sherlock

Louisiana has half the population of Virginia. Virginia is ranked the 18th richest state in per capita income, Louisiana 48th.

So, why has Louisiana been so phenomenally successful in flood control efforts since Katrina while Virginia writes its own framework for action that it is too expensive here?

Primarily because Louisiana figured out after Katrina that:

  1. the feds simultaneously have all the flood control resources — money, expertise, experience, scale — that states do not have, and both write the regulations and regulate flood control.
  2. the state had to organize both the state and local governments to deal with the federal government with a single voice.

The new agency charged with that monumental and immediate task, while quickly and iteratively creating itself, was the Coastal Protection and Restoration Authority (CPRA) of Louisiana.

There is much for Virginians to know about and learn from Louisiana’s success. You will see that the Bayou State has way bigger flooding problems to solve than does Virginia.

Their success must be a model for us.

Yet the Commonwealth seems hell bent on ignoring the methods that enabled that success. Our leaders also deny that engineered defenses, “castles,” are even affordable as part of the solution set in Virginia. Each idea is both ill considered and dangerous.

I will describe briefly how Louisiana has done its part in this. Continue reading

Federal Contracting in Northern Virginia Reaches $60 Billion Annually

Northern Virginia

by James C. Sherlock

The Washington Business Journal (WBJ) reported today that annual federal contracting in Northern Virginia has reached $60 billion. That compares to federal contracting there of $33.7 billion in 2000 (2020 dollars).

As a reference points, I consulted St. Louis Fed data for Virginia GDP in those same years and converted the 2000 data to 2020 dollars.

The GDP of Virginia in 2020 was $551.8 billion. In 2000 the GDP of the state was $412.1 billion in 202o dollars.

So, the percentage of Virginia GDP attributable to federal contracting in Northern Virginia increased from 8.1% in 2000 to 10.9% in 2020.

No comment, just observation.

The Costliest Floods in Interior Virginia Since 1969

Car in tree in Nelson County after Camille

by James C. Sherlock

I offer this survey of Virginia’s biggest interior floods since 1969, mostly courtesy of the National Weather Service, as equal time for my reporting on coastal flooding in Virginia.

The interior is where the most deaths have occurred in Virginia floods, not the coast.

The deaths reach those levels in interior Virginia through a combination of:

  • topography, especially where rain runs off the mountains,
  • sometimes relatively short notice alerts compared to coastal weather forecasting, and
  • the historic practice of building in hollars in the mountains and bottom lands adjacent to rivers.

Rainwater surging down mountains into rivers can be catastrophic at every point in its flow.

This will provide both a photo remembrance and a brief written record of each of those four storms. Continue reading

Virginia’s Coast and Flood Control – The Past Is Prologue

by James C. Sherlock

Granby Street Norfolk after Great Hurricane of 1933

So how do we picture how bad a hurricane or Nor’easter could be along Virginia’s coast? What might it look like?

Won’t the Outer Banks catch the worst of any hurricane and break it up?

Well, no.

Consider some stunning historical examples. Continue reading

Flood Control — Fatal flaws in Virginia’s Approach

Hampton Roads Federal Installations

by James C. Sherlock

It is hurricane season, if you had not noticed.

This is the first of a multi-part series of articles on flood control in Virginia.

This first one will provide a brief overview of where we stand in flood control planning and construction in the Commonwealth with an emphasis on Hampton Roads.

The next three will discuss the federal role, the Commonwealth role and the regional/local roles in more depth.

The development of a Virginia Coastal Resilience Master Plan is the responsibility of the Commonwealth’s Chief Resilience Officer, the Secretary of Natural Resources. So far, it looks like it.

The current path the Commonwealth has chosen has fatal flaws.  A discussion of those flaws follows.

First some background. Continue reading

Campaign Finance Reform in Virginia – the New Governor Must Lead

by James C. Sherlock

I consider campaign finance reform the foremost issue facing representative government in Virginia.

We are one of only a few states with no campaign donations limits at all. We pay for that in legislation enacted and not enacted because of the preferences of huge donors. And in the stink of legal public corruption.

It also drives way up the cost of running and keeps good people from participating.

The new governor will have to lead. Continue reading

Redistricting is Working – Sen. Barker Threatens to Resign

by James C. Sherlock

Something must be going right. Sen. George Barker, D-Alexandria, has threatened to resign. Seems he is unable, at least so far, to pick his voters in the redistricting process.

Virginia’s new bipartisan redistricting commission is working the details with two months to complete its work.

Barker is on that commission. But he lives in Clifton, at the western tip of the current 39th Senate district. Oops.

His current 39th Senate District (pictured above) resembles a golf driver in which he lives in the toe. But his comfortable Democratic margins live in the shaft of the 39th that reaches all the way into Alexandria.

As a matter of fact, the state’s Democrats are packed so thickly in Northern Virginia that geographically compact districts can produce fewer, not more, Democrats in the General Assembly.

So they won’t be geographically compact. But Sen. Barker apparently lives too far from the main Democratic vein to merit an exception. Continue reading

The President Had Somewhere Important to Be

Credit: Getty Images

by James C. Sherlock

The caption of the photo:

“US President Joe Biden looks down alongside First Lady Jill Biden as they attend the dignified transfer of the remains of a fallen service member at Dover Air Force Base in Dover, Delaware, August, 29, 2021, one of the 13 members of the US military killed in Afghanistan last week.”

I watched.  I am sure I had lots of company.

  • Virginia Veterans — nearly 730,215 — one out of 10 adults.
  • Virginia active duty (89,303) and reserve military (25,977) = 115,280
  • Virginia Army National Guard 7,500 soldiers and 46 armories
  • Virginia Air National Guard 192nd Fighter Wing at Langley AFB Hampton – approximately 200.

In an unblinking story for The Washington Post, Matt Viser exposed a failure of leadership and understanding of the moment that was a direct insult to all Americans.

The President was there to representing us all. He shamed us. Continue reading

A is for Activist

by James C. Sherlock

Sometimes the discussions about the ever increasing political content in Virginia K-5 classrooms is hard to visualize. Perhaps this will help.

The Daily Wire discovered the video below posted on a VDOE website by a couple of teachers in Chesapeake public schools as a resource for 3rd grade teachers.

The website is GoOpenVa.org, a site for sharing “digital resources with the end goals of providing equitable access to great learning materials throughout the state, and supporting new approaches to learning and teaching for all Virginians.”

The Daily Wire article explains.

To make it enticing to teachers looking to check off boxes, each lesson on the GoOpenVA platform is marketed as fulfilling certain state educational standards.

By instructing students to liken Black Lives Matter to Martin Luther King (after learning about him from a tumblr account), (this) lesson says teachers can take credit for fulfilling the “Learning Domain: History and Social Science” Standard: “The student will compare and contrast ideas and perspectives to better understand people or events in world cultures.”

Digital content for the students in this lesson plan includes the YouTube video above.

“Great learning materials” indeed.

Coming to a third grade classroom near you.

Retirees Can Help the Schools

by James C. Sherlock

Virginia has 132 school divisions.

I don’t pretend to know what each has done to address the monumental task of teaching kids who have been at varying levels disconnected from the educational system for 18 months.

But I offer a suggestion that some may already be using: seek the assistance — as volunteers or temporary employees — of retirees.

These may include: (1) retired teachers; (2) retirees with some teaching experience and verified subject matter expertise in high-need specialties; and (3) those with special staff qualifications.

Such an initiative will have to be managed carefully and well to ensure the experience is efficient and effective for both the children and the adults and the schools can access the rules relatively easily.

The Virginia Department of Education (VDOE) will need to clear the way by organizing and publishing state licensing guidance. Continue reading