RICHMOND, Va. — After a nursing home industry group was a no-show for a presentation before a state panel that advises the governor on nursing home oversight, the group blamed its absence on "travel complications."
But text messages obtained by CBS 6 revealed travel was the excuse the group planned to cite for optics, and the actual reason stemmed from disagreements with the health department over the contents of its presentation.
Last month, Virginia's Nursing Home Oversight Advisory Panel, a public body created under an executive order issued by former Governor Glenn Youngkin partly in response to CBS 6's investigative reporting on nursing home quality issues and continued under Governor Abigail Spanberger, was set to hear presentations from three industry lobbying groups.
Two of those groups, the Virginia Health Care Association — which represents almost all of the state's nursing facilities — and LeadingAge Virginia — which represents only non-profit facilities — presented as expected.
The third group, Virginians Advocating for Seniors (VAFS), did not.
When asked by CBS 6 why not, Health and Human Resources Secretary Marvin Figueroa said, “I think the conversation we wanted to have was about quality, and they're an important partner to make sure that we're increasing quality. And it's telling that they weren't here.”
He did not elaborate further.
VAFS is a relatively new trade association. Within about a year, its political action committee (PAC) has already donated hundreds of thousands of dollars to Virginia politicians, including $250,000 to Governor Abigail Spanberger's inaugural committee and her PAC.
The group previously said its political giving is only one part of what it does and that the rest involves trying to shape public policy that impacts quality outcomes in nursing homes.
VAFS says it represents 97 nursing homes but has not answered CBS 6's multiple questions asking which ones. Campaign finance reports show its PAC is funded by entities that federal data connects to at least four corporate chains — Marquis Health Services, Lifeworks Rehab, Eastern Healthcare Group, and Hill Valley Healthcare. All but Marquis perform below the national average on overall quality ratings.
Internal emails, obtained by CBS 6 through a Freedom of Information Act request, showed Joe Hilbert with the Virginia Department of Health (VDH), the state agency that regulates the industry, asked industry representatives to present at the September 30 advisory panel meeting.
Hilbert requested that they talk about how they identify facilities that need quality improvement.
VAFS sent its presentation to VDH in advance on September 26. On September 29, the day before the meeting, Hilbert told VAFS he wanted the group to "delve more deeply" into what it does when its member facilities have "significant quality concerns."
Frank Vitello, who VAFS said is a "senior member of the team," responded that every facility handles those situations "exactly the same way" and that there is "no secret sauce."
Hilbert responded by sending Vitello a link to a CBS 6 story that featured resident advocates marching for nursing home reform and accountability.
Richmond
Richmond advocates march for nursing home reform and accountability
Vitello responded, "This article is all about staffing. The staffing folks are driving media because the report on staffing mandate is coming out in a couple weeks."
When asked by CBS 6 what Vitello meant by that email, a VAFS spokesperson said, “VAFS believes that staffing is over-measured as a quality metric in Virginia nursing homes—and that the media disproportionately covers it. Workforce Development and quality incentives, among other policies, deserve a more prominent place in the nursing home conversation."
The report that Vitello referenced was released last week by the Joint Commission on Health Care and recommended that Virginia establish a staffing mandate. The report said "a substantial body of evidence" links higher staffing levels to better quality of care outcomes.
Later that day on September 29, Vitello texted Hilbert, "We're going to withdraw from the meeting tomorrow," saying, "the politics of this venue are probably not going to be helpful trying to have the conversations that need to happen."
He added, "Optically, we're going to say that we had difficulties in travel."
A VAFS spokesperson later told CBS 6 its presenter couldn't make it due to "travel complications."
VAFS did not directly answer CBS 6's questions about what Vitello meant by the "politics of the venue" and why that would not be helpful.
In a statement to CBS 6, VAFS spokesperson Jay Sandusky said, "VAFS decided against presenting to the Advisory Panel to avoid highlighting our difference of opinion with VDH about the contents of our presentation. Our presentation included a broad set of data about quality outcomes in the nursing home industry, while VDH wanted a more focused presentation concentrating on crisis management. Because crisis management at nursing homes has a very standard set of state guidelines followed by every facility, we felt we had little to contribute in that realm."
Records obtained by CBS 6 also showed someone at VDH at some point sent or received a text message that said, "He wants to call out VAFS for skipping."
The text VDH provided to CBS 6 did not say who sent and received the message or when. VDH did not answer CBS 6's questions asking for more context.
In a statement to CBS 6, VDH spokesperson Maria Reppas said, "Virginians living in nursing homes deserve to be safe and treated with dignity. The Virginia Department of Health is committed to working with residents, families, advocates, and providers to improve the quality of care and strengthen accountability. Insofar as Virginians Advocating for Seniors help us achieve those goals, we welcome their ideas and continued involvement. We share a responsibility to the people who depend on these facilities and the families counting on them."
