RICHMOND, Va. — Governor Glenn Youngkin has announced a lineup of healthcare providers, industry professionals, state government leaders, legal experts, and consumer advocates who have now been tasked with coming up with solutions to make nursing homes better.
As part of Youngkin's recent executive order aimed at strengthening the oversight of facilities, the Nursing Home Oversight and Accountability Advisory Board has been established. It will make policy recommendations to the state health commissioner and governor centered around improving care.
As one member put it, the stakeholders will be "a part of what's now looking like a wake-up call" as the industry has come under scrutiny for what health officials have called declining quality of care and as the state health department has been criticized for its failures to complete timely complaint investigations and inspections of facilities.
“There is no reason why Virginia, a state that can do so many things so well, should still continue to have nursing home care this bad," said Jim Dau, state director of the AARP Virginia and a member of the board.
The twenty board members were selected by Virginia's Secretary of Health and Human Resources Janet Kelly, and CBS 6 was able to catch up with some of them to discuss the perspectives they'll bring to the table, the changes they'd like to see, and the solutions they're proposing.
Joanna Heiskill is one of the consumer advocates on the board. She's a co-founder of the group Justice and Change for Victims of Nursing Facilities, which provides support to families of residents, collects their stories, and lobbies on their behalf.
"I'm honored to be able to be a sounding voice on the board for every family member that's going through literal hell right now because they can't seem to find a way to make things better for their loved one," she said.
Heiskill's advocacy stems from the personal experience of putting her mother in a facility in 2019. During her time there, she said her mother was given incorrect medication, her dietary needs were not met, and staff improperly withdrew her Social Security and resident trust cash without authorization— which was confirmed through inspection records.
“I reflect a lot on how she suffered, and it's hard to reconcile that, because I put her there," she said.
"What do you see as the number one issue facing the industry right now?" reporter Tyler Layne asked.
“Training and staffing. That goes hand in hand. Training staff, not only how to care for your loved one, but also training those who are in management how to actually manage," Heiskill said. "I would also want to review or take a look at companies that are purchasing these nursing facilities and their agenda, their qualifications, their record. I think that's very important."
She added that she felt government agencies involved in the regulation of nursing homes to include the Virginia Department of Health, the Department of Medical Assistance Services, and Adult Protective Services seem fragmented and don't communicate well enough across agencies.
Peter Anderson, a plaintiff's attorney with the Rawls Law Group who specializes in medical malpractice, hopes to bring a unique perspective to the board. He's spent years investigating facilities and poring through revealing records obtained during the litigation process.
“What I’ve seen is the worst of the worst, unfortunately— anything from pressure ulcers to sexual assault cases occurring in the nursing home," Anderson said.
“What do you see as the biggest issue facing the industry right now?” Layne asked.
“It’s not having sufficient resources to empower the nursing home staff, and what this comes down to is really a corporate negligence problem. If there were sufficient staff and sufficient resources in these nursing homes, a lot of these injuries and horrible events could be avoided," he said.
Anderson believes those issues could be addressed through stronger ownership transparency requirements and more robust tracking of how companies spend their Medicare and Medicaid dollars.
"Staffing, of course, is a big area of overhead for these facilities. It's the big cost center. So, what's the obvious item to cut if you're a business? It's the staffing," Anderson said. “What we see in a lot of cases, sadly, is that the corporation is more interested in making profit than having good patient care."
Bringing decades of experience on the provider side, Mandy Gannon, a nursing home administrator with Green Tree Healthcare, looks to represent the needs of caregivers and the facilities they work in.
“We have to have the resources in order to provide the care to the residents and the patients and in order to grow staff," Gannon said.
With 30 years of working in the industry, Gannon said she has seen "dramatic" transformations. One of the biggest changes, she said, is that residents in these facilities are much sicker than they used to be.
“I’m not sure that the general population really understands the acuity level of what we're caring for," Gannon said.
And a majority of them are insured through the taxpayer-funded Medicaid program, she said.
While patients' needs have grown significantly, she said government funding has not.
“I don't know that Medicaid in particular has caught up with the amount of care that we're providing and what we're paying. Medicaid is just not covering those costs," she said. “I have to be comfortable and be able to sleep at night and look myself in the mirror every morning that I'm providing the care and that I have the financial means given to me to provide that care.”
Other areas of interest for her include addressing staffing shortages and seeking better collaboration with regulators.
While she said she appreciates and welcomes accountability, she said the regulatory process has felt more "adversarial" lately.
Jim Dau, the state director of AARP Virginia, said he hopes to help implement "long overdue, long neglected programs" to address staffing and safety in long-term care.
His top two priorities include expanding access and resources to people entering the workforce and beefing up the agencies that hold facilities accountable.
“We need more inspectors to go in and actually provide the mandatory inspections that these facilities need to keep operating. At the same time, we need to fully fund the long-term care ombudsman program, which has never been fully funded in Virginia," he said.
The long-term care ombudsman program helps settle disputes between residents and facilities and provides liaisons who can facilitate families' requests.
He applauded the Youngkin administration for spearheading these initiatives on a topic that he feels is often overlooked and said he hopes the board's work continues with the next administration as well.
"I know that in comparison to other states that Virginia shouldn't be near the bottom of the list in terms of providing quality care," Dau said. "This is going to be a long, complicated process that's going to require resources and attention and political will. We have to try. People are literally depending on it."
The board is expected to have its first meeting by Sept. 15.
Share your nursing home stories with the CBS 6 Investigative Team: Email Melissa Hipolit and Tyler Layne
