HENRICO COUNTY, Va — Virginia's lacking oversight of nursing homes is causing frustration among people worried for their loved ones in long-term care facilities.
They're submitting complaints to the state to raise concerns about safety issues, quality of care, and facility conditions, but they're waiting several months for the state to respond to those complaints.
'Every day was a new horror'
Take Heather Tyler's situation, for example.
She said she gets a sick feeling thinking about her husband's brief stay at Westport Rehabilitation and Nursing Center in Henrico County.
“Every day was a new horror," Tyler told CBS 6. "Absolutely pitiful, disgusting, deplorable. Any words you can think of that's horrendous is the word for it."
She took Earl Tyler to the nursing home in January of this year, as he dealt with Alzheimer's, narcolepsy, and incontinence.
Since Earl is a veteran, she said she found Westport due to it being a VA-contracted facility.
But she said she instantly became concerned with the cleanliness of his room.
“I mean, you can see the marks on the wall and the dirt on the edges," Tyler said, showing CBS 6 pictures she took of the conditions.
One day, Tyler said she found Earl covered in his own urine.
“He's sitting there and he's holding his leather belt in his hand, and it's dripping, and I'm looking at him," Tyler said. "It was the same clothes I had put on him at 11 o'clock the day before, the same Depends I had put on him at 11 o'clock the day before. He was soaked from his elbows to his knees."
She said her worries escalated after discovering Earl had fallen two times, and on one occasion, he was unable to move his hand, prompting Tyler to take him to the emergency room.
"He reached out, and his hand was kind of curled up, and it was quivering. And it was, 'What the hell happened to your hand?'” Tyler recalled.
The final straw, she said, was when she found marks on Earl's body, including what she said appeared to be bruises and a cut on his head.
Tyler alleged staff members were unaware of the marks and could not explain them.
“I was really so angry, so incredibly angry," Tyler said. “I just cried. Cried and cried and cried.”
After just 19 days, Tyler decided to remove her husband from the facility.
CBS 6 reached out to Westport Rehabilitation and Nursing Center multiple times to request a response to Tyler's allegations and is still waiting to hear back.
Investigation delays: 'Make them accountable'
Shortly after removing Earl, Tyler said she worked with an advocate from the state's long-term care ombudsman program to file a complaint with the Virginia Department of Health (VDH), the state agency responsible for inspecting nursing homes for compliance with government regulations.
That was in January. It's now September, and Tyler said VDH has not taken any action on her claims.
When CBS 6 brought Tyler's concern to VDH, a spokesperson said the agency had no updates on the status of her complaint.
“Get off your rear ends and do something about this. Make people responsible. Make them accountable," Tyler said.
Her frustrations are very similar to Steve Lambert's.
Last month, CBS 6 reported that it took VDH eight months to investigate complaints Lambert submitted about Westport out of concern for the conditions his brother faced.
Lambert's brother died before VDH initiated the investigation.
As a former licensing, enforcement, and regulatory manager for facilities under the supervision of the Virginia Department of Social Services, Lambert said VDH's response time was unacceptable.
“They need a system in place to provide the proper oversight in a timely and effective manner to ensure that these vulnerable people are not harmed," Lambert said.
Tyler happened to catch Lambert's story on the news and felt compelled to speak up too.
“It was like a godsend," Tyler said. "I thought, wow, someone has led me. This is a divine intervention that someone said, 'Turn on this TV and turn on that channel.'"
A failure to meet federal standards
Federal investigation standards separate nursing home allegations by priority.
According to guidelines set by the Centers for Medicare and Medicaid Services (CMS), complaints assessed at even the lowest severity levels should be addressed within 45 days or as a potential focus area during the facility's next on-site inspection. Westport has had at least two on-site inspections since Tyler submitted her complaint.
As CBS 6 previously reported, VDH has a 40% vacancy rate for long-term care facility inspectors, also known as surveyors. Virginia has nearly 300 nursing homes and 29 surveyors to inspect them, according to data provided by VDH.
Compared to other states, Virginia has the fourth-highest percentage in the country of nursing homes that are overdue for recertification. CMS requires recertification inspections at least every 15 months.
Nearly 70% of Virginia's nursing homes are overdue, as of September. The national average is 22.4%.
Last month, CMS released its 2023 performance review of state agencies, and it showed Virginia was still struggling to improve upon the timeliness of its investigations and inspections, which were negatively impacted by the pandemic.
The audit found Virginia did not show improvement in reducing past-due inspections from the prior year and did not meet standards to initiate timely investigations of the most serious complaints.
CMS requires states to investigate allegations threatening the immediate jeopardy of one's safety within three days, but Virginia did not meet that benchmark at least 80% of the time.
VDH declined multiple interview requests to discuss these topics.
A spokesperson for CMS said state agencies struggle because Congress hasn't increased funding for its inspection program since 2015, despite a sharp rise in nursing home complaints.
As a result, state agencies are left understaffed and under-resourced, which a Congressional report found creates poor nursing home conditions.
'What can I do to get you money?'
Tyler said she has been on the phone with several leaders in the health department including the licensing director, the regulatory affairs director, and assistants in the health commissioner's office.
“And everyone just keeps saying, 'We need funding, we need people, we need funding, we need people.' Isn’t that what senators are for?” Tyler said. “What can I do to get you money?”
She even wrote to U.S. senators Tim Kaine and Mark Warner and Gov. Glenn Youngkin to advocate for more nursing home oversight and accountability.
Tyler also filed complaints with Veteran Affairs and Adult Protective Services.
She said she wants to share her concerns with "anyone who will listen," but what she wants most is for state and federal officials to take urgent action to improve oversight and protect vulnerable nursing home residents.
“Everybody can tell you a horror story about this, and yet it's accepted, or it's just, 'Oh, that's awful,' and nothing happens. It's damn awful, and something has to be done," Tyler said.
CBS 6 spoke with Sen. Tim Kaine and Gov. Glenn Youngkin and reached out to several other elected officials to ask how they're working to address nursing home oversight concerns.
That part of the story airs Thursday, September 26.
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