RICHMOND, Va. — Officials with the Virginia Department of Health (VDH) said it "should not be an issue anymore" to utilize all available funding meant for nursing home oversight initiatives after the agency did not use millions of federal dollars that could've been spent on those efforts in recent years.
During a state nursing home advisory board meeting in late October, VDH's Chief Operating Officer Christopher Lindsay addressed CBS 6's reporting that revealed the agency did not use $2.4 million in federal funding meant for the regulation of healthcare facilities from 2021-2023.
That figure came directly from the Centers for Medicare and Medicaid Services (CMS), which gives states money to inspect and investigate nursing facilities to ensure residents receive safe, quality care in accordance with federal standards. A CMS spokesperson said Virginia "returned" the unspent federal funds.
Lindsay argued VDH did not "return" the money, because the agency never actually received the money. The reason the funding wasn't used, he said, is because VDH's nursing home oversight office was understaffed. An internal review of that office produced earlier this year revealed some key positions remained vacant for years, and there was no formal retention plan in place despite high turnover.
"There's been some recent discussion around funding from CMS and that VDH actually returned funds to CMS, and I want to correct some of that. VDH does not actually receive funds proactively. VDH can only pull down funds from CMS if there is an eligible expense which we can attribute that fund to. So because many of these positions were so long vacant, there was nothing to pull down money from CMS and attribute to those positions," Lindsay said.
But even with vacancies, according to CMS, the funds could've also been used for hiring new staff, recruitment efforts, training, and bringing in contractors to help complete inspections and complaint investigations.
"Not to use the money they have or that they're given seems really troubling," said Toby Edelman, a resident advocate and nursing home regulation expert with the Center for Medicare Advocacy. "You could hire more staff, pay better wages, make sure that [inspectors] go to training conferences, that they know what they're doing, help them pass the test. There are important things that that money could have been used for."
For fiscal year 2024, VDH did not draw down an additional roughly $4 million out of the total $7.7 million available, according to VDH. VDH previously said it planned to work with CMS to retroactively draw down "as many of these additional federal funds as possible."
CBS 6 asked the agency to confirm how much money, if any, will be left unused for fiscal year 2024. A VDH spokesperson said that information was still not yet available.
The unspent funding occurred in the years leading up to Governor Glenn Youngkin's decision to issue an executive order in August 2025 to reform VDH's nursing home oversight office as it struggled to complete timely inspections while observing worsening quality of care in facilities.
As of Wednesday, federal data shows 78% of Virginia nursing homes are still overdue for routine inspection, ranking the state the second worst in the country for late inspections. At the same time, consumers are filing a record number of complaints about facilities, which frequently allege poor conditions and neglect. The agency has previously said that investigating serious complaints takes priority over completing standard inspections, which contributes to inspections falling behind schedule.
In a statement last month, House Speaker Don Scott (D-Portsmouth) and Delegate Mark Sickles (D-Fairfax County) also responded to CBS 6's report by criticizing Governor Youngkin's administration, saying in part, "Failing to use available federal funds to strengthen oversight is another stain on the administration’s record and is not just irresponsible – it’s a betrayal of the families who trust the Commonwealth to protect their loved ones. While VDH has faced challenges for a long time, this administration needs to stop bragging about all the ‘progress’ they’ve made and do what they can to use all resources at their disposal, including federal dollars, to turn this mess around."
Lindsay said amid aggressive recruitment initiatives, directed by Governor Yougkin's executive order, VDH is swiftly hiring more inspectors and leaders, which will resolve the funding problem.
“That should not be an issue anymore, because now these positions are being filled, and as the positions are filled and those individuals are doing work, we were able to be pulling down that money and attributing it again to those eligible expenses," Lindsay said.
Since July 2025, Lindsay said VDH has received more than 1,300 applications for open job listings. 14 medical facility inspector candidates have officially accepted job offers, and key leadership roles, including a director position, have also been filled. The vacancy rate of inspectors has declined from nearly 50% in August to 15% in November.
The agency is also working to take more aggressive accountability actions against nursing homes that present "numerous and egregious" violations of care and safety standards.
Joe Hilbert, VDH's Deputy Commissioner for Governmental and Regulatory Affairs, told the advisory board in October that the agency historically "has not made great use" of its existing authorities to suspend or revoke a facility's license and/or restrict admissions to a facility.
"We've been reluctant to do that historically, but times change," Hilbert said.
Moving forward, he said VDH is developing new procedures to take stronger actions when warranted and is working on promulgating regulations that will allow the state to expand its enforcement options to include imposing fines, requiring staff training, and placing a license on probation.
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