RICHMOND, Va — A top state official says "drastic changes" are taking shape that aim to make nursing homes better, delivering on a promise, he said, that Governor Glenn Youngkin's administration made to improve care for vulnerable seniors as the commonwealth ranked among the bottom states in the country for quality.
“I’m very, very proud of the progress that we've made," Christopher Lindsay, Chief Operating Officer of the Virginia Department of Health (VDH), said in an interview with CBS 6. “I've got to give Governor Youngkin a lot of credit here, because he was directly involved in this conversation back in the summer, and we decided that this is something we needed to make some drastic change towards.”
Lindsay has played a key role in implementing an executive order Youngkin issued in August to strengthen accountability and oversight of the state's nearly 300 nursing facilities.
The action was partly a response to CBS 6's investigative reporting highlighting the concerns of families complaining about poor quality of care in record numbers, and VDH's failures to ensure timely facility inspections and complaint investigations. Research has shown that inadequate state oversight and enforcement responses can put residents at risk of danger and lead to poor nursing home conditions.
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Nursing home care worsens, Virginia struggles to hold facilities accountable
“I would say that you specifically and CBS [6] as a whole have had an incredible amount of impact on this. Bringing a voice to many citizens that actually came to our advisory board was incredibly important. CBS [6]'s reporting made the ‘why’ much more apparent as we were engaging in this process of rebuilding OLC," Lindsay said.
As previously reported, VDH's Office of Licensure and Certification (OLC) had been significantly understaffed for years, rendering it incapable of carrying out its oversight duties. Further, an internal review completed earlier this year revealed nearly every aspect of the office was not functioning properly, employees lacked training and skills, and they were not given the proper resources to do their jobs.
So, the executive order directed an overhaul of OLC with just four months to do it. When it was announced, multiple advocacy groups praised the governor for spotlighting the issues facing long-term care, but some democratic leaders have expressed skepticism over the timing and intent of the actions.
Vacancy rates improve, but inspections still lag
First, VDH was to bolster its staffing of inspectors by filling every vacancy by the end of the year.
With aggressive recruitment efforts, Lindsay said his team has brought the vacancy rate of long-term care facility inspectors from over 40% in the summer to 9% currently. He said that represents OLC filling 13 out of the initial 17 open positions, which he referred to as a "resounding success." However, the 9% vacancy rate does not account for five additional positions that were recently added to a newly formed regional office, which will also need to be filled.
“Are you seeing that inspections are starting to get done in a more timely manner?” reporter Tyler Layne asked.
“We expect that to happen, yes," Lindsay answered.
Lindsay declined to share the current average interval between standard inspections, also known as surveys, which are supposed to occur at least once every 15 months. The surveys are required by the federal government to ensure facilities, which typically receive most of their funding through Medicaid and Medicare sources, meet basic health and safety standards.
In June 2025, VDH reported the average interval was 22 months, an improvement from 37 months in June 2024.
But publicly available federal data shows 84% of Virginia's nursing homes are still overdue for routine inspection, as of December 2025.
“That number is actually worse than what it was this time last year, and it puts Virginia as the second worst state in the country for overdue inspections. How do you square that with what you're saying are the successes of this executive order?” Layne asked.
“The fruits of this labor are going to take some time to come, and I think it's important that the effort that we've put in now, next year, you should see a far different outcome," Lindsay said.
He added it will take about eight months before newly hired staff are fully trained and certified to perform inspections.
The Virginia Health Care Association, which represents the industry and recently criticized what it called VDH's "broken" oversight system due to late inspections, said in a statement it "appreciates the commitment VDH has made to strengthening the Office of Licensure and Certification team and to advancing nursing home survey efforts."
New portal launched as complaints skyrocket
Further, Youngkin instructed the agency to provide transparent consumer information to the public, to which VDH posted a link on its website to existing nursing home quality data maintained by the Centers for Medicare and Medicaid Services (CMS). This data displays a nursing home's quality ratings, staffing data, and health inspection results.
However, some experts and stakeholders have raised concerns that the CMS data can sometimes be incomplete. Lindsay said OLC will be monitoring the information to ensure Virginia's facilities "are accurately recorded in this portal."
The governor also told VDH to modernize its operations. To that end, Lindsay said OLC launched a new user-friendly portal, developed with the help of outside consultants, so that people can lodge complaints against facilities more easily.
“Previously, as complaints came into the office of licensure, it was taken on a handwritten note, through a telephone call, even a fax machine or email. So, there was a lot of opportunity for mismessaging or messaging to go several days without being addressed," he said. "What this complaint portal will allow us to do is more accurately triage complaints as they come in, more accurately assign them and lead to faster outcomes in these surveys.”
Another benefit of the complaint portal, Lindsay said, is that OLC can use it to track data on types of complaints and trends related to facility ownership, control type, and location.
In 2025 so far, VDH said 1,508 nursing home complaints have been filed, more than doubling the 730 complaints filed in 2024. State Health Commissioner Dr. Karen Shelton has previously said that complaints typically allege poor conditions and neglect, and VDH is noticing the complaints growing more severe in nature.
Advisory board aims to 'amplify voices,' make real changes
Lastly, the governor established an advisory board made up of stakeholders to come up with recommendations for the state health commissioner to improve care and accountability. Health and Human Resources Deputy Secretary Leah Mills said the board aimed to "amplify the voices of families, residents, and dedicated advocates" which she said ensured "meaningful representation" from those directly impacted, "unlike any other body in the commonwealth."
The board held three total meetings. CBS 6 covered each of them:
A common theme throughout the discussions was that members representing families and residents feel some nursing homes with particularly poor performance put profits over quality of care while those representing provider perspectives said they face immense challenges hiring enough care staff.
"We must also confront a deeper structural issue, what I call the root and the beginning of these issues— the corporate ownership of nursing facilities without limits and restrictions is not sensible. It's dangerous to allow corporations to purchase and operate these homes as profit-driven enterprises. It's wrong because what happens is that you have profit over quality of health. This is how we got here," said Joanna Heiskill, a resident advocate with Justice and Change for Victims of Nursing Facilities, during a meeting.
"I'm in the process of importing [registered nurses] from the Philippines, just because we can't find them here. So you can't just say arbitrarily that you're going to hire more people," said Jonathan Cook, who runs non-profit nursing homes, during a meeting. "To just say that we have to create regulations and ratios without understanding where the people come from, staffing retirement communities, I don't think anybody understands how difficult that really, really is."
While a final report from the board is expected to be released in January, preliminary recommendations include expanding VDH's authority to deny the sale of nursing homes to owners with a poor quality history, address the rise of private equity's involvement in the industry, and strengthen ownership disclosure.
“There's lots of external parties from Virginia that come into the state and own many, many facilities, and I think we need to have a good understanding and provide the data for that transparency of ownership," Lindsay said. "We found that there's many different layers to these organizations both in Virginia and out when you look at the real estate component of nursing homes as well. So, a more broader understanding of each layer would be certainly important to driving transparency."
AARP Virginia, which has representation on the advisory board, said there's still a lot of work left to do, but expressed optimism that the efforts stemming from the board and executive order will lead to further action.
"Poor resident care in Virginia nursing homes is one of the most urgent issues facing the Commonwealth. AARP Virginia is hopeful that Executive Order 52 and the work of the Nursing Home Oversight and Accountability Advisory Board will lead to meaningful policy change that puts quality care over owner profits," said Jared Calfee, State Advocacy Director for AARP Virginia, in a statement.
Heiskill of Justice and Change for Victims of Nursing Facilities said it was "premature" to declare success from the executive order as families believe "conditions remain unchanged" in nursing homes.
"There has been no measurable improvement in nursing facilities. Oversight measures have yet to deliver results, and the complaint portal remains unproven. Enforcement and policy efforts have not translated into better care. This is not reform—it’s window dressing," Heiskill said in a statement. "For decades, our elderly have suffered while corporations put profit over lives. Families have endured heartbreak while watered-down solutions dominate the conversation."
She added, "It’s time to stop congratulating ourselves and start fixing what’s broken."
What comes next?
With Youngkin nearing the end of his term, any recommendations from the board and continued work regarding OLC will be left to Governor-elect Abigail Spanberger's administration.
CBS 6 asked Spanberger whether she will continue on with the executive order. She did not directly answer the question but addressed the issue broadly.
“We need greater accountability. We certainly need to ensure that we're doing the nursing home inspections," Spanberger said during a press conference last week. "I have heard from folks, largely in the healthcare space, that there's some clear missing elements of how it is that we actually get to provide those inspections when they are so understaffed and so far behind, but as a broad priority, absolutely, we must ensure that we are doing those necessary inspections and ensuring that anyone living in a nursing home has quality care."
Speaker of the House of Delegates Don Scott (D-Portsmouth) also chimed in on the question, saying Youngkin's executive order didn't accomplish anything.
“Regarding that executive order, that's like a last-minute band aid. That's just like, let me C-Y-A, as opposed to fixing it. He had four years to fix this nursing home issue," Scott said. "He knows that they are understaffed in getting those nursing homes inspected, which is slowing down the reimbursement rates from the feds. They know this. They didn't fix it."
Meanwhile, Delegate Mike Cherry (R-Colonial Heights), who represents the district of Colonial Heights Rehabilitation and Nursing Center, which remains at the center of a special grand jury investigation into alleged abuse and neglect, commended Governor Youngkin's focus on strengthening oversight.
"I regularly hear from families concerned about the quality of care their loved ones receive in nursing homes," Del. Cherry said in a statement. "Filling vacancies in OLC will make a real difference. Because this is not a partisan issue in any sense of the work, I trust that Governor-elect Spanberger will continue making this a priority."
Lindsay said he disagreed with Speaker Scott's assertion, because years of work needed to first take place to fix VDH's agency-wide administrative issues with grant management and human resources management before he could focus on rebuilding individual offices.
A report released by the legislature's research arm last year revealed deep systemic operational challenges impacting financial management, accountability, and staffing across all of VDH. Youngkin's office said at the time those issues were inherited.
"This was not an effort that could have been undertaken three years ago or two years ago or even one year ago," Lindsay said. "A lot of our effort needed to be put to building up the financial house at VDH that allowed us to pivot more recently to accomplish goals like we're seeing in OLC.”
“How do all the things we’re talking about translate into actual better care for the patients?” Layne asked.
“I 100% believe that more presence by VDH in facilities with trained inspectors and supervisors, we will start to see substantive change in the quality of care in Virginia's nursing homes," Lindsay said.
CBS 6 requested an interview with Governor Youngkin for this story but a spokesperson referred the request to VDH.
CBS 6 is committed to sharing community voices on this important topic. Email your thoughts to the CBS 6 Newsroom.
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