RICHMOND, VA — A group of nursing home advocates and former healthcare workers rallied at Virginia's state capitol this week, calling on lawmakers to establish mandatory minimum staffing standards for long-term care facilities across the commonwealth.
Certified nursing assistant Victoria Jackson, who previously worked in nursing homes before leaving due to what she described as burnout and unsafe working conditions, led the effort to push for staffing requirements that she says would protect both residents and employees. According to reporting by WTVR, Jackson told the crowd that healthcare workers face poor treatment and fear retaliation when raising concerns about facility conditions.
"We don't want to work in toxic work environments," Jackson said, as reported by the local CBS affiliate. "We need to be compensated fairly for what we do, because we're charged with keeping people alive and safe, and we get treated like we're disposable."
The rally comes as Virginia legislators debate multiple bills aimed at reforming nursing home oversight and quality standards. Delegate Rodney Willett, a Democrat representing Henrico County, introduced legislation this session that would have established a staffing standard for Virginia nursing homes. However, according to WTVR, the bill was converted into a study measure by the time it passed the House of Delegates.
In an interview with the news station, Willett attributed the change to funding constraints, noting that a staffing minimum would require increased Medicaid reimbursements to facilities to cover the cost of additional employees. While the exact cost remains uncertain, Willett estimated it would total significantly less than $20 million annually, according to the report.
The response from industry groups has been divided. The Virginia Health Care Association, which represents nearly all nursing homes in the state, expressed appreciation that legislators recognize the need to fund any staffing mandate, according to reporting. Meanwhile, LeadingAge Virginia, representing nonprofit facilities, voiced disappointment that the staffing requirement was removed from the bill and urged lawmakers to reconsider.
Sam Kukich, founder of the advocacy group Dignity for the Aged and a member of Governor Youngkin's nursing home advisory board, expressed frustration with the legislative process. According to the news report, Kukich questioned what additional study was needed and voiced skepticism that staffing ratios would ever be established in Virginia.
Advocates argue that consumer voices lack the same lobbying influence as the nursing home industry. Jackson told the news station it is "disturbing" that legislators appear more responsive to the industry they regulate than to the constituents who elect them.
Several nursing home reform measures have been introduced during the 2026 General Assembly session with varying levels of success. Senator Glen Sturtevant, a Republican from Colonial Heights, carried legislation aimed at preventing facilities from diverting public funds away from direct care through related-party rent transactions. He also introduced a bill to increase physician presence in nursing homes. However, according to reporting, the first bill failed to advance and the second was significantly weakened.
Sturtevant told WTVR that nursing home reform efforts often face substantial obstacles due to industry lobbying and influence at the General Assembly.
Despite these setbacks, Delegate Willett pointed to several meaningful oversight measures that are advancing through the legislature. These include a bill from Delegate Delores McQuinn directing a comprehensive study of nursing home quality, operations, finances, and access. Another measure from Delegate Elizabeth Guzman would streamline nurse aide training programs, while a bill from Senator Christopher Head directs the state health commissioner to improve quality and hire additional inspectors.
Willett also sponsored legislation requiring nursing home operators to disclose ownership information and directing the health commissioner to review an operator's five-year record when evaluating ownership change applications. According to the report, Willett said the measures would bring greater accountability and transparency to the industry.
"You're going to see more accountability. You're going to see more transparency," Willett told the news station. "Maybe folks were able to sort of stay under the radar, cut some costs, cut some care. That's not going to be tolerated going forward."
Federal Staffing Requirements
The Centers for Medicare & Medicaid Services finalized a federal minimum staffing rule in 2024 requiring nursing homes to provide at least 3.48 hours of nursing care per resident per day, including a minimum of 0.55 hours from registered nurses. The rule is being phased in over several years, with facilities required to have a registered nurse on-site 24 hours per day, seven days a week by 2026. However, implementation timelines and enforcement mechanisms vary, and some states have sought to establish their own standards that exceed federal minimums.
Federal regulations define adequate staffing as having sufficient nursing staff with the appropriate competencies and skills to meet residents' needs. Inadequate staffing has been linked to increased rates of pressure ulcers, falls, infections, and other adverse outcomes for nursing home residents.
Advocacy and Policy Context
The rally in Richmond reflects a broader national conversation about nursing home quality and staffing levels. The COVID-19 pandemic brought renewed attention to conditions in long-term care facilities, where residents experienced disproportionately high rates of illness and death. Healthcare workers also reported severe burnout, inadequate personal protective equipment, and insufficient support during the crisis.
Multiple states have considered or enacted staffing ratio requirements in recent years, though implementation has varied widely. Advocates argue that mandatory minimums are essential to ensure adequate care, while industry representatives often cite workforce shortages and funding limitations as barriers to implementation.
Resources for Families
Families with loved ones in Virginia nursing homes who have concerns about staffing levels or quality of care can contact the state's Long-Term Care Ombudsman program for assistance. The ombudsman program provides free advocacy services to residents and families and can investigate complaints about facility conditions.
The National Long-Term Care Ombudsman Resource Center can be reached at 1-800-677-1116. Additional information and resources are available at ltcombudsman.org.
Residents and families can also file complaints directly with the Virginia Department of Health, which licenses and inspects nursing homes in the commonwealth. Federal nursing home inspection reports and quality ratings are publicly available through Medicare's Care Compare website at medicare.gov/care-compare.
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