Empty nursing home bed

As the threat of a federal mandate inches closer to reality, nursing homes in Virginia are reporting major difficulties finding qualified staff. 

A recent survey from the Virginia Health Care Association/Virginia Center for Assisted Living of its members found that 31% of respondents said they had “few to no applicants” for open positions. And 91% of respondents said they have vacancies for certified nursing assistants — a role that makes up a significant part of the recently proposed federal staffing mandate. 

“For three years, workforce issues have been the most persistent and significant challenge facing Virginia’s long-term care providers,” said Keith Hare, president and CEO of VHCA-VCAL, in a press release announcing the survey results. “Virginia made significant investments in this care during the pandemic, and yet the flattened funding this year in the Medicaid program does not cover the expenses of providing 24/7 care for residents.” 

A state nursing home staffing mandate that is scheduled to take effect July 1, 2025, was supported by provider advocates, who said it did a good job of melding required care hours with financial incentives for facilities and flexibility for regulators in levying punitive actions for noncompliance. The VHCA supported the legislation, which requires 3.08 hours of total nursing care per resident per day and did not specify nursing categories to fulfill the mandated time. 

Based on the survey results, though, many facilities would find it hard to meet the new rules amid worker shortages. Eighty-one percent of the 170 respondents had vacancies among licensed practical nurses and 64% had RN vacancies. Responses were gathered from Sept. 11 to Oct. 6, 2023,

“The survey shows regardless of the payor, no facility is immune to the impacts of the workforce crisis,” a VHCA spokesperson told McKnight’s Long-Term Care News Tuesday. “Because nearly seven in 10 individuals in Virginia’s nursing facilities rely on Medicaid for their care, staffing challenges obviously impact them.”

Nearly half of facilities – 44% – had placed a hold on new admissions at least once since June 1, and 94% asked staff to work overtime or take on extra shifts to provide adequate care during shortages. Seventy-eight percent of facilities face shortages filling shifts, and 39% have a waiting list for new admissions. 

Hare told the Richmond NBC-TV affiliate that the burnout from the pandemic continues to rage with many nursing home staff leaving the industry altogether. 

“I don’t say this lightly,” he said during an interview with NBC12. “I think it’s the biggest public policy issue that is not just facing the state but facing our country.”