What’s new: In follow-up to legislation passed earlier this year, VDH has issued updated regulations affecting electronic monitoring in resident rooms in nursing facilities and general liability insurance coverage requirements. The new language is effective November 19, 2025.

• See the full text of the changes as well as updated language related to advanced medication aides, who will be able to administer drugs in nursing facilities.

Professional liability insurance requirements for nursing homes and certified nursing facilities: Directed by SB 1152, each nursing home must maintain per facility, non-eroding general liability insurance coverage of $1 million per occurrence. The new requirement is found at 12VAC5-371-160 (B) (underlined text is new language).

B. Each nursing facility shall maintain, per facility, noneroding general liability insurance coverage in a minimum amount of $1 million per occurrence, and professional liability coverage in an amount at least equal to the recovery limit set forth in § 8.01-581.15 of the Code of Virginia per patient occurrence, to compensate residents or individuals for injuries and losses resulting from the negligent or criminal acts of the nursing facility. Failure to maintain minimum insurance limits under this section shall result in revocation of the nursing facility’s license. Each nursing facility shall provide at licensure renewal or have available to the board proof of the insurance coverages as required by this subsection.

For context: During the legislative session, VHCA-VCAL worked with the bill patron to remove language in prior iterations of the legislation that would have established a $3 million aggregate policy limit for each facility, which was highly problematic for multi-facility operators. The legislation also struck a requirement for facilities to obtain coverage for criminal acts.

Electronic monitoring in nursing facility resident rooms: SB 821 required VDH to update its regulations to allow the use of electronic monitoring in all resident rooms. However, due to VHCA-VCAL’s advocacy, monitoring in semi-private rooms will be visual only (no audio) to protect the privacy rights of roommates. The legislation and subsequent regulations include other provisions supported by VHCA-VCAL, like language specifying that the costs of the monitoring are to be borne by the resident or resident’s legal representative.

• The full text of the electronic monitoring requirements are found at 12VAC5-371-191 Electronic monitoring in resident rooms. VHCA-VCAL encourages members to read the text in its entirety to operationalize any necessary changes to your electronic monitoring policies and procedures.

In addition to these two changes, VDH updated the regulations related to advanced medication aides registered by the Board of Nursing (BON) who can administer drugs in a nursing home licensed by VDH

• Although VDH has amended its regulations to include advanced medication aides, further work by the BON is needed to develop the regulations defining the scope of practice for advanced medication aides. These regulations will specify the list of drugs that advanced medication aides are permitted to administer to long term care residents in Virginia nursing homes.