This week at the General Assembly the House Health and Human Services (HHS) Committee heard two priority bills for VHCA-VCAL.

• The committee voted unanimously to report HB 717, the change of operator reform bill, and HB 605, the bill to reestablish a Virginia staffing standard. Both bills were referred to the House Appropriations Committee because of their impact on the state budget.

Next week marks crossover, the halfway point of the legislative session and the deadline by which the House and Senate must act on bills that originated in their chamber.

Highlights of bills tracked by VHCA-VCAL.

Nursing home staffing standard: HB 605 will next be heard by the House Appropriations Committee as delegates weigh its impact on the state budget.

• In its current form, nursing facilities would be required to provide at least 3.08 hours of case mix-adjusted total nurse staffing hours per resident per day on average by July 1, 2027. The standard would increase to 3.25 hours effective July 1, 2031.
• The bill includes language tying enforcement to initial and ongoing funding for the state’s share of the cost of the standard in the Medicaid base rates. It also specifies that if funding for the Medicaid Value-Based Purchasing program is reduced or suspended below the 2025 levels adjusted for inflation, the standard cannot be enforced.
• The bill also directs the Joint Commission on Health Care to include VHCA-VCAL and other stakeholders in an assessment of the feasibility of an RN hours of care component and consideration of the contributions of other direct care professionals providing hands-on care in meeting a future standard.
• VHCA-VCAL is grateful to bill patron and HHS Committee Chairman Del. Rodney Willett (D-Henrico) for his openness to listening to the association’s concerns about the bill as introduced which included a 3.25 hours standard.

Change of operator: The VHCA-VCAL backed bill to improve the transparency around nursing facility change of operator, HB 717 and SB 247 are advancing without opposition.

• The Senate bill was passed on a 40-0 vote. HB 717 will be heard by the House Appropriations Committee in the coming days.

Periodic medical visits: The Senate Education Committee agreed with the recommendation of its health professions subcommittee members and adopted a substitute to SB 555 to align Virginia’s medical visit and assessment schedules with the federal requirements.

• As introduced, the bill included several requirements of concern to VHCA-VCAL, including a mandate that nursing homes ensure each resident receives a visit at least monthly by a physician, physician assistant, or nurse practitioner after the initial 90-day monthly visit requirement.
• As the bill is now amended, no additional requirements would be imposed on providers unless the federal physician visit schedule is not met, in which case notice must be provided to the resident and the resident’s representative.
• The bill has been referred to the Senate Finance and Appropriations Committee for consideration.

Requirement for automated external defibrillators (AED): The HHS Committee advanced HB 1522 requiring nursing homes and assisted living facilities (ALFs) to have and maintain an AED and have staff trained to use such automated external defibrillator.

• The requirements have a delayed effective date of July 1, 2027, which was a provision VHCA-VCAL worked to have included in the bill.

Publicly accessible NF and ALF information portal: HB1116, which would have codified the nursing facility information portal created under Gov. Glenn Youngkin’s administration and create a similar one for DSS for ALFs, was tabled by a 6-0 vote in the HHS subcommittee of the House Appropriations Committee on February 11.

• The bill also contained language requiring nursing homes and ALFs to provide quarterly reports to VDH or DSS with information key facility performance metrics, and any newly identified additional data reporting items, including incidents involving emergency medical services. VHCA-VCAL worked with the bill patron Del. May Nivar (D-Henrico) to get the bill in a favorable posture.

ALF resident referral agencies: The HHS Committee’s social services subcommittee voted to continue HB 297 to 2027, effectively ending its consideration for the year.

• The companion Senate bill, SB 791 is on the Rehabilitation and Social Services Committee docket for February 13.

Stay tuned: With the crossover next week, we will have a full recap of bills that are advancing or have been defeated. The Legislative Conference on February 23-24 will also include a comprehensive update on legislation.