Nursing homes; establishes procedures for implementation of sanctions, civil penalty.
Summary
HB2253 creates a new enforcement framework for Virginia nursing homes by authorizing the State Health Commissioner to impose administrative sanctions for certain licensure violations identified in recent state inspections. The bill applies to findings from inspections within the prior 24 months, so long as the findings were communicated to the facility within 14 business days of the survey end date. Covered conduct includes violating Board or Commissioner orders, violating Chapter 5 nursing home requirements or related regulations, or permitting, aiding, or abetting illegal acts in the delivery of health care services.
The bill limits sanctions to violations no more severe than a federal CMS level 2 deficiency and allows two main remedies: placing the facility on probation and imposing civil penalties of up to $500 per violation per day, capped at $10,000 for related incidents. Collected penalties are directed to the Nursing Scholarship and Loan Repayment Fund to support nurse scholarship and loan repayment programs for nurses who serve in Commonwealth long-term care facilities. The bill also requires a plan of correction, may require staff training at the facility’s expense, preserves the facility’s responsibility for resident safety during sanctions, and provides notice, hearing, and judicial review rights under the Administrative Process Act.
Impact
HB2253 amends several sections of the Code of Virginia governing nursing home and health facility enforcement, including adding new Code section 32.1-27.3 and conforming changes to sections 32.1-127.01, 32.1-134.1, 32.1-134.4, and 32.1-135. It expands the Commissioner’s enforcement tools for nursing homes while coordinating those tools with existing court-based remedies, license suspension/revocation authority, and federal CMS enforcement. The bill also requires regulations from the State Board of Health before sanctions may be imposed and directs the Board to establish criteria, penalty schedules, and procedures, including notice to Medicaid officials when a license is revoked or suspended.
Sentiment
The bill appears to have broad bipartisan support and moved through both chambers unanimously, with every recorded vote showing 0 nays. It was reported favorably from subcommittee and committees, passed the House 99-0, and passed the Senate 40-0. The voting history suggests general agreement that the bill addresses nursing home oversight and enforcement without significant partisan division.
Contention
There is little evidence of major opposition in the available record, but the bill does contain several built-in limits that likely reflect policy concerns about overreach. It restricts sanctions to less severe deficiencies, requires a corrective action plan and notice/hearing procedures, and prevents duplicative state sanctions when CMS has already sanctioned the same conduct. The main policy tension is between giving the Commissioner stronger tools to address nursing home noncompliance and preserving due process, avoiding overlap with federal enforcement, and limiting sanctions to lower-level deficiencies.
Office of Inspector General provisions modified within the Department of Education; Office of the Inspector General records access provided; data classified; immunity and confidentiality in reporting or participating in an investigation provided; and process for notice, appeal, and withholding of payments established;