Health, Department of, and State Health Commissioner; nursing home oversight and accountability.

An Act to amend the Code of Virginia by adding in Article 2 of Chapter 5 of Title 32.1 sections numbered
32.1-138.5:2
and
32.1-138.5:3
, relating to Department of Health and State Health Commissioner; nursing homes; oversight and accountability; periodic medical visits and resident assessments.
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding in Article 2 of Chapter 5 of Title 32.1 sections numbered
32.1-138.5:2
and
32.1-138.5:3
as follows:
§
32.1-138.5:2
. Periodic medical visits.
If any required visits to a resident by a physician do not take place in accordance with the federal physician visit schedule described in 42 C.F.R. § 483.30(c), any nursing home licensed under this chapter shall send notice to the resident, the resident's family or legal representative, and the Department.
§
32.1-138.5:3
. Resident assessment and plan of care.
A. All nursing homes licensed under this chapter shall conduct comprehensive assessments of each resident's needs pursuant to subsection B. Such assessments shall accurately describe the resident's capability to perform daily life functions and significant impairments in functional capacity, and shall include:
1. Medically defined conditions and prior medical history;
2. Medical status;
3. Physical and mental functional status;
4. Sensory and physical impairments;
5. Nutritional status and requirements;
6. Special treatments or procedures;
7. Psychosocial status;
8. Discharge potential;
9. Dental condition;
10. Activities potential;
11. Rehabilitative potential;
12. Cognitive status;
13. Drug therapy; and
14. Any known advance directives.
B. The nursing facility shall conduct a complete assessment as described in subsection A:
1. No later than 14 days after the date of admission;
2. Promptly after a significant change in the resident's physical or mental condition; and
3. In all cases, at least once every 366 days.
C. The nursing home shall review each resident's assessment at least once every 92 days and shall update the plan of care as indicated.
D. Each assessment shall be coordinated by a registered nurse who signs, dates, and certifies completion of the assessment.
E. Each assessment shall be conducted or coordinated with the participation of health professionals. Each person completing a portion of the assessment shall sign and date such portion of the assessment.
F. The nursing home shall use the results of the assessment to develop, review, and revise the resident's comprehensive plan of care.
G. The nursing home shall develop a comprehensive plan of care for each resident within seven days of completion of the comprehensive assessment. Such plan shall include measurable objectives and timetables to meet the resident's medical, nursing, nutritional, and psychosocial needs identified in the comprehensive assessment. The plan shall also describe the services that are to be furnished to maintain or improve the resident's physical, mental, and psychosocial status. Upon request, a copy or summary of such comprehensive plan of care, as defined by the facility's established policy, shall be delivered to the resident and the resident's family or legal representative within seven days of completion.
H. The comprehensive plan of care required pursuant to subsection G shall be prepared by a multidisciplinary team. The multidisciplinary team shall include a registered nurse, the attending physician, to the extent practicable, and other staff in disciplines as determined by the resident's needs. The resident and the resident's family or legal representative shall also be provided a meaningful opportunity to participate in developing the plan of care.
2. That the Department of Health (the Department) and the State Health Commissioner shall take steps to improve care quality, protect residents, and strengthen oversight and accountability of nursing homes in the Commonwealth.
3. That the Department of Health (the Department) shall work with relevant stakeholders to develop and implement a plan to expand workforce capacity in the Office of Licensure and Certification and fill all open medical facilities inspector positions. As part of the plan to expand workforce capacity, the Department shall establish and maintain an Office of Licensure and Certification recruitment dashboard to track and update vacancies. The Department shall also utilize traditional and non-traditional recruiting measures to recruit across markets for open positions at the Office of Licensure and Certification.
4. That in order to accelerate training and onboarding initiatives, the Department of Health shall establish a dedicated training manager to lead the development and implementation of comprehensive staff training initiatives at the Office of Licensure and Certification and create an onboarding plan to support future recruitment and retention.
5. That the Department of Health's Chief Information Officer shall coordinate with the Virginia Information Technologies Agency and the Office of Regulatory Management to assess the feasibility of automating tasks and reducing administrative burdens through the use of artificial intelligence or other means.
6. That the State Health Commissioner shall submit by December 1 and annually thereafter a report to the Governor and General Assembly with recommendations for continued improvement of nursing home quality and oversight in the Commonwealth.