2026 SESSION

SENATE SUBSTITUTE

26109436D

HOUSE BILL NO. 1357

AMENDMENT IN THE NATURE OF A SUBSTITUTE

(Proposed by the Senate Committee on Finance and Appropriations

on March 9, 2026)

(Patron Prior to Substitute—Delegate McQuinn)

A BILL to direct the Joint Commission on Health Care to conduct a comprehensive assessment of the quality of care, resident safety, and operational practices of nursing facilities in the Commonwealth.

Be it enacted by the General Assembly of Virginia:

1. § 1. That the Joint Commission on Health Care (the Joint Commission) shall conduct a comprehensive assessment of the quality of care, resident safety, and operational practices of nursing facilities in the Commonwealth. In conducting such assessment, the Joint Commission shall (i) examine nursing facilities licensed by the Virginia Department of Health and nursing facilities certified to participate in Medicaid or Medicare; (ii) conduct a statewide study and make recommendations to improve nursing facility quality, safety, transparency, accountability, and resident experience; and (iii) evaluate (a) quality and safety outcomes, including trends in preventable harms, avoidable hospitalizations, infection prevention and control, medication management, and management of other adverse events; (b) staffing levels and stability, including staffing patterns by shift, turnover and vacancy rates, use of agency staffing, training, competency, and supervision, and the relationship between staffing and resident outcomes; (c) complaint, survey, and enforcement systems, including the timeliness and effectiveness of inspections, complaint response, corrective action plans, sanctions, and repeat deficiencies; (d) resident rights and protections, including rights related to admissions and discharge practices, involuntary transfers and discharges, grievance procedures, family communication, and access to ombudsman services; (e) care coordination and transitions, including coordination with hospitals and community providers and discharge planning practices; (f) ownership and operational models and practices, including ownership structures, related-party transactions, management agreements, real estate arrangements, and transparency of controlling interests, and how such practices affect staffing and quality; (g) financial and payment policy, including Medicaid reimbursement structure, the extent to which payments support direct care, and opportunities to align payment with quality outcomes; (h) emergency preparedness and continuity of operations, including outbreak response, staffing surge capacity, and readiness for severe weather and power disruptions; (i) data reporting and transparency, including public access to facility performance information and the availability of understandable information for residents and families; and (j) disparities in quality and access, including differences across regions and resident populations. The Joint Commission on Health Care shall report its findings and recommendations from its study to the Governor and the Chairs of the House Committees on Appropriations and Health and Human Services and the Senate Committees on Finance and Appropriations and Education and Health by December 1, 2027.