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The nursing home says it will meet the that Virginia will put in place on July 1 to boost the quality of long-term care after the COVID-19 pandemic, which hit nursing homes and assistant living facilities hardest. The new staffing standards are lower than pending federal requirements, but nursing homes say they face a stiff challenge to find enough qualified employees to fill current job vacancies.

鈥淚t you don鈥檛 have the nursing staff, you can鈥檛 achieve quality care,鈥� said , a former nurse who has served as vice president of operations at Saber Healthcare for more than 16 years, including the pandemic.

The Ohio-based company owns 33 nursing homes in Virginia, including Autumn Care and Tyler鈥檚 Retreat at Iron Bridge in Chester.

鈥淲e鈥檙e not exactly short-staffed, but we鈥檙e not staffed at what I want to be staffed at to make sure care is consistent,鈥� Stanfield said.

Finding the money to hire and keep those employees would be harder under Gov. Glenn Youngkin鈥檚 budget amendment that would cut proposed state funding by $10 million for nursing home staff. The cut also would remove $11.6 million in matching funds from the federal government under the Medicaid program for elderly, disabled and impoverished Virginians.

The combined cut would be doubled again because the new reimbursement rate would remain in place for two years, until the state revises all of its provider reimbursement rates under Medicaid. The total cost would be $43.3 million.

鈥淚t addresses money which goes directly toward that direct care,鈥� Stanfield said. 鈥淚t goes only to hire nursing staff.鈥�

Broader effort

Youngkin proposed the cut as part of a broader effort to identify $300 million in savings to deposit in the state鈥檚 revenue reserve fund as a hedge against potential revenue losses because of cuts President Donald Trump and ally Elon Musk are making in the federal workforce and spending that are crucial to Virginia鈥檚 economy. The Republican governor supports Trump鈥檚 cost-cutting initiative, but said he is preparing for potential revenue losses that members of the General Assembly fear.

鈥淓veryone around the table will need to take a little less than what they want, but still, there is a substantial increase in so many areas,鈥� the governor said when he announced 205 amendments and eight line-item vetoes to the budget that the General Assembly adopted on Feb. 22.

That does not reassure Virginia鈥檚 nursing home owners.

Amy Hewett, a spokesperson for the Virginia Health Care Association, said, 鈥淲e鈥檙e very concerned about the budget amendment and working to get it overturned.鈥�

鈥淭his isn鈥檛 overall (provider) rates,鈥� Hewett said. 鈥淚t鈥檚 direct care staff.鈥�

Del. Mark Sickles, D-Fairfax, a member of the House Appropriations Committee and chair of the House health care committee, said the proposed cut in nursing home rates is not likely to survive when the assembly reconvenes on Wednesday to consider the governor鈥檚 proposed vetoes and amendments to legislation, including the budget bill.

It takes a simple majority to vote down a budget amendment 鈥� unlike the two-thirds vote it takes to override a governor鈥檚 veto of legislation.

Sickles is dismayed by the cuts that Youngkin proposed to assembly spending on Medicaid and other human services. Those cuts including reducing by half $8.7 million the legislature included for community services boards to coordinate support services for intellectually disabled people on the state鈥檚 priority waiting list, one of the governor鈥檚 own initiatives.

鈥淲e have the money, we can afford to do it,鈥� he said. 鈥淧oor people need health care, too.鈥�

Sickles acknowledged the concern that House Democrats have expressed about the potential damage to Virginia鈥檚 budget from the ongoing Trump and Musk cost-cutting, which they expect they will have to address in special session later this year.

鈥淚f we all know that (revenue losses are coming), then we need to look at that billion-dollar tax cut in this budget,鈥� he said. Sickles referred to a one-time rebate to taxpayers that the General Assembly proposed and approved for delivery in mid-October.

The timing of the proposed cut in nursing home rates doesn鈥檛 help, with the state finally set to establish minimum staffing standards for nursing homes.

鈥淲e鈥檙e trying to balance the carrot and the stick,鈥� Sickles said. 鈥淲e realize prices are high everywhere. It鈥檚 costly to take care of our most vulnerable citizens.鈥�

Del. Otto Wachsmann, R-Sussex, an independent pharmacist in Stony Creek, is concerned about the quality of care in nursing homes in his district and their ability to hire nurses and aides. He sponsored legislation Youngkin already signed into law this year that would increase the fees nursing homes pay to the state to hire more health inspectors to ensure the quality of care and impose sanctions for violations of nursing home standards.

Wachsmann said nursing homes in his rural district already pay more to hire certified nursing assistants to drive from urban areas every day for work.

He also cited the case of a nursing home owner in a more populated part of the district whose business plan turned upside down after federal regulators reclassified the area as rural, reducing its rates to the provider by more than $1 million a year.

鈥淚 find this is happening a lot,鈥� Wachsmann said. 鈥淧eople are underpaid.鈥�

Saber Healthcare is paying about $25 an hour for certified nursing assistants at Autumn Care of Mechanicsville, Stanfield said. Registered nurses are earning about $45 an hour.

But it鈥檚 still not enough to hire and keep staff, she said, especially in the Hampton Roads area, much less meet a pending federal minimum staffing requirement that is higher than the one the state is about to implement.

鈥淚鈥檓 not against it,鈥� Stanfield said. 鈥淭he more staff we have, the better off we are, but where am I going to find the bodies?鈥�