Long-Term Care Landscape in Virginia 2024
Explore the comprehensive overview of long-term care facilities in Virginia, including nursing homes and assisted living facilities, with insights into workforce trends, aging population statistics, upcoming staffing mandates, and the innovative Medicaid NF Value-Based Purchasing Program.
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Long Term Care Overview for the 2024 Legislative Health Care Boot Camp Virginia Health Care Association | Virginia Center for Assisted Living August 2024
361 Provider Members 258 Nursing Facilities (often referred to as nursing homes) 30,964 Beds representing 97% of Virginia s total NF beds 103 Assisted Living Facilities (ALFs) 7,699 Assisted Living Beds Services not covered by Medicaid (almost exclusively private pay) StatewideVirginia has 288 licensed NFs and 567 licensed ALFs 2
Typical NF has ~120 dually-certified beds Long-term services and supports (almost exclusively Medicaid) Short-term rehab services (usu. Medicare) 87K+ patients served each year Virginia s Nursing Facilities
Percent Change in Health Care Sector Employment since February 2020 Virginia 20 18.1% Home Health Care While other health care sectors have fully recovered and grown their workforce above pre-pandemic levels, the nursing home workforce is still working to return to 2020 levels. 15 % change from February 2020 13.8% Ambulatory Services 10 5 2.9% Hospitals 0 -1.6% Nursing Facilities -5 -4.3% Assisted Living Source: Bureau of Labor Statistics, Quarterly Census of Employment and Wages. NAICS Industries 621,6216, 622 6231, 623312.
Virginias Aging Population ~1.9M Virginians are aged 60+ projected to increase to 2.2M in 2030 Virginia s population aged 65+ is expected to grow from 15.9% in 2020 to 18.9% in 2030 Pressures Pressures on Nursing on Nursing Homes Homes Impending NF Staffing Mandates Virginia: in effect July 1, 2025 Federal: in effect May 11, 2026 (urban) / May 10, 2027 (rural)
Medicaid NF Value-Based Purchasing (VBP) Program VBP is an innovative performance-based supplemental payment program designed to boost quality care for residents 6 metrics: NFs are assessed for attainment and improvement + additional funds awarded to NFs based on performance From Year 1 Year 2: Metrics are showing marked improvement Many states are looking at Virginia s success and the VBP program as a model
2025 Session Priorities 1. Base Medicaid Rate Enhancement VBP has been a tremendous program, yet its success is limited by underfunded base payment rates under the Medicaid program By design, Medicaid pays the full cost of NF care only for 50% of the days for which the program is responsible Cost coverage needs to improve to fully achieve the quality enhancements we all desire 2. VBP Payment Mechanics Although NFs incur costs of the quality improvement initiatives on an ongoing basis, the program pays awards in lump sums after the fact By shifting the VBP awards to a prospective rate add-on, NFs would have funding throughout the year + budget certainty and borrowing capability
For questions, please contact: Keith Hare | President and CEO | keith.hare@vhca.org Steve Ford | Senior Vice President for Policy & Reimbursement | steve.ford@vhca.org April Payne, MBA, LNHA | Chief Quality & Regulatory Affairs Officer | april.payne@vhca.org
