I wish I could fix the long term care crisis. I wish patients would get the care they have been promised; that their physical and emotional needs would be met, and that their families could rely on facilities who say adequate care will be provided.
I wish I could magically wave a wand, or file a series of strategic lawsuits that would prevent for profit facility owners from making millions while understaffing and under caring for medically compromised patients.
I wish I could help the people who call me and say “this shouldn’t happen to anyone else,” “My mother deserved better” “this is negligence” ” I feel so guilty” “what can I do to stop this from happening again?”
But I can’t. One lawyer, one lawsuit in Virginia on behalf of a compromised patient, defended by insurance companies and facilities who claim the real crisis is finding good help —- won’t change a thing. Not a single thing.
For years now, we decline 98% of the calls we get from families whose loved one has been injured or killed in a long term care facility (nursing home or assisted living). We decline because we know that true accountability is not often possible through the civil justice system.
In America’s long term care crisis (and yes, it is a crisis) there are actions and steps that can change outcomes and lead to better care, but lawsuits are not one of the most useful or forceful drivers of that change. ***
The immediate steps to protecting patients are:
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Laws that allow states to take licenses from facilities who put profits over patients, and cause patient harm;
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Laws that require staffing levels to meet patient needs while spelling out staffing minimums;
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Laws that prevent for profit long term care (so profits are re-invested to hire and retain staff rather than be swept away to owner’s pockets); and
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Laws that give states the right to fine bad facilities with substantial monetary penalties, which are then given to patients and their families who have suffered the most harm.
And sadly, the above legislative steps haven’t occurred because long term care is political. The millions that can be made on the backs of our elderly pays for good lobbyists in Richmond and Washington, and politicians are hesitant to pass laws that harm the pipeline of profits for their friends and donors.
Don’t believe me that Long Term Care needs a political solution?
Ok then. Read this:
In sum – politics have limited what home health care is available through Medicare, making nursing facilities the only option.
In sum, we were going to have staffing requirements under federal law in Nursing Homes but Trump’s supporter shut it down – after they donated to the President to curry favor for their own profits.
https://www.baconsrebellion.com/the-deadly-consequences-of-non-compliant-nursing-home-reporting/’
In sum, Virginia has no real enforcement mechanism against bad facilities.
https://www.wtvr.com/news/local-news/colonial-heights-rehabilitation-year-later-dec-18-2025
In sum, the criminal justice system hasn’t been the answer either for negligent and abusive care.
So when families call me, hoping I can make it better for their loved one and or at the very least, make it better future patients, I explain that I usually can’t.
I tell them to file a complaint with Virginia Department of Health for Nursing Homes or Department of Social Services for Assisted Living and Memory Care units.
Then, I ask them to get political. I can hear the sigh on the other end of the phone when I bring this up. These are folks who need someone to carry their burden, not someone who asks them to add to their burden with more work. Further, most don’t know the difference between their Congressman / woman in Washington and representatives in Richmond. Most have never contacted a law maker before. Most believe engaging with our political system to be a useless waste of their time.
However, it is the only way to effectuate real change.
Tomorrow I will post HOW to effectuate real change in our legislative bodies and how now is the time to do it!
Part II – coming 1/29/26.
**** In some states, lawsuits do make a difference. These are states without Malpractice caps, arbitration agreements being upheld in most long term care contracts, and laws that don’t limit wrongful death claims to the beneficiaries loss of solace. State law in Virginia severely limits the impact of a civil claim against a nursing home, and as such, limits whether behavior changes are ever inspired by large verdicts.