VirginiaHB15222026 Regular SessionHouseWALLET

Nursing homes and assisted living facilities; licensure, automated external defibrillators.

Sponsored By: Garrett McGuire (Democratic)

Became Law

Summary

Nursing homes and assisted living facilities; licensure; automated external defibrillators. Requires nursing homes and assisted living facilities to have and maintain an automated external defibrillator and have staff trained to use such automated external defibrillator.

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Bill Overview

Analyzed Economic Effects

14 provisions identified: 11 benefits, 0 costs, 3 mixed.

Elder care safety and protections

Nursing homes and certified nursing facilities must have an AED on site and staff trained to use it; assisted living must have one before new or renewed licenses. Employees who are mandated reporters must be trained on how to report adult abuse and the penalties for not reporting. Residents must be offered annual flu shots and a pneumococcal shot per ACIP, unless declined or contraindicated. Before admissions over three days, facilities must check if a person is on the sex-offender registry and sign up for State Police notices. Facilities must carry at least $1,000,000 in general liability per incident and professional liability at or above the state recovery limit, and show proof at license renewal.

Hospital patient rights and visits

Hospitals must give you a written list of your rights and responsibilities at admission. Adult patients can choose who may visit them, within safety limits. If a hospital lets a minor see records online, it must also give the parent or guardian access unless blocked by law or missing consent. Inpatients may use their own smart assistant devices, and hospitals must protect health privacy. Hospitals must have a process for second opinions and review on life-sustaining care, and you have 14 days after the decision is recorded to give notice to seek legal review. During a declared communicable-disease emergency, patients may receive clergy visits under safety rules. For inpatient psychiatric refusals, doctors must speak directly to coordinate care, and include a poison specialist when requested for tox concerns.

Nursing home family access and refunds

Nursing homes must clearly disclose their admissions policies to applicants. At a family council’s request, facilities must send up to six joint notices a year to the resident’s contact and post them. During a COVID-19 public health emergency, residents must be offered at least one visit every 10 days, with in-person or virtual visits following CDC/CMS guidance. After discharge or death, any unspent patient funds on deposit must be refunded within 30 days of a written request (some continuing care entrance fees are excluded).

Pregnancy, newborn and postpartum support

Hospitals that deliver babies must have a plan to admit or transfer women who arrive in labor. They must follow Board rules for stillbirth care and counseling. The state sets levels of newborn care with rules on staff, ratios, equipment, and protocols. When a postpartum woman has substance use, hospitals must make a written discharge plan for her and her infant, discuss it, involve family when possible, and notify the community services board when federal law allows.

Safer 24/7 emergency room care

Hospitals with emergency rooms must have a Virginia-licensed doctor on duty and physically present at all times. ER urine drug screens must include fentanyl. ERs must have a plan for substance-use emergencies, including screening, follow-up care, and giving or prescribing naloxone with referrals. ERs must have a security plan based on a risk check and standards, with on-site police or trained security when needed; waivers are possible. In emergencies, staff can take verbal treatment orders, but they must be signed or co-signed within 72 hours.

Safer surgeries and smoother recovery

Hospitals that do surgeries must use smoke evacuation systems for planned procedures likely to create surgical smoke. If your elective surgery is likely to need outpatient physical therapy, the hospital must tell you before surgery, and you should choose a therapy provider before discharge.

Temporary extra beds during emergencies

During a declared disaster or a state emergency order, hospitals and nursing homes can add temporary beds without a separate license. They must be able to safely staff care across the facility. The extra beds are allowed for the disaster or emergency period plus 30 days.

Hospitals track workplace violence, protect reporters

Hospitals must run a workplace violence reporting system and tell staff how to use it. They must record all voluntary reports, analyze them, and keep records for at least two years. Hospitals must ban retaliation against anyone who reports or seeks help. They must send data to the chief medical and nursing officers at least every three months. Each year they must send a de-identified summary, including the number of incidents, to the Department.

Licenses for assisted living and day centers

Anyone running an assisted living facility, adult day center, or child welfare agency must be licensed. Licenses show the maximum number of people served and must be posted. Assisted living license terms can be 6 months, 1, 2, or 3 years based on compliance. Adult day centers that serve only PACE enrollees under the required agreement do not need a separate license. Hospitals, nursing homes, and certified nursing facilities may operate adult day centers if they obtain any needed license.

Stronger hospital rules and licensing fees

State rules for hospitals, nursing homes, and certified nursing facilities must match medical best practices and federal Medicare and Medicaid standards. The Board sets minimums for building, operations, staffing and training, in‑home services, infection control, disaster planning, and security. The Board can classify and license facilities by bed count and specialty or service. Licensing fees for hospitals and nursing homes can change at most once a year and only when program costs and funding differ by more than 10%, to cover inspection and licensing costs fairly.

Know air ambulance costs before you go

Before a hospital arranges non-emergency air medical transport, it must give you written or electronic notice. The notice must say you may be able to choose medically appropriate ground transport. It must also warn that you may owe charges if the air provider is out of network or the trip is not covered by your insurance.

Medication access and safety in facilities

Facilities that treat hemophilia and stock clotting factors must record lot numbers and notify doctors and recipients if a lot is contaminated. Trained nursing home staff may store, dispense, or give cannabis oil to residents with a valid state certification. Hospitals may partner with the Department of Health to provide naloxone or other opioid reversal medicine to uninsured patients.

Organ and tissue donation steps

Hospitals must have an organ donation plan that follows federal rules. They must have agreements with a certified organ procurement group, a tissue bank, and an eye bank. Staff must notify these groups quickly and use trained people to speak with families. Hospitals must train staff and have donor care procedures.

No license for public child-placing agencies

State or local officers, employees, or agents who run a child-placing agency within their official duties do not need a separate license. This exemption applies only when they act within their legal authority.

Sponsors & Cosponsors

Sponsor

  • Garrett McGuire

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 302 • No: 13

House vote 3/4/2026

Senate amendment agreed to by House

Yes: 89 • No: 5

Senate vote 3/2/2026

Education and Health Amendment agreed to

Yes: 0 • No: 0

Senate vote 3/2/2026

Passed Senate with amendment Block Vote

Yes: 40 • No: 0

Senate vote 2/27/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 2/27/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/26/2026

Reported from Education and Health with amendment

Yes: 15 • No: 0

House vote 2/16/2026

Read third time and passed House

Yes: 91 • No: 6

House vote 2/10/2026

Reported from Health and Human Services with amendment(s)

Yes: 21 • No: 1

House vote 2/5/2026

Subcommittee recommends reporting with amendment(s)

Yes: 9 • No: 1

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0323)

    4/6/2026Governor
  2. Approved by Governor-Chapter 323 (effective 7/1/2026)

    4/6/2026Governor
  3. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/14/2026Governor
  4. Enrolled Bill communicated to Governor on March 14, 2026

    3/14/2026House
  5. Signed by Speaker

    3/12/2026House
  6. Fiscal Impact Statement from Department of Planning and Budget (HB1522)

    3/11/2026House
  7. Bill text as passed House and Senate (HB1522ER)

    3/11/2026House
  8. Enrolled

    3/11/2026House
  9. Signed by President

    3/11/2026Senate
  10. Senate amendment agreed to by House (89-Y 5-N 0-A)

    3/4/2026House
  11. Passed Senate with amendment Block Vote (40-Y 0-N 0-A)

    3/2/2026Senate
  12. Education and Health Amendment agreed to

    3/2/2026Senate
  13. Engrossed by Senate as amended

    3/2/2026Senate
  14. Read third time

    3/2/2026Senate
  15. Passed by for the day Block Vote (Voice Vote)

    2/27/2026Senate
  16. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    2/27/2026Senate
  17. Rules suspended

    2/27/2026Senate
  18. Senate committee offered

    2/26/2026Senate
  19. Reported from Education and Health with amendment (15-Y 0-N)

    2/26/2026Senate
  20. Assigned Education sub: Health

    2/24/2026Senate
  21. Fiscal Impact Statement from Department of Planning and Budget (HB1522)

    2/17/2026House
  22. Referred to Committee on Education and Health

    2/17/2026Senate
  23. Constitutional reading dispensed (on 1st reading)

    2/17/2026Senate
  24. Read third time and passed House (91-Y 6-N 0-A)

    2/16/2026House
  25. Engrossed by House as amended

    2/13/2026House

Bill Text

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