VirginiaSB5352026 Regular SessionSenateWALLET

Nursing homes and certified nursing facilities; required liability insurance coverage.

Sponsored By: Mark D. Obenshain (Republican)

Became Law

Summary

Nursing homes and certified nursing facilities; required liability insurance coverage. Provides that the regulations of the Board of Health shall require purchasers of licensed nursing homes or certified nursing facilities with claims-made policies of liability insurance coverage to purchase an extended reporting endorsement of two years after the date of sale or to purchase liability insurance coverage with dates that begin two years prior to the date the existing owner's policies end.

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Bill Overview

Analyzed Economic Effects

16 provisions identified: 14 benefits, 0 costs, 2 mixed.

Stronger maternity and newborn care

Hospitals that deliver babies must have a plan for admitting or transferring pregnant women in labor. Hospitals must set policies for stillbirth care, including counseling. The state sets clear levels of neonatal care so parents know what services and staffing a hospital has. If a mother is identified as substance-abusing after birth, the hospital must create a written discharge plan, make referrals, involve family when possible, and notify the local community services board when allowed by federal law.

Higher statewide hospital and nursing home standards

The state sets minimum rules for building upkeep, staffing, training, equipment, infection control, disaster plans, and security in hospitals and nursing homes. The Board’s rules must substantially match major federal Medicare and Medicaid safety standards.

Safer ERs and better overdose care

Hospitals with emergency rooms must have a licensed physician in the ER at all times. When the ER orders a urine drug screen to diagnose a patient, it must include fentanyl testing. ERs must keep a security plan and place an off-duty police officer or trained security in the ER when their risk check shows it is needed, unless the state grants a waiver. ERs must use a discharge plan for substance-use emergencies that includes screening, referrals, and naloxone provided or prescribed. Hospitals may also partner with the Health Department to provide naloxone to uninsured patients.

Stronger hospital care and ethics protocols

Hospitals must use smoke evacuation for planned surgeries that make surgical smoke. In emergencies, staff may take verbal treatment orders, but the originator must sign within 72 hours or an authorized clinician must co-sign. Psychiatric units must, on request, have the on-call psychiatrist speak directly with the referring doctor and, when toxicology is in question, with a poison control specialist. Hospitals that can give life-sustaining treatment must have a review policy with a second opinion, committee review, a written explanation in the chart, and notice of rights; if a patient or agent hires a lawyer and wants to join the review, they must notify the CEO in writing within 14 days. Hospitals must also follow organ donation protocols and keep agreements with the organ procurement organization, a tissue bank, and an eye bank.

Stronger visitation rights in hospitals and homes

Hospitals must let adult patients choose who may visit, with limits only for care needs or crowding. During a declared contagious-disease emergency, hospitals and nursing homes must allow clergy visits following CDC, CMS, and public health orders. In a COVID-19 emergency, nursing homes must follow a visitation plan and offer at least one visit every 10 days, unless the patient or representative waives it.

Clearer patient notices before transport and discharge

Before arranging non-emergency air transport, hospitals must give written or electronic notice that you may choose ground transport and may owe the bill if the air provider is out of network or not covered. For elective surgeries likely to need outpatient physical therapy, hospitals must tell you ahead of time and have you pick a therapy provider before discharge. On admission, hospitals must give you a written notice of your rights and responsibilities.

Certified cannabis oil in nursing homes

Authorized nursing home staff may store, dispense, and give cannabis oil to a resident who has a valid written certification under state law. The rule only applies when that certification is in place.

Hospitals and homes may run adult day centers

Licensed hospitals, nursing homes, and certified nursing facilities may operate adult day centers if they obtain any extra license needed. This gives caregivers and older adults more options where facilities choose to offer the service.

Nursing homes must train abuse reporters

Nursing homes and certified nursing facilities must train staff who are mandated reporters on how to report adult abuse, neglect, or exploitation and the consequences for not reporting. This helps protect residents and supports proper reporting.

Patient tech access and privacy rules

Hospitals, nursing homes, and certified nursing facilities must set written rules for staff access to a patient’s smart assistant while inpatient and protect health data under HIPAA. If a hospital gives a minor online access to records, it must also give the parent or guardian access, unless the law bars sharing or required consent is missing.

Resident and family voice in nursing homes

Nursing homes must tell applicants their admissions rules and any preferences before placement. If the family council asks, the home must send up to six joint notices a year to a resident’s chosen contact, post them, and allow family members to attend council meetings.

Safety checks and vaccines in nursing homes

Before admitting someone who is expected to stay over three days, or who ends up staying that long, nursing homes must check if the person is required to register as a sex offender. Homes must also offer residents a yearly flu shot and a pneumococcal shot, unless it is medically unsafe or the resident refuses.

Hospitals must track workplace violence

Hospitals must set up a system to report, track, and analyze workplace violence. They must record every incident employees report, keep the records at least two years, and include required details. Hospitals must report data quarterly to clinical leaders and send an annual, de-identified report to the state. They must also have a policy that bans retaliation against employees who report or seek help.

Minimum insurance for nursing homes

Each nursing home must keep at least $1,000,000 in general liability insurance per incident (non-eroding). It must also carry professional liability at least equal to the recovery limit set in state law per patient incident. When ownership changes and the policies are claims-made, the buyer must buy a two-year reporting “tail” or two years of retroactive coverage. The state may revoke a license if coverage lapses, and proof is required at renewal.

Nursing homes must get sex offender alerts

Nursing homes and certified nursing facilities must register with the State Police for sex offender alerts. They receive notice when someone on the Sex Offender and Crimes Against Minors Registry registers, re-registers, or verifies in the same or a neighboring ZIP code. This gives facilities timely local safety information to help protect residents.

Facility licensing, fees, and surge beds

The Board can license hospitals and nursing homes by specialty and by bed count. License and inspection fees must be fair, may change no more than once a year, and only when program expenses plus state funding are more than 10% above or below costs; hospitals and nursing homes are analyzed separately. During an official bed-shortage emergency or certain emergency orders, facilities may add temporary beds or locations without a new license for the emergency period plus 30 days.

Sponsors & Cosponsors

Sponsor

  • Mark D. Obenshain

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 259 • No: 1

Senate vote 3/3/2026

House amendment agreed to by Senate

Yes: 40 • No: 0

House vote 2/27/2026

Passed House with amendment

Yes: 95 • No: 0

House vote 2/24/2026

Reported from Health and Human Services with amendment(s)

Yes: 21 • No: 1

House vote 2/19/2026

Subcommittee recommends reporting with amendment(s)

Yes: 10 • No: 0

Senate vote 2/10/2026

Read third time and passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 2/9/2026

Education and Health Amendments agreed to

Yes: 0 • No: 0

Senate vote 2/6/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/6/2026

Constitutional reading dispensed Block Vote (on 1st reading)

Yes: 39 • No: 0

Senate vote 2/5/2026

Reported from Education and Health with amendments

Yes: 14 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0505)

    4/8/2026Governor
  2. Approved by Governor-Chapter 505 (effective 7/1/2026)

    4/8/2026Governor
  3. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/10/2026Governor
  4. Enrolled Bill communicated to Governor on March 10, 2026

    3/10/2026Senate
  5. Fiscal Impact Statement from Department of Planning and Budget (SB535)

    3/9/2026Senate
  6. Bill text as passed Senate and House (SB535ER)

    3/9/2026Senate
  7. Enrolled

    3/9/2026Senate
  8. Signed by President

    3/9/2026Senate
  9. Signed by Speaker

    3/9/2026House
  10. House amendment agreed to by Senate (40-Y 0-N 0-A)

    3/3/2026Senate
  11. Passed House with amendment (95-Y 0-N 0-A)

    2/27/2026House
  12. Engrossed by House as amended

    2/27/2026House
  13. committee amendment agreed to

    2/27/2026House
  14. Read third time

    2/27/2026House
  15. Read second time

    2/26/2026House
  16. Reported from Health and Human Services with amendment(s) (21-Y 1-N)

    2/24/2026House
  17. Subcommittee recommends reporting with amendment(s) (10-Y 0-N)

    2/19/2026House
  18. House subcommittee offered

    2/19/2026House
  19. Assigned sub: Health Professions

    2/16/2026House
  20. Read first time

    2/13/2026House
  21. Referred to Committee on Health and Human Services

    2/13/2026House
  22. Placed on Calendar

    2/13/2026House
  23. Fiscal Impact Statement from Department of Planning and Budget (SB535)

    2/11/2026Senate
  24. Read third time and passed Senate Block Vote (40-Y 0-N 0-A)

    2/10/2026Senate
  25. Education and Health Amendments agreed to

    2/9/2026Senate

Bill Text

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