I am writing to express my strong support for stricter oversight of Virginia's nursing facilities, but I urge the Virginia Department of Health to tie these enforcement mechanisms to mandatory staffing standards and transparent accountability. 

To achieve meaningful quality improvements, the state must implement the following safeguards:

1. Enforceable Staffing Standards: VDH must strictly enforce mandatory, case-mix adjusted staffing ratios that protect residents from neglect and burnout among care providers.
2. Frequent & Predictable Enforcement: Proposed sanctions must be deployed consistently. Repeat violations must lead to swifter, binding actions, such as frozen admissions or license supervisions. 
3. Direct Financial Accountability: Nursing homes must provide clear financial accountings of all Medicare and Medicaid funds. Public taxpayer dollars should be legally mandated to directly toward resident care and frontline staff wages, rather than being funneled into corporate conglomerates or private equity profits. Money directly affects their health! CREATE AN AUDITING GROUP WITHIN VDH!

Thank you for your efforts to Protect Virginia's seniors. I look forward to seeing these protections solidified.