VDH and CMS both need to provide more oversight for these facilities, not only for care being provided, but also for billing, compliance, and regulatory aspects of SNF care. A lot of these companies (mentioned in both Bacons Rebellion and Tyler Layne’s coverage of substandard SNFs in VA) have made significant profits despite their poor staffing and care ratings. The state is far too behind on their annual inspections and must consider both physical care and proper documentation/billing practices as they try and catch up.