Concerns Raised Over Federal Rule Allowing Infrequent Doctor Visits for Nursing Home Patients

RICHMOND, Va. — Families of nursing home residents are expressing alarm about the limited doctor visits required at skilled nursing facilities, highlighting potential gaps in patient care. Federal regulations, as outlined by the Virginia Department of Health’s Office of Licensure, mandate that doctors see new residents only within 30 days of admission and just twice within the first 90 days. This has sparked concerns among families who feel their loved ones need more frequent medical attention.

Take the case of Jeannette Stiltoner, who suffered a stroke in 2022 and was admitted to VCU Medical Center. Her daughters, Joann Norman and Debbie White, expected regular doctor oversight when she was transferred to Colonial Heights Rehabilitation and Nursing Center in February 2023. Instead, they were shocked to learn how rarely doctors are required to visit. “I don’t even know who her doctor was,” Norman said, noting that a psychiatric doctor’s visit was documented, but no regular physician check-ins occurred. White added, “You’d think a doctor would be there more often for someone recovering from a stroke.”

The issue extends beyond Stiltoner’s case. Federal rules allow nursing homes to operate with minimal doctor involvement, requiring a medical director to oversee care but not necessarily to see patients. This has left families like Norman’s feeling that care is inadequate. “It’s like they’re just left to the nurses, who are stretched thin,” White said.

Dr. William Wright, a geriatric specialist, is working to address these gaps through his group, SNF/LTC Partners of Virginia, which focuses on improving doctor presence in long-term care. He emphasized the importance of frequent physician visits, especially in the first few weeks of a patient’s stay. “For a successful rehab, doctors should be checking in weekly, at least for the first two to three weeks, to review a patient’s history and adjust care,” Wright said.

Data from the Virginia Department of Health shows that staffing shortages often exacerbate the problem, with nurses and aides frequently handling tasks that might benefit from a doctor’s expertise. A 2024 report noted that facilities like Colonial Heights, already under scrutiny for care quality, struggle with low staff-to-patient ratios, which can limit oversight.

Families are calling for stricter regulations to ensure more consistent doctor visits. “It’s not right that someone can go a month without seeing a doctor when they’re in such a vulnerable state,” Norman said. As Virginia’s aging population grows, advocates argue that updating these standards is critical to protecting nursing home residents.