                                 CODE OF VIRGINIA

(EFFECTIVE PURSUANT TO ACTS 2025, C. 432, CL. 2) ELECTRONIC MONITORING IN
RESIDENT ROOMS (§ 32.1-138.5:1)

A. As used in this section:
			&#8220;Electronic monitoring&#8221; means the use of a surveillance device
with a fixed position video camera or audio recording device, or a combination
thereof, that is installed in a resident&#8217;s room and broadcasts or records
activities or sounds occurring within the confines of the room. Electronic
monitoring shall not include use of a device that enables audio communication
into the resident&#8217;s room from another source.
			&#8220;Family member&#8221; means the resident&#8217;s spouse, parent,
stepparent, child, stepchild, brother, sister, half-brother, half-sister,
grandparent, or grandchild.
			&#8220;Legal representative&#8221; means a person legally responsible for
representing or standing in the place of the resident for the conduct of his
affairs. This may include a guardian, conservator, attorney-in-fact under
durable power of attorney, trustee, or other person expressly named by a court
of competent jurisdiction or the resident as his agency in a legal document that
specifies the scope of the representative&#8217;s authority to act. A legal
representative may only represent or stand in the place of a resident for the
function for which he has legal authority to act.

B. All requests for electronic monitoring shall be made in writing and signed by
the resident or, if the resident has been legally deemed incompetent, the
resident&#8217;s legal representative. Only electronic monitoring in accordance
with this section is permitted.
			Electronic monitoring shall be permitted only:

   1. Upon the informed consent of the resident or resident&#8217;s legal
   representative, which shall be obtained prior to the installation or use of
   any electronic monitoring device. Consent for electronic monitoring shall be
   kept in the resident&#8217;s medical record;

   2. When the resident resides:
   				a. In a room with no roommates; or
   				b. In a room with any roommates and obtains written consent to visual
   recording from such roommates or, if any roommate has been legally deemed
   incompetent, such roommate&#8217;s legal representative. When a resident
   resides with any roommates, only video electronic monitoring shall be
   permitted pursuant to this subsection;

   3. Upon execution of an agreement for the sharing and release of medical data
   and information protected by the federal Health Insurance Portability and
   Accountability Act of 1996 (42 U.S.C. &#xA7; 1320d et seq.) signed by the
   resident or resident&#8217;s legal representative or, if applicable, any such
   agreement signed by any roommate or roommate&#8217;s legal representative
   shall be kept in all consenting individuals&#8217; medical records; and

   4. When the nursing facility has secured and password-protected wireless
   Internet access or other means available to operate the electronic monitoring
   device without modification to the nursing facility or a change in level or
   capacity of Internet access.

C. A nursing facility shall allow electronic monitoring of a resident of a
nursing facility if the electronic monitoring is conducted in accordance with
this section. A nursing facility shall not refuse to admit an individual and
shall not discharge or transfer a resident due to a request to conduct
authorized electronic monitoring.

D. Family members shall not implement or activate electronic monitoring over the
objections of or contrary to the instructions of the resident or the
resident&#8217;s legal representative. No electronic monitoring equipment may be
installed over the objections of or contrary to the instructions of the resident
or resident&#8217;s legal representative.

E. Nursing facilities shall designate one or more staff persons to be the point
of contact for electronic monitoring requests and for providing information and
policies upon request during normal business hours.

F. Except as provided in subsection O, nursing facilities may assume custodial
ownership of any recordings from electronic monitoring devices from the resident
or resident&#8217;s legal representative. Recordings from electronic monitoring
devices shall not be considered part of the resident&#8217;s medical record.

G. If a nursing facility chooses to assume ownership of recordings from
electronic monitoring devices pursuant to subsection F, the nursing facility
shall not permit viewings of recordings without consent of the resident or
resident&#8217;s legal representative except to the extent that disclosure is
required by law or for quality assurance purposes.

H. A nursing facility shall not be held liable for any breach of data or privacy
related to the presence of the electronic monitoring device.

I. A nursing facility shall require its staff to immediately report any
incidents regarding safety or quality of care discovered or reported to staff as
a result of viewing a recording from an electronic monitoring device to the
administrator of the nursing facility.

J. A nursing facility shall have no obligation to seek access to a recording for
which it has not assumed custodial ownership or to have knowledge of a
recording&#8217;s content unless (i) the nursing facility is aware of a recorded
incident of suspected abuse or neglect or of an accident or injury based upon a
report received by the facility of such incident, accident, or injury or (ii)
the resident, the resident&#8217;s legal representative, or a government agency
seeks to use a recording.

K. Unless a nursing facility chooses to assume ownership of any recordings from
an electronic monitoring device, the resident or resident&#8217;s legal
representative shall be responsible for all aspects of the operation of the
electronic monitoring device, including the removal and replacement of
recordings; adherence to local, state, and federal privacy laws; and use of
firewall protections to prevent images that would violate obscenity laws from
being inadvertently shown on the Internet.

L. A nursing facility shall prohibit assigned staff from refusing to enter a
resident&#8217;s room solely because of electronic monitoring.

M. A nursing facility shall make reasonable physical accommodations for
electronic monitoring devices, including:

   1. Providing a reasonably secure place to mount the device; and

   2. Providing reasonable access to power sources if already in proximity to the
   device.

N. A nursing facility shall require a resident or resident&#8217;s legal
representative to pay for all costs, other than the cost of electricity,
associated with the purchase and installation of the electronic monitoring
device. In addition, a nursing facility offering facility-managed electronic
monitoring may charge a one-time fee not to exceed $150 when the electronic
monitoring device is installed along with a security deposit not to exceed $250.
A nursing facility may charge a monthly fee not to exceed $10 to cover costs
associated with the electronic monitoring device. Such costs may include
equipment, secured and password-protected wireless Internet and server
capabilities, compliance with life safety and building and electrical codes,
maintenance or removal of the equipment, posting and removal of any public
notices, or structural repairs to the building resulting from the removal of the
equipment. Nursing facilities shall give 45 days&#8217; notice of an increase in
monthly fees.

O. The resident or resident&#8217;s legal representative of a room with an
electronic monitoring device may verbally or in writing condition consent to the
installation or use of the electronic monitoring device. Such conditions on
consent may include: (i) the ability of the resident, any roommate, or staff at
the request of the resident or any roommate, to turn off or disable the audio or
video electronic monitoring device during certain periods of time and (ii) a
prohibition on the ability of the nursing facility to, pursuant to subsection F,
choose to assume custodial ownership of any recordings from the electronic
monitoring device after the electronic monitoring device has been installed and
is operational. If the resident or resident&#8217;s legal representative or any
roommate or roommate&#8217;s legal representative places any such conditions on
consent, the nursing facility and staff shall ensure that the installation, use,
and operation of the electronic monitoring device and any electronic monitoring
or other activities conducted in connection therewith are conducted in
compliance with such conditions.

P. The nursing facility shall conspicuously post and maintain a notice at the
entrance to the resident&#8217;s room stating that an electronic monitoring
device is in operation.

Q. Nursing facilities shall notify assigned staff for the resident when
electronic monitoring is in use in a resident&#8217;s room pursuant to this
section.

R. Each nursing facility shall adopt policies and procedures for electronic
monitoring consistent with this section.

S. Each nursing facility shall adopt a policy prohibiting staff from willfully
tampering with electronic monitoring devices in violation of this section.
Adjusting or disabling an electronic monitoring device during the provision of
patient care shall not constitute willful tampering if such adjusting or
disabling is done in order to protect the dignity of a resident or at the
direction of the resident or resident&#8217;s legal representative.

T. If the placement or position of the electronic monitoring device creates risk
to a nursing facility employee, resident, or any roommate, or if the resident or
resident&#8217;s legal representative or family member violates the nursing
facility&#8217;s policies and procedures for electronic monitoring, the
equipment may be disabled and removed and the resident, resident&#8217;s legal
representative, or family member responsible for the camera shall be notified of
the removal.

HISTORY: 2025, c. 432.