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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>359090</law_id><section_number>32.1-138.5:1</section_number><catch_line>(Effective pursuant to Acts 2025, c. 432, cl. 2) Electronic monitoring in resident rooms</catch_line><edition url="https://vacode.org/2026/" slug="2026" current="TRUE" last_updated="2026-08-02">2026</edition><structure><unit label="title" level="1" order_by="75" identifier="32.1">Health</unit><unit label="chapter" level="2" order_by="5" identifier="5">Regulation of Medical Care Facilities and Services</unit><unit label="article" level="3" order_by="4" identifier="2">Rights and Responsibilities of Patients in Nursing Homes</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> As used in this section:
			&#x201C;<span class="dictionary">Electronic monitoring</span>&#x201D; 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&#x2019;s room and broadcasts or records activities or sounds occurring within the confines of the room. <span class="dictionary">Electronic monitoring</span> shall not include use of a device that enables audio communication into the resident&#x2019;s room from another source.<br/><br/>			&#x201C;<span class="dictionary">Family member</span>&#x201D; means the resident&#x2019;s spouse, parent, stepparent, child, stepchild, brother, sister, half-brother, half-sister, grandparent, or grandchild.<br/><br/>			&#x201C;<span class="dictionary">Legal representative</span>&#x201D; means a <span class="dictionary">person</span> legally responsible for representing or standing in the place of the resident for the conduct of his affairs. This may include a guardian, conservator, <span class="dictionary">attorney-in-<span class="dictionary">fact</span></span> under durable <span class="dictionary">power of attorney</span>, trustee, or other <span class="dictionary">person</span> expressly named by a <span class="dictionary">court</span> of competent <span class="dictionary">jurisdiction</span> or the resident as his agency in a legal document that specifies the scope of the representative&#x2019;s authority to act. A <span class="dictionary">legal representative</span> may only represent or stand in the place of a resident for the function for which he has legal authority to act. <a id="paragraph-1335806" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> All requests for <span class="dictionary">electronic monitoring</span> shall be made in writing and signed by the resident or, if the resident has been legally deemed incompetent, the resident&#x2019;s <span class="dictionary">legal representative</span>. Only <span class="dictionary">electronic monitoring</span> in accordance with this section is permitted.
			<span class="dictionary">Electronic monitoring</span> shall be permitted only: <a id="paragraph-1335807" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#B"><i class="fa fa-link"/></a></p></section>
						<section id="B1" class="indent-1"><p><span class="prefix-number">1.</span> Upon the informed consent of the resident or resident&#x2019;s <span class="dictionary">legal representative</span>, which shall be obtained prior to the installation or use of any <span class="dictionary">electronic monitoring</span> device. Consent for <span class="dictionary">electronic monitoring</span> shall be kept in the resident&#x2019;s medical record; <a id="paragraph-1335808" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#B1"><i class="fa fa-link"/></a></p></section>
						<section id="B2" class="indent-1"><p><span class="prefix-number">2.</span> When the resident resides:
				a. In a room with no roommates; or<br/><br/>				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&#x2019;s <span class="dictionary">legal representative</span>. When a resident resides with any roommates, only video <span class="dictionary">electronic monitoring</span> shall be permitted pursuant to this subsection; <a id="paragraph-1335809" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#B2"><i class="fa fa-link"/></a></p></section>
						<section id="B3" class="indent-1"><p><span class="prefix-number">3.</span> 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&#x2019;s <span class="dictionary">legal representative</span> or, if applicable, any such agreement signed by any roommate or roommate&#x2019;s <span class="dictionary">legal representative</span> shall be kept in all consenting individuals&#x2019; medical records; and <a id="paragraph-1335810" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#B3"><i class="fa fa-link"/></a></p></section>
						<section id="B4" class="indent-1"><p><span class="prefix-number">4.</span> When the nursing facility has secured and password-protected wireless Internet access or other means available to operate the <span class="dictionary">electronic monitoring</span> device without modification to the nursing facility or a change in level or capacity of Internet access. <a id="paragraph-1335811" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#B4"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> A nursing facility shall allow <span class="dictionary">electronic monitoring</span> of a resident of a nursing facility if the <span class="dictionary">electronic monitoring</span> 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 <span class="dictionary">electronic monitoring</span>. <a id="paragraph-1335812" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#C"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> <span class="dictionary">Family members</span> shall not implement or activate <span class="dictionary">electronic monitoring</span> over the objections of or contrary to the instructions of the resident or the resident&#x2019;s <span class="dictionary">legal representative</span>. No <span class="dictionary">electronic monitoring</span> equipment may be installed over the objections of or contrary to the instructions of the resident or resident&#x2019;s <span class="dictionary">legal representative</span>. <a id="paragraph-1335813" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> Nursing facilities shall designate one or more staff <span class="dictionary">persons</span> to be the point of contact for <span class="dictionary">electronic monitoring</span> requests and for providing information and policies upon request during normal business hours. <a id="paragraph-1335814" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> Except as provided in subsection O, nursing facilities may assume custodial ownership of any recordings from <span class="dictionary">electronic monitoring</span> devices from the resident or resident&#x2019;s <span class="dictionary">legal representative</span>. Recordings from <span class="dictionary">electronic monitoring</span> devices shall not be considered part of the resident&#x2019;s medical record. <a id="paragraph-1335815" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#F"><i class="fa fa-link"/></a></p></section>
						<section id="G"><p><span class="prefix-number">G.</span> If a nursing facility chooses to assume ownership of recordings from <span class="dictionary">electronic monitoring</span> devices pursuant to subsection F, the nursing facility shall not permit viewings of recordings without consent of the resident or resident&#x2019;s <span class="dictionary">legal representative</span> except to the extent that disclosure is required by <span class="dictionary">law</span> or for quality assurance purposes. <a id="paragraph-1335816" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#G"><i class="fa fa-link"/></a></p></section>
						<section id="H"><p><span class="prefix-number">H.</span> A nursing facility shall not be held liable for any breach of data or privacy related to the presence of the <span class="dictionary">electronic monitoring</span> device. <a id="paragraph-1335817" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#H"><i class="fa fa-link"/></a></p></section>
						<section id="I"><p><span class="prefix-number">I.</span> 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 <span class="dictionary">electronic monitoring</span> device to the administrator of the nursing facility. <a id="paragraph-1335818" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#I"><i class="fa fa-link"/></a></p></section>
						<section id="J"><p><span class="prefix-number">J.</span> 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&#x2019;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&#x2019;s <span class="dictionary">legal representative</span>, or a government agency seeks to use a recording. <a id="paragraph-1335819" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#J"><i class="fa fa-link"/></a></p></section>
						<section id="K"><p><span class="prefix-number">K.</span> Unless a nursing facility chooses to assume ownership of any recordings from an <span class="dictionary">electronic monitoring</span> device, the resident or resident&#x2019;s <span class="dictionary">legal representative</span> shall be responsible for all aspects of the operation of the <span class="dictionary">electronic monitoring</span> device, including the removal and replacement of recordings; adherence to local, state, and federal privacy <span class="dictionary">laws</span>; and use of firewall protections to prevent images that would violate obscenity <span class="dictionary">laws</span> from being inadvertently shown on the Internet. <a id="paragraph-1335820" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#K"><i class="fa fa-link"/></a></p></section>
						<section id="L"><p><span class="prefix-number">L.</span> A nursing facility shall prohibit assigned staff from refusing to enter a resident&#x2019;s room solely because of <span class="dictionary">electronic monitoring</span>. <a id="paragraph-1335821" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#L"><i class="fa fa-link"/></a></p></section>
						<section id="M"><p><span class="prefix-number">M.</span> A nursing facility shall make reasonable physical accommodations for <span class="dictionary">electronic monitoring</span> devices, including: <a id="paragraph-1335822" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#M"><i class="fa fa-link"/></a></p></section>
						<section id="M1" class="indent-1"><p><span class="prefix-number">1.</span> Providing a reasonably secure place to mount the device; and <a id="paragraph-1335823" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#M1"><i class="fa fa-link"/></a></p></section>
						<section id="M2" class="indent-1"><p><span class="prefix-number">2.</span> Providing reasonable access to power sources if already in proximity to the device. <a id="paragraph-1335824" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#M2"><i class="fa fa-link"/></a></p></section>
						<section id="N"><p><span class="prefix-number">N.</span> A nursing facility shall require a resident or resident&#x2019;s <span class="dictionary">legal representative</span> to pay for all costs, other than the cost of electricity, associated with the purchase and installation of the <span class="dictionary">electronic monitoring</span> device. In addition, a nursing facility offering facility-managed <span class="dictionary">electronic monitoring</span> may charge a one-time fee not to exceed $150 when the <span class="dictionary">electronic monitoring</span> 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 <span class="dictionary">electronic monitoring</span> 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&#x2019; notice of an increase in monthly fees. <a id="paragraph-1335825" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#N"><i class="fa fa-link"/></a></p></section>
						<section id="O"><p><span class="prefix-number">O.</span> The resident or resident&#x2019;s <span class="dictionary">legal representative</span> of a room with an <span class="dictionary">electronic monitoring</span> device may verbally or in writing condition consent to the installation or use of the <span class="dictionary">electronic monitoring</span> 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 <span class="dictionary">electronic monitoring</span> 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 <span class="dictionary">electronic monitoring</span> device after the <span class="dictionary">electronic monitoring</span> device has been installed and is operational. If the resident or resident&#x2019;s <span class="dictionary">legal representative</span> or any roommate or roommate&#x2019;s <span class="dictionary">legal representative</span> places any such conditions on consent, the nursing facility and staff shall ensure that the installation, use, and operation of the <span class="dictionary">electronic monitoring</span> device and any <span class="dictionary">electronic monitoring</span> or other activities conducted in connection therewith are conducted in compliance with such conditions. <a id="paragraph-1335826" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#O"><i class="fa fa-link"/></a></p></section>
						<section id="P"><p><span class="prefix-number">P.</span> The nursing facility shall conspicuously post and maintain a notice at the entrance to the resident&#x2019;s room stating that an <span class="dictionary">electronic monitoring</span> device is in operation. <a id="paragraph-1335827" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#P"><i class="fa fa-link"/></a></p></section>
						<section id="Q"><p><span class="prefix-number">Q.</span> Nursing facilities shall notify assigned staff for the resident when <span class="dictionary">electronic monitoring</span> is in use in a resident&#x2019;s room pursuant to this section. <a id="paragraph-1335828" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#Q"><i class="fa fa-link"/></a></p></section>
						<section id="R"><p><span class="prefix-number">R.</span> Each nursing facility shall adopt policies and procedures for <span class="dictionary">electronic monitoring</span> consistent with this section. <a id="paragraph-1335829" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#R"><i class="fa fa-link"/></a></p></section>
						<section id="S"><p><span class="prefix-number">S.</span> Each nursing facility shall adopt a policy prohibiting staff from willfully tampering with <span class="dictionary">electronic monitoring</span> devices in violation of this section. Adjusting or disabling an <span class="dictionary">electronic monitoring</span> device during the provision of patient care shall not constitute willful tampering if such adjusting or disabling is done in <span class="dictionary">order</span> to protect the dignity of a resident or at the direction of the resident or resident&#x2019;s <span class="dictionary">legal representative</span>. <a id="paragraph-1335830" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#S"><i class="fa fa-link"/></a></p></section>
						<section id="T"><p><span class="prefix-number">T.</span> If the placement or position of the <span class="dictionary">electronic monitoring</span> device creates risk to a nursing facility employee, resident, or any roommate, or if the resident or resident&#x2019;s <span class="dictionary">legal representative</span> or <span class="dictionary">family member</span> violates the nursing facility&#x2019;s policies and procedures for <span class="dictionary">electronic monitoring</span>, the equipment may be disabled and removed and the resident, resident&#x2019;s <span class="dictionary">legal representative</span>, or <span class="dictionary">family member</span> responsible for the camera shall be notified of the removal. <a id="paragraph-1335831" class="section-permalink" href="https://vacode.org/32.1-138.5_1/#T"><i class="fa fa-link"/></a></p></section></text><history>2025, c. 432.</history><metadata></metadata></law>
