House Joint Resolution 160 (HJR 160) of the 2004 General Assembly Session would have required the Joint Commission on Health Care (JCHC) to "examine the issue of developing a pain management standard for long-term care facilities in Virginia." The House Rules Committee tabled HJR 160 but requested a review of the issue by JCHC.

This three-year study included a staff report in 2004 on Virginia’s previous efforts to address pain management, a report in 2005 by the Virginia Health Quality Center titled "Virginia-Specific and National Findings on the Nursing Home Quality Initiative Related to Pain Management," and a final JCHC report in 2006.

A stakeholder work group was convened by JCHC staff to examine the need for new pain management standards for long-term care facilities in Virginia. The following organizations were represented on the work group:

• Virginia Assisted Living Association,
• Virginia Association for Home Care and Hospice,
• Virginia Association for Hospices,
• Virginia Association of Nonprofit Homes for the Aging,
• Virginia Board of Nursing,
• Virginia Health Care Association, and
• Virginia Health Quality Center.

The workgroup identified three major barriers to effective pain management in long-term care facilities including education, cultural challenges, and systemic problems. However, the workgroup also found that a number of initiatives were underway in Virginia to help address these barriers. After considering the numerous public and private initiatives that were underway, the workgroup concluded that establishing specific pain management standards for long-term care facilities would be both ineffective and unnecessary.