Nursing Home Infection Control Measures Still Need Improvement Years After COVID: Study

Researchers report that persistent staffing issues in U.S. nursing homes are compromising the ability of facilities to implement effective infection controls.

The findings of a new study raises serious concerns about the continuing risk of preventable nursing home infections, indicating that facilities throughout the U.S. still struggle to implement adequate infection control measures, which was a problem highlighted during the peak of COVID-19, and has continued to go unaddressed nationwide.

A team of researchers led by Liza L. Behrens at Pennsylvania State University, published a report last week in the Journal of the American Medical Directors Association (JAMDA), warning that infection control problems nursing homes faced during the height of the pandemic–low staffing, poor infection control, and a lack of access to testing supplies–are still major issues at facilities throughout the U.S.

Nursing Home Infections During COVID-19

Nursing homes experienced numerous infection control problems during the COVID-19 pandemic, with prior research indicating that staffing shortages were one of the top contributing factors to those issues.

Understaffing contributed to a failure of facilities to follow infectious disease protocols, resulting in substandard care for nursing home and long-term care facility residents Those factors were linked to surging nursing home infection rates and deaths, reaching more than 1,000 deaths per day due to a lack of adequate staff, proper care, and oversight.

The U.S. Centers for Disease Control and Prevention (CDC) published a study in 2020, highlighting a link between COVID-19 and nursing home quality of care, indicating facilities which received better federal ratings prior to the pandemic were less likely to experience severe outbreaks at their facilities.

In this new study, Behrens’ team interviewed leadership at more than 5,000 nursing homes across 12 states, focusing on perspectives during periods of reduced resources, such as the pandemic, to better understand how to support nursing homes in the future. They also analyzed publicly reported survey data.

Their findings indicate nursing homes continue to struggle with similar problems today as the did during COVID-19, even though the pandemic has ended. Nursing home leaders reported high infection rates among residents and a lack of access to resources like personal protective equipment and testing supplies.

The researchers found that most facilities report they still face serious issues with staffing shortages. This affects how staff approach vaccinations for residents and implement isolation practices for infected residents in facilities.

Despite the end of the COVID-19 pandemic, leadership in nursing homes and long-term care facilities reported challenges with securing testing supplies and receiving funding for personal protective equipment like face masks and gowns.

The researchers emphasize the need for public policies designed to improve resources for nursing homes. A focus on funding for the long-term financial burden nursing homes face from COVID-19 infections is necessary, considering elderly patients face the greatest risk of coronavirus transmission and deaths linked to the virus post-pandemic, the researchers concluded.

“Nursing home leaders continue to struggle delivering quality infection prevention and control care post-pandemic and require focused support in several areas,” Behrens’ team wrote. “Policies should support continued reporting of infection prevention and control-related metrics and adequate funding to account for the long-term financial burden nursing homes face.”

New Nursing Home Staffing Requirements

Federal regulators have acknowledged the staffing problem. In April, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on minimum staffing requirements for CMS-certified nursing homes in the U.S., which are designed to help reduce the risk of unsafe and low-quality care provided to elderly or ill individuals in the U.S.

However, the plan has received pushback from nursing home industry lobbyists, who say the staffing requirements will cause facilities to shut down because they do not have the funding, nor a large enough pool of trained candidates to fill those staffing roles.

Federal regulators have said they do not see a problem with nursing homes fulfilling the new federal requirements.