Nursing Home Infection Control Problems Cited in About 4 in 10 Inspections: GAO

As hospitals and care facilities continue to treat a growing number of COVID-19 patients, a new government report indicates about 40% of the nursing home facilities inspected across the United States have been previously cited for infection control problems.

The U.S Government Accountability Office (GAO) issued a new report (PDF) on May 20, warning that in the years prior to the COVID-19 outbreak, inspections found persistent lapses in infection control and prevention policies a large portion of the nation’s nursing homes.

These nursing home infection control problems already placed residents at greater risk of contracting an infection, which may have been a signal for the rapid spread of COVID-19 at nursing homes during the current pandemic.

GAO investigators reviewed nursing home inspection results collected at 15,500 facilities between 2013 and 2017. According to their findings, 82% of the facilities inspected, or 13,299, had at least one deficiency related to infection control and prevention. The inspectors found infection-related deficiencies over multiple consecutive years in four out of every 10 nursing homes investigated.

Common violations included employees failing to properly wash hands, not isolating sick residents during outbreaks, and failing to screen for sick employees entering the facilities to care for residents.

Although the vast majority of nursing home facilities had some lapses in infection control and prevention, the report indicates the federal Centers for Medicare and Medicare Services carried out enforcement actions for only one percent of violations classified as not severe from over the five year period.

The GAO report noted several violations found over the study period were warning signs that nursing homes would be vulnerable during a pandemic.

One incident included a New York facility which experienced a respiratory infection outbreak that ultimately sickened 38 residents. According to the citation, the facility failed to keep an accurate list of the infected patients, failed to isolate them, and allowed those sick to continue using common spaces, such as dining halls with patients not experiencing any symptoms.

A report published earlier this week warned that one of the nation’s largest nursing home chains, Life Care Centers, failed to meet standards designed to stop the spread of infections at its nursing homes and long-term care facilities. Federal investigators said the chain continued failing to meet basic standards even after a number of its facilities suffered COVID-19 outbreaks and deaths.

Government inspectors found problems in at least 10 Life Care nursing homes over the past six weeks, not including those found at the Life Care Center of Kirkland in Washington state, where the first reported COVID-19 outbreak emerged in February 2020.

Nursing homes nationwide are struggling to protect the population of older and at-risk individuals living in long-term care facilities, which have become a breeding ground for the virus. Since many residents have serious underlying health conditions, which complicate coronavirus illnesses, recent reports suggest more than 30,000 coronavirus deaths have been linked to nursing homes nationwide, representing about a third of all coronavirus deaths in the United States.

Officials warn the outbreaks among the nation’s nursing homes is a consequence of nursing home neglect in long-term care facilities. Nursing homes face chronic under-staffing and a lack of preparation among staff for pandemic care.

COVID-19 has infected more than 1.5 million Americans and has surpassed 93,000 deaths. Globally the coronavirus pandemic has infected more than 5 million people and has led to over 315,000 deaths. There is no known cure or vaccine.