Nursing Home’s Coronavirus Response Put Residents At Risk in Washington State, Federal Investigators Say

After a nursing home in Washington state became the epicenter as the coronavirus outbreak emerged in the United States late last month, a report released by federal investigators suggests that the nursing home failed to respond to the coronavirus outbreak sufficiently, placing residents in jeopardy.

The U.S. Centers for Medicare and Medicaid Services (CMS) issued a press release on March 23, which outlines the findings of inspections at the Life Care Center nursing home in Kirkland, Washington, which recorded the first U.S. case on January 20.

The findings have led to a new coronavirus guidance for nursing homes (PDF), outlining how the regulatory agency will handle inspections and surveys at facilities nationwide throughout the ongoing crisis.

At least 29 residents, staff and visitors to the Washington nursing home have died as a result of the coronavirus (COVID-19) outbreak, and at least two-thirds of the residents have been infected, along with a large portion of the staff.

Inspectors from CMS and the Washington Department of Social and Health Services State Survey Agency conducted an investigation into the nursing home’s handling of the initial outbreak on March 16. According to the CMS, investigators found three situations they deemed to be “Immediate Jeopardy”, meaning patients were in imminent danger.

The investigators found that the facility failed to rapidly identify and manage sick residents, failed to properly notify the Washington Department of Health about respiratory infections among the residents, and did not have an adequate backup plan after the primary clinician there also developed the coronavirus.

“The coronavirus outbreak at Life Care was an unprecedented situation for the state of Washington,” Washington Department of Social & Health Services Secretary Cheryl Strange said in the press release. “We have worked closely with our federal partners over the last several weeks to determine what lead to the outbreak there and what contributed to its spread throughout the facility. We have learned valuable lessons. We are applying these lessons daily in our efforts to prepare long term care facilities throughout the state for the potential of COVID-19.”

State and federal officials are trying to use what happened at the nursing home as a learning lesson for nursing care facilities nationwide. Currently, CMS indicates there are 147 nursing homes in 27 states which have at least one case of a resident with COVID-19.

CMS and the U.S. Centers for Disease Control and Prevention (CDC) are coordinating with nursing homes with coronavirus infection cases to identify the next facilities likely to be affected and send in inspectors ahead of time to ensure they are prepared to combat it and protect residents.

To that effect, CMS is postponing all other types of inspections to focus its resources on infection control and cases of immediate jeopardy.

This means the CMS will only focus on complaint inspections, targeted infection control inspections and self-assessments during the current emergency. Standard inspections and revisit inspections not associated with Immediate Jeopardy situations are suspended.