Nursing homes struggled with infection control long before COVID-19: watchdog

Nursing homes struggled with infection control long before COVID-19: watchdog
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Thousands of nursing homes struggled to follow infection control requirements long before the COVID-19 pandemic struck the U.S., according to a government watchdog report Wednesday.

More than 80 percent of all nursing homes surveyed between 2013 and 2017 — about 13,300 facilities — were cited for at least one infection control deficiency in that time period and for failing to follow rules intended to prevent the spread of diseases, like staff hand-washing protocols, according to the report from the nonpartisan Government Accountability Office (GAO). 

Violations range from staff coming to work sick, not wearing masks, and not being vaccinated for the flu to not isolating sick residents from others. Infection control deficiencies are the most common type of deficiencies among nursing homes, according to the report.


“This new report shows that warning signs were ignored and nursing homes were unprepared to face a pandemic,” said Sen. Ron WydenRonald (Ron) Lee WydenBiden comments add momentum to spending bill's climate measures  These Senate seats are up for election in 2022 Democrats call on Biden administration to ease entry to US for at-risk Afghans MORE (D-Ore.), who requested that the GAO undertake the report.

“For years nursing home surveys pointed out areas where federal standards for nursing home safety and enforcement efforts should be improved, but the Trump administration chose not to correct them. Too many seniors and their families have suffered as a result of this pandemic, and there need to be big changes in the way nursing homes care for seniors.”

The Trump administration is moving to relax an Obama-era rule that required nursing homes to employ at least one specialist in preventing infections.

The infection control shortcomings are highlighted by the COVID-19 pandemic,  which has spread rapidly through America’s nursing homes, killing at least 28,100 residents and workers, according to a New York Times tally. 

The elderly are particularly at risk for severe illness and death from COVID-19 because they tend to have weakened immune systems and underlying health conditions that exacerbate the disease. COVID-19 spreads quickly in nursing homes, which typically have tight quarters and communal settings. 

Nursing homes are often short-staffed and experience high staff turnover, likely because of low pay and limited paid leave policies that also encourage workers to come to work sick. 


The GAO report found about half of the nursing homes cited for infection control deficiencies in that five-year period had violations in consecutive years, indicating “persistent problems” with following the rules.

In individual years from 2013 to 2019, between 39 and 41 percent of nursing homes surveyed had at least one infection prevention and control deficiency. 

Between 2013 and 2017, 99 percent of those deficiencies were classified as “not severe,” meaning the residents were not harmed and nursing homes were rarely fined.  

But the reported noted "many of these practices can be critical to preventing the spread of infectious diseases, including COVID-19."