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Government report shows nursing homes have long struggled to contain the spread of infections

According to a new GAO report, 40% of nursing homes were cited for failing to take the proper measures to prevent infectious diseases from spreading throughout their facilities

Coronavirus Nursing Home
The nursing home in Kirkland, Wash., where the most U.S. deaths from coronavirus have been reported.
John Moore/Getty Images
Updated: May 21, 2020 - 8:29am

The Facts Inside Our Reporter’s Notebook

Prior to the coronavirus outbreak in nursing homes across the nation, the Government Accountability Office found that as many as four in 10 nursing homes that were inspected were cited for infection control and prevention issues.

The report, released on Wednesday, found that there was a “persistent” pattern of violations at these nursing homes, though the majority of the violations were report as not severe. The federal Centers for Medicare and Medicaid Services oversaw correction efforts for just 1% of the not severe violations in the report.

The Associated Press has calculated that more than 34,000 coronavirus-related deaths, more than a third of all U.S. pandemic deaths, have taken place at nursing homes or long-term care facilities.

The GAO report suggests that about 40% of nursing homes that were inspected in the last two years had an issue with infection control and prevention. However, during the full period of inspection, from 2013 to 2017, 80% of nursing homes had at least one issue pertaining to their practices surrounding infection control and prevention.

At one facility in California, the report found that a nursing assistant had been ill with a fever, cough and cold for two days but continued to work. Workers who had not had their season flu shots were working without masks, and several employees had not been screened for tuberculosis before being hired. The facility did not face and enforcement action.

A New York nursing home was unable to safely and effectively control an outbreak of a respiratory infection that had impacted 38 residents. The facility did not keep a complete or accurate list of the ill individuals, and did not isolate them from symptom-free residents. Staff assisted both ill and healthy residents without isolating, and residents continued to dine together in a shared area. In this case, the federal CMS did take action, insisting that the nursing home retrain its staff.

The failure of nursing homes to effectively curb the spread of the coronavirus means a slew of new federal reports is  imminent. The head the Medicare and Medicaid agency, Seema Verma, has announced that her agency will appoint a commission to examine the nursing home and long-term care facility response and recommend a course of action. The GAO has also said that it will conduct independent investigations into how the CMS responded to the outbreak.