Infection Control

Nursing home residents are among the most vulnerable members of our communities and the most susceptible to illnesses like COVID-19. While these residents comprise just 1.2% of our country’s population, recent reporting shows they account for approximately 40% of COVID-19 deaths. The danger that poor infection control practices in nursing homes presents to tens of thousands of our fellow citizens is nothing new.

In an analysis from the Centers for Medicare and Medicaid Services (CMS), 82% of nursing homes across the country were cited for infection control problems between 2013 and 2017. Half were repeat offenders. Lack of consistent handwashing and infrequent disinfection of common areas were chief culprits. Such failures allowed illness like seasonal flu to sweep across numerous facilities. The statistics on COVID-19 infection and death rates in nursing homes illustrate the dangers to residents created by poor infection control practices.

Traditionally, there are three avenues of protection from harm for nursing home residents – (1) state level inspections and regulation required by CMS, (2) visits by family members and (3) civil liability in cases of neglect, resulting in injury and/or death. Each of these layers of protection have significantly eroded in recent months.

Adequate infection control measures are central to the safety and wellbeing of nursing home residents, some of the most vulnerable members of society and those most susceptible to illness. In an acceleration of trends away from strong regulation, it is now becoming harder in many states to enforce accountability by suing facilities for negligence.

Even with the unprecedented rise in infection, healthcare facilities in general have been shielded from liability, and nursing homes in particular from fault in COVID-19-related claims. Kentucky and Mississippi are two such states. Proponents of these measures have argued that exposure to liability impedes staff members’ effective decision-making, arguably false; that existing rules and regulations do enough to protect patients, also false; and that the involvement of family and friends of patients serve as a sufficient check on patient safety, which is now a less potent safeguard given necessary restrictions on in-person nursing home visits.

Worsening standards for infection control in nursing homes are nothing new. The problems go far beyond the current pandemic and reflect gaps in the system that have long existed. For years, eased regulatory standards have chipped away at protections for patients, creating under-resourced and understaffed nursing homes where proper safeguards are impossible. In June, a Pennsylvania nursing aide shared that during a typical shift, lasting as long as 16 hours at a time, he was fortunate if he could change a patient’s soiled diaper once in an eight-hour period. He further stated that low pay meant many staff members came to work sick, feeling they had no other choice.

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