The U.S. Government Accountability Office (GAO) released a report that describes the prevalence of infection prevention and control deficiencies in community living centers (CLCs) prior to the COVID-19 pandemic.
Future GAO reports will examine more broadly the quality of care at CLCs and Department of Veterans Affairs’ (VA’s) response to COVID-19 in the nursing home settings for which VA provides or pays for care.
Thousands of veterans rely on nursing home care provided or paid for by the VA. Ensuring the quality of care in VA-owned and -operated community living centers has become even more critical with the emergence of COVID-19. As part of our ongoing review of center care quality, we examined deficiencies in infection prevention and control practices that inspections found at 135 centers before the pandemic (FY 2015-2019).
· 95 percent of inspected centers were cited for infection control deficiencies such as failure to use gowns and gloves or to clean reusable items
· 62 percent were cited for these deficiencies in consecutive years
COVID-19 is a new and highly contagious respiratory disease causing severe illness and death, particularly among the elderly. Because of this, the health and safety of the nation’s nursing home residents—including veterans receiving nursing home care in CLCs—has been a particular concern.
The VA is responsible for overseeing the quality of nursing home care provided to residents in VA-owned and -operated community living centers (CLC). VA models its oversight process on the methods used by the Centers for Medicare & Medicaid Services, which uses inspections of nursing homes to determine whether the home meets federal quality standards. These standards require, for example, that CLCs establish and maintain an infection prevention and control program. VA uses a contractor to conduct annual inspections of the CLCs, and these contractors cite CLCs with deficiencies if they are not in compliance with quality standards. Infection prevention and control deficiencies cited by the inspectors can include situations where CLC staff did not regularly use proper hand hygiene or failed to correctly use personal protective equipment. Many of these practices can be critical to preventing the spread of infectious diseases, including COVID-19.
GAO analysis of VA data shows that infection prevention and control deficiencies were the most common type of deficiency cited in inspected CLCs, with 95 percent (128 of the 135 CLCs inspected) having an infection prevention and control deficiency cited in 1 or more years from fiscal year 2015 through 2019.
GAO also found that over the time period of its review, a significant number of inspected CLCs—62 percent—had infection prevention and control deficiencies cited in consecutive fiscal years, which may indicate persistent problems. An additional 19 percent had such deficiencies cited in multiple, nonconsecutive years.
