An HHS report released in January found that more than 1,000 nursing homes had a 75 percent or higher rate of infection during the first year of the COVID-19 pandemic.
The report, conducted by the department's office of inspector general, analyzed data from the Minimum Data Set, Medicare Enrollment Database, Medicare Parts A, B and C claims, payroll based journal and the Certification and Survey Provider Enhanced Reporting system to find what went wrong during the early part of the pandemic. The report also provided key areas for improvement for infection control.
Here are six key findings:
- More than 1,300 nursing homes had extremely high infection rates — 75 percent or higher — during two surges in 2020. Nursing homes with extremely high infection rates during the first surge were concentrated in the Northeast. During the second surge, the nursing homes with extremely high infection rates were spread across the U.S. but appeared particularly in the Midwest.
- For-profit nursing homes made up a disproportionate percentage of homes with extremely high infection rates during both surges.
- Nursing homes with extremely high infection rates experienced 20 percent mortality rates, roughly double that of other nursing homes.
- Counties with high COVID-19 transmission rates did not always lead to nursing homes in that county reaching extremely high infection rates.
- Fifty-four percent of the nursing homes with extremely high infection rates were not cited with an infection control deficiency in 2020.
- Nursing homes with extremely high infection rates reported nursing hours at or above both of Medicare's specific requirements. Medicare required nursing homes to provide at least eight consecutive hours of registered nursing services per day and 24 hours of licensed nursing services per day.
The report offered three ways to improve infection control:
- Re-examine current nursing staff requirements and revise them as necessary.
- Improve how surveys identify infection control risks to nursing home residents and strengthen guidance on assessing the scope and severity of those risks.
- Identify nursing homes in most need of infection control intervention and provide oversight and technical assistance to these facilities.