Amid CMS’s Infection-Control Crackdown, Study Finds Widespread Citations at Nursing Homes

As the Centers for Medicare & Medicaid Services (CMS) promises a crackdown on infection control inspections amid the coronavirus crisis, a new analysis finds that citations for infection-related violations are widespread in the industry.

While officials and the media are taking a closer look at nursing homes’ compliance histories and amping up regulatory scrutiny, one study found disease prevention control failures have been prevalent across the space since 2017, according to federal records reviewed by Kaiser Health News.

“9,372 nursing homes, or 61%, were cited for one or more infection-control deficiencies,” Kaiser Health News concluded, citing its own analysis. “It also found violations were more common at homes with fewer nurses and aides than at facilities with higher staffing levels.”


The report found that 53% of facilities with five-star staffing ratings on Nursing Home Compare, CMS’s consumer-facing quality scorecard, received violations for failing to comply with infection-control standards in the last three years. Among those with one-star staffing levels, that figure was 65%.

Four out of 10 nursing homes with five-star quality ratings have received citations related to infection-control protocols, which includes staff working with unwashed hands and neglecting to wear protective gear when patients are in isolated rooms, according to Kaiser Health News.

The analysis highlighted that almost all violations are included in the total star rating — with the exception of 1% of minor offenses not attached to fines. Staffing problems add greater complexity to successfully implementing prevention protocols due to high turnover and the use of part-time and temporary staff, who may be unfamiliar with updated facility regulations. In addition, due to wage pressures and thinning benefits, some staff may fail to stay at home even when they fall ill.


The news comes as the Centers for Medicare & Medicaid Services (CMS) announced a sweeping plan to pivot its survey focus directly toward infection-control compliance in skilled nursing facilities — while halting non-emergency survey initiatives.

“We are obviously prioritizing those that are impacted by the coronavirus,” CMS administrator Seema Verma said on a Wednesday conference call with reporters. “But we’re starting with a special focus on nursing homes and hospitals, where there’s been some type of a situation, or in areas where we’re seeing community spread. So that’s going to start immediately.”

CMS’s move came largely in response to a coronavirus outbreak at a Kirkland, Wash. facility operated by Life Care Centers of America, which has seen at least six deaths as of Thursday.

CMS and the Centers for Disease Control and Prevention (CDC) will visit Life Care Centers of America to check on prior and current health prevention control protocols, Verma announced Wednesday.

Companies featured in this article: