Cases of COVID-19 among nursing home residents has reached a record high and deaths are on the rise again despite efforts to limit the spread of the coronavirus in skilled nursing facilities, which serve as home to some of the virus’s most vulnerable victims.
On Feb. 28, a woman in King County, Washington, was the first nursing home patient to test positive for COVID-19. The virus quickly spread through the facility, infecting 81 residents, 34 staff members and 14 visitors. Twenty-three of them died. Since then, the virus has spread through nursing homes across the country with a vengeance. By early spring, nursing homes were logging about 11,000 cases a week. The Centers for Medicare & Medicaid Services (CMS) jumped in and began putting infection control measures in place to stop the spread.
By the end of June, the number of weekly cases dropped to 6,319, CMS Administrator Seema Verma told facility operators during a mid-August conference call. But CMS teams “found significant deficiencies in infection and control practices,” she said. As a result, weekly cases jumped to about 12,000 by the end of July. “And we’re seeing an uptick, unfortunately, in the losses.”
“This is not just a testing issue or a supply issue,” she said. “Our deep concern is that even in nursing homes that are doing testing on a regular basis, we are still seeing significant spread.” CMS members have seen how one or two cases of COVID-19 in a nursing home can turn into dozens of cases “in a matter of hours,” she cautioned. “We could have a more significant crisis on our hands.”
The number of weekly COVID-19 deaths among nursing home residents peaked at 3,130 at the end of May and was trending downward until the last week of July, when 1,706 COVID-19-related deaths were reported.
Verma assured nursing homes that the agency wasn’t looking to fine facilities, though CMS has issued $15.5 million in fines to more than 3,400 nursing homes for violating infection control requirements or failing to report COVID-19 data.
“We are using every tool in our toolbox to do what we can to try to mitigate the spread and try to keep nursing home residents safe,” Verma told MedPage Today. However, CMS has sent strike force teams to some facilities three times and still have not seen improvement in compliance. “In those cases, penalties may be more appropriate for that facility.”