"Nursing home residents and staff have been especially impacted by the COVID-19 pandemic," a new report from the Office of the Inspector Gener at the Department of Health and Human Services stated.
Nursing homes had "monumental and ongoing staffing challenges." They included "significant loss of staff" and problems in hiring, training, and retaining new staff. "Many nursing homes used outside staffing agencies to fill gaps, which had significant downsides. Nursing homes continued to struggle with costs, testing protocols, personal protective equipment (PPE) compliance, and vaccination rates after initial challenges were resolved."
The OIG had the following recommendations:
- Implement and expand upon its policies and programs to strengthen the nursing home workforce.
- Reassess nurse aide training and certification requirements.
- Update the nursing home requirements for infection control to incorporate lessons learned from the pandemic.
- Provide effective guidance and assistance to nursing homes on how to comply with updated infection control requiments.
- Facilitate sharing of strategies and information to help nursing homes overcome challenges and improve care
This is the third in a three-part series of reports.
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The first said that "COVID-19 had a devastating impact on Medicare beneficiaries in nursing homes during 2020," and added that 40% of residents had or likely had COVID-19 in 2020. Almost 1,000 more Medicare and Medicaid beneficiaries died per day in April 2020 than in April 2019. Overall mortality increased from 17% in 2019 to 22% in 2020.
The second report found that more than 1,300 nursing homes had infection rates of 75% or more during surges in the spring and fall of 2020.
Previous recommendations included reexamination of nursing staff requirements; necessary revisions; targeting of nursing homes most in need of infection control intervention; and provision of enhanced oversight and technical assistance as appropriate.
The Centers for Medicare & Medicaid Services, responding to the report, was critical about weaknesses it saw in the methodology. "Although CMS appreciates OIG's review, it is important to note that OIG's findings are based on 25 interviews with administrators that took place almost two years ago (beginning in December 2021)," CMS wrote.
"Since then, CMS has taken numerous actions to further strengthen infection prevention and control within nursing homes," the agency continued. "CMS acknowledges that administrators can provide valuable insight. However, there are many other stakeholders whose views are not represented, such as residents, resident advocates, and federal and state oversight entities.
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