APIC Applauds GAO’s Report on COVID-19 in Nursing Homes

In a recent press release, the Association for Professionals in Infection Control and Epidemiology (APIC) has applauded a report published this March by the U.S. Government Accountability Office (GOA) for identifying actions to improve infection prevention and control (IPC) practices in nursing homes. The GAO’s report is based on recommendations from a panel of experts, including representatives of APIC.

In the report, the GAO recommends that the U.S. Department of Health and Human Services (HHS) enhance efforts to develop staffing solutions and strengthen mandatory IPC training for nursing home staff.

According to the release, APIC has long advocated for the U.S. Centers for Medicare & Medicaid Services (CMS) to require each nursing home facility to have at least one full-time, dedicated, infection preventionist on staff and that these individuals are trained in IPC. The CDC’s healthcare-associated infection (HAI) tracking system—the National Healthcare Safety Network —should build on current reporting requirements in nursing homes to include surveillance of HAIs and drug-resistant pathogens, such as Candida auris. C. auris is currently on the rise in long-term care facilities and has been identified by the CDC as an urgent antimicrobial resistance threat. (Check out CDC Issues Warning on Antimicrobial-Resistant Fungus to learn more about the dangers of C. auris and other fungi.)

Before the COVID-19 pandemic led to devastating consequences in nursing homes, HAIs killed as many as 380,000 residents each year, according to the release. Unlike in hospitals, where IPC departments are well-established, nursing homes often have inadequate infection prevention requirements and infrastructure. Many times, the role of an infection preventionist is filled by someone expected to serve as the infection preventionist while also serving full-time in another capacity with other major responsibilities. As a result, the release said, nursing home infection preventionists spend less than one-third of their time on IPC-related work. Only 40% have specialized training in IPC and less than 10% are certified.

APIC believes this lack of investment resulted in tragic deaths from COVID-19. At the peak of the pandemic, more than one-third of all deaths were associated with nursing homes. Likewise, drug-resistant pathogens have been allowed to spread unchecked in these facilities. Seventeen states now have reported cases of C. auris with the clinical case count more than tripling between 2019 and 2021.