Coronavirus In IL: Nursing Homes Struggle To Control Infections

ILLINOIS — Coronavirus cases are expected to peak in Illinois in the coming days, and authorities are struggling to slow the spread of the virus. The state continues to see more than 1,500 new cases and dozens of deaths per day, and older Illinoisans and those with underlying health conditions are especially vulnerable. But an analysis has found that 76 percent of nursing homes in Illinois have been cited in recent years for problems with infection control.

According to a data analysis by Kaiser Health News and distributed by The Associated Press, 9,700 of the nation's more than 15,000 nursing homes — about 63 percent — were cited by the federal government at least once during the last two inspection cycles, which ran from February 2016 to February 2020. Nearly 3,500 nursing homes, or 23 percent, were cited more than once.

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Even among those homes with the federal government's top rating — five out of five stars — 40 percent have been cited at least once for infection problems. Such citations were issued to 80 percent of the worst-rated homes, those with just a single star.

Check federal ratings for nursing homes in your area.

Infections of any type are a persistent challenge for skilled nursing facilities. Kaiser noted that as many as 3.8 million infections occur in homes each year, killing nearly 388,000 residents. Controlling coronavirus infections is further complicated by limited testing — Gov. J.B. Pritzker said Wednesday that the state is still falling short of it's 10,000-test-per-day goal.

But the Kaiser analysis found that many infection citations concern basic sanitary practices, including workers' failure to wash hands as they move from patient to patient, or wear masks, gloves and gowns when dealing with contagious patients. Those practices are important at any time, but especially when battling a highly contagious virus like the coronavirus.

Other citations involved matters less likely to factor into disease transmission — allowing patients to develop bedsores, for example.

"Nursing centers are required to have an infection prevention and control plan, an Infection Preventionist, and an emergency preparedness plan. All of these steps have helped our members prepare for this pandemic," the American Health Care Association told Patch in response to an email seeking comment from the group's Illinois chapter.

"The people we care for in our nursing centers are certainly a high-risk population, and we can always find ways to improve infection prevention. Citations have increased due to new CMS infection control regulations that went into effect in 2019. With more regulations, there are more opportunities for citations. Most citations were isolated to one instance that did not cause resident harm. Criticism on infection control at this time is only designed to increase concern about the preparedness of our health care providers and is not helpful during a pandemic."

According to the Illinois Health Care Association and Illinois Center for Assisted Living, nursing homes must take four steps to limit the spread of the new coronavirus in their facilities. They must isolate infected residents in a single room; minimize all contact between residents by keeping healthy residents in their rooms as much as possible and enforcing social distancing; increase precautions such as hand-washing and wearing facemasks, gloves and other personal protective equipment; and increase monitoring of residents for respiratory symptoms and fever.

Likewise, the Illinois Department of Public Health emphasizes both preventing the coronavirus from coming into facilities and stemming its spread within them.

"Healthcare resources in Illinois will become strained in the weeks ahead and healthcare facilities should plan for enhanced surge capacity," the department said in a news release. "Healthcare facilities should implement and adhere to policies and practices that minimize exposures to respiratory pathogens including SARS-CoV-2."

To keep the coronavirus out, state health officials recommend placing signs at entrances to facilities turning away visitors if they have respiratory symptoms and ensuring employees have enough sick leave to stay home if they have symptoms. Basic hygiene, disinfection practices, and access to personal protective equipment is also crucial to stopping the virus if it gets in, state officials say.

Federal inspectors classify violations in one of four levels of severity. Most of these fall into the category of "potential harm." Less severe violations might create "potential for minimal harm," but more severe ones might threaten "actual harm," and the most severe put patients in "immediate jeopardy," requiring prompt correction.

Among Illinois' 723 nursing homes, the severity of most citations fell into the "potential for harm" category.

Use this interactive map to see how often nursing homes in your area were cited for infection control problems.

Read more from Patch:

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• 3 Joliet Coronavirus Deaths At Symphony: WJOL
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• Coronavirus In The South Suburbs: 4 Suspected Nursing Home Deaths
• Lemont Nursing Home Denial Contradicts Medical Examiner's Finding

Source: A Kaiser Health News analysis of the Nursing Home Compare database from the Centers for Medicare and Medicaid Services as of February 2020, which details the "deficiencies" or citations that each nursing home received during inspections over the last two inspection cycles, which stretch back to February 2016. They include planned inspections, which occur once every 9 to 15 months, and inspections prompted by complaints or facility-self reporting of problems. The Kaiser data was distributed by the Associated Press.