In August 2024, the Department of Health and Human Services Office of Inspector General issued a report entitled “Certain For-Profit Nursing Homes May Not Have Complied With Federal Requirements Regarding the Infection Preventionist Position” in which it reported:
As of July 2022, there were 15,178 Medicare- and Medicaid-certified nursing homes nationwide, of which 10,702 were for-profit nursing homes (located in the 50 States, the District of Columbia, Guam, and Puerto Rico). More than 1.3 million people reside in Medicare and Medicaid certified nursing homes nationwide. Approximately two-thirds of those nursing homes are for-profit nursing homes, and the remaining one-third of nursing homes is comprised of nonprofit and Government-owned nursing homes.
In October 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that stated infection prevention and control is a critical issue for nursing homes because of the high number of health care associated infections, the residents’ increased susceptibility to infections, and the significant exposure to health care associated infections residents face. To minimize exposure to and transmission of infections and contagious diseases, it is critical that nursing homes strictly adhere to Federal requirements for proper infection prevention and control practices. Prior Office of Inspector General (OIG) audits found that nursing homes did not always comply with infection prevention and control (IPC) Federal regulations regarding designating an infection preventionist (IP) who met Federal requirements for that position.
Under these regulations, nursing homes are required to designate at least one individual as the IP who is responsible for the facility’s IPCP. Per the regulations, the IP(s) must: (1) have primary professional training in nursing, medical technology, microbiology, epidemiology, or other related field; (2) be qualified by education, training, experience, or certification; (3) work at least part-time at the facility; and (4) have completed specialized training in infection
prevention and control (42 CFR § 483.80(b)(1-4)).
The OIG selected a simple random sample of 100 for-profit nursing homes from the 10,702 for-profit nursing homes to determine whether they complied with Federal regulations pertaining to IPs during the audit period July 1, 2021
through June 30, 2022.
Of the 100 for-profit nursing homes in the nationwide sample, 76 complied with Federal requirements pertaining to IPs; however, 24 may not have complied with certain requirements. Specifically:
- 17 nursing homes potentially did not comply with the requirement that the IPs complete specialized IPC training prior to assuming their role, and
- 7 nursing homes potentially did not comply with the requirement to designate an IP.
Nursing home officials attributed the potential noncompliance to: (1) difficulties hiring and retaining experienced and qualified IPs; (2) significant changes in IPs, administrators, or ownership; (3) challenges completing specialized training in a timely manner due to pandemic work demands and changing regulatory requirements; and (4) struggles accessing available statewide in-person or online training.
On the basis of the sample results, OIG estimated that 2,568 for-profit nursing homes nationwide (approximately 1 in 4 for-profit nursing homes) may not have complied with Federal requirements pertaining to IPs during its audit period. As a result, there may be increased health and safety risks for the residents and staff of these nursing homes.
If you or a loved one may have been injured (or worse) as a result of an infection in a nursing home in the United States, you should promptly find a nursing home malpractice lawyer who may investigate your nursing home infection claim for you and represent you or your loved one in a nursing home infection case, if appropriate.
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