'It makes no sense': Feds consider relaxing infection control in US nursing homes

May 4, 2020

The federal government is considering rolling back infection control requirements in U.S. nursing homes – even as the long-term-care industry's residents and workers are overwhelmed by the coronavirus.

A rule proposed last year by the Centers for Medicare and Medicaid Services (CMS) would modify the amount of time an infection preventionist must devote to a facility from at least part-time to "sufficient time," an undefined term that lets the facility decide how much time should be spent. The regulation has not been finalized, but CMS last week defended its proposal, saying it aims to reduce regulatory burden and strengthen infection control.

Opponents of the change said the rule could leave nursing home residents more vulnerable to infection. They expressed concern, especially given the devastation COVID-19 has caused within long-term care facilities.

"It makes no sense at all – prior to pandemic, but more so now during a pandemic – to roll back any of the necessary infection and control requirements and the federal regulations," said Lindsay Heckler, a supervising attorney at the Center for Elder Law & Justice, a civil legal services agency in Buffalo, New York. "They should be strengthening these infection and control requirements."

CMS has acknowledged that infection is "the leading cause of morbidity and mortality" in the nation's 15,600 nursing homes. In its proposed rule, the agency said 1.6 million to 3.8 million infections occur each year in those facilities, with almost 388,000 deaths attributed to infections.

The coronavirus has put a spotlight on the problem. More than 16,000 long-term-care residents and staff have died of COVID-19, according to a USA TODAY analysis of government data. And nearly 97,000 residents and staff have tested positive for the virus. Those figures are an undercount, because testing has been limited and many states have not released full data.