Medicare/Medicaid Issues Infection Control
Violations to 15 Percent of Nursing Homes
Strong correlation between low staffing levels and
the receipt of an infection control deficiency citation
May 3, 2011 Fifteen percent
of U.S. nursing homes receive deficiency citations for infection control
per year, according to a new study published in the May issue of the
American Journal of Infection Control, the official publication of
APIC - the Association for Professionals in Infection Control and
Conducted by a team of
researchers at the University of Pittsburgh's Graduate School of Public
Health, the study analyzed deficiency citation data collected for the
purpose of Medicare/Medicaid certification between 2000 and 2007. The
data represented approximately 16,000 nursing homes per year and a panel
of roughly 100,000 observations.
The records analyzed represent
96 percent of all U.S. nursing home facilities. The team discovered a
strong correlation between low staffing levels and the receipt of an
infection control deficiency citation.
Infections are the leading
cause of morbidity and mortality in nursing homes, responsible for
nearly 400,000 deaths per year. Although this has been the focus of
mainstream media attention, very little empirical research has been
conducted on the subject.
The Centers for Medicare and
Medicaid Services (CMS) requires that nursing homes be certified before
receiving reimbursement for Medicare and/or Medicaid residents.
of this certification process, facilities that do not meet certain
standards are issued deficiency citations. This study examined the
deficiency citation for infection control requirements known as the
"Our analysis may provide some
clues as to the reason for the persistent infection control problems in
nursing homes," state the authors.
"Most significantly, the issue
of staffing is very prominent in our findings; that is, for all three
caregivers examined (i.e., nurse aides, LPNs and RNs) low staffing
levels are associated with F-Tag 441 citations. With low staffing
levels, these caregivers are likely hurried and may skimp on infection
control measures, such as hand hygiene."
The authors conclude, "The
high number of deficiency citations for infection control problems
identified in this study suggests the need for increased emphasis on
these programs in nursing homes to protect vulnerable elders."
A number of states have
enacted legislation that applies to infection prevention practices in
long-term care facilities. Illinois is poised to pass legislation
requiring an infection preventionist in each skilled nursing facility.
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