Life Care Center of Kirkland in Washington, the first long-term care facility in the United States with a wide-scale coronavirus outbreak, was recently charged with a $600,000 fine for deficiencies that enabled the virus’ spread. Additionally, due to the slew of deficiencies, they are at risk of losing their Medicare and Medicaid funding. Life Care Center—and its lack of infection control—is not the only facility of its kind. Facilities across the United States are at high risk of exposing one of the most vulnerable populations, the elderly and those who need 24/7 medical attention, to an onslaught of infections from COVID-19. At this critical juncture, where the actions of staff and infection procedures mean life or death for many, facilities and staff must respond swiftly with a stringent infection control plan.
Even with the best efforts in place, most long term care facilities are ill-prepared to admit and care for COVID-19 positive patients. Because nursing home and assisted living facility residents, due to their age, compromised immune systems and underlying health conditions, are already at risk of respiratory diseases such as influenza and pneumonia, they are particularly at risk of COVID-19 infection and possible death. Since facilities should already have infection prevention plans and strategies in place for existing infectious diseases, and because these strategies overlap with those recommended for COVID-19, these facilities should theoretically have been prepared to respond accordingly.
In addition to existing infection control plans, the CDC provided guidelines to draft and implement a COVID-19 Preparedness Checklist for skilled nursing homes and other long-term care facilities. Some recommended strategies are to monitor and restrict visitors, test and identify active cases, isolate any active cases, and handle, store, process, and treat all patients and their belongings with the appropriate protective gear. Yet, regardless of existing plans, if not properly implemented, the likelihood of community spread of the virus remains too high to risk. Existing understaffing combined with the lack of preparation means staff, who are already spread thin, lack the time and resources for proper infection control, often leading to dire consequences. In fact, of the 320 fatalities in Los Angeles, 29% of them were found to be residents of nursing homes. And according to the LA Times, 89% of the long-term facilities with COVID—19 had already been cited for infection control violations in the past.