HHS-OIG Audit Suggests 1 in 4 Nursing Homes Are Not Compliant with Infection Preventionist Requirements
An audit by the HHS Office of Inspector General (HHS-OIG) indicates more than one-quarter of nursing homes either did not designate an infection preventionist (IP) or designated an IP who had not been completely trained for the position.
Due to the high number of healthcare-associated infections in nursing homes, the significant exposure to infections, and the increased susceptibility of nursing home residents to infections, the HHS Centers for Medicare & Medicaid Services (CMS) issued a final rule in October 2016 stating that infection control is a critical issue. The final rule required nursing homes to establish and maintain an infection prevention and control program (ICIP) that ensures a safe, sanitary, and comfortable environment and to strictly adhere to federal requirements for proper infection prevention and control practices.
Infection prevention and control regulations include the requirement to designate an infection preventionist (IP) and for that individual to meet federal requirements for that position. HHS-OIG has conducted previous audits of nursing homes and found that for-profit nursing homes did not always comply with those requirements. In July 2022, HHS-OIG selected a random sample of 100 nursing homes from the 10,702 for-profit nursing homes in the 50 States, the District of Columbia, Guam, and Puerto Rico, and assessed whether they were compliant with IP requirements from July 1, 2021, through June 30, 2022.
While 76 nursing homes were compliant, 24 did not meet federal requirements pertaining to IPs, 17 of which potentially did not comply with the requirement to provide the IP with complete specialized infection prevention and control training prior to assuming the role and 7 failed to designate an individual as an IP. If the sample is representative of all 10,702 for-profit nursing homes, HHS-OIG estimates that 2,568 nursing homes are not fully compliant with the IP requirements, including around 750 nursing homes that may not have appointed an IP. According to HHS-OIG, 1.3 million people in the United States are living in nursing homes and those individuals are susceptible to healthcare-associated infections. The failure to appoint or provide complete training to IPs means nursing home residents face increased health and safety risks.
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HHS-OIG recommended the CMS instruct state survey agencies to follow up with the 24 identified nursing homes to verify that they have taken appropriate corrective actions and for the CMS to share the audit report with state agencies and encourage them to focus oversight on verifying nursing homes in their respective states have designated an IP and are providing complete training prior to filling the position. The CMS concurred with and agreed to implement the recommendations.
