Audits uncovering non-compliant nursing homes

Facilities now account for 62% of all COVID-19 deaths

AUDITS OF MORE THAN 350 skilled nursing homes across the state indicate a minority but significant number of the facilities are not in adherence with a 28-point checklist of infection control procedures, industry sources said.

The sources said they didn’t have exact numbers, but some industry officials complained privately that the audit process itself was chaotic with mixed messages on the standards for inspections.

Marylou Sudders, the secretary of health and human services, said last week that the audits would be wrapped up by Friday. Facilities are scheduled to start receiving funding next week from $130 million Gov. Charlie Baker set aside recently for them. The initial payments will go to every facility, but future payments are expected to be contingent on coming into compliance with the infection control procedures.

The death toll in the state’s long-term care facilities hit 3,338 on Thursday, up 102 from Wednesday. By comparison, deaths at hospitals and all other medical facilities increased by 65 to 2,144. COVID-19 deaths at nursing homes now account for 61 percent of all COVID-19 deaths in the state.

Sudders said at a State House press conference that the National Guard, which has been deployed to do mobile testing for COVID-19 at long-term care facilities, is now sending guard members to fill in as medical staffers at some of the nursing homes struggling with staff shortages.

Nursing homes in Massachusetts are privately owned but overseen by the state. They also receive a large amount of their funding from the state. For years, they have complained that they are underfunded and unable to hire the employees they need.

When the COVID-19 outbreak first surfaced, the Baker administration focused most of its attention on hospitals, testing, and personal protection equipment, trying to make sure the rising number of cases didn’t overwhelm the state’s medical system.

That strategy has worked well, but as the coronavirus found its way into long-term care facilities, it ravaged an elderly population that was particularly vulnerable to attack. People older than 70 account for 85 percent of COVID-19 deaths; the average age of COVID-19 victims is 82.

On April 27, the Baker administration agreed to provide an additional $130 million in funding to nursing homes, but the money required compliance with a 28-point infection control competency checklist. Audits of the facilities began last week.

Facilities receive one point for compliance with each item on the checklist. Those scoring 24 or higher will be declared in adherence, those scoring 20 to 24 will be in adherence but warrant reinspection to fix some issues, and those with scores less than 20 will be deemed not in adherence.

Meet the Author

Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

Any facility failing to adhere to one of six core competency items on the checklist will also be declared not in adherence.  The six core competencies center on isolating residents with COVID-19, closing all congregate spaces, training  staff on how to wear personal protection equipment, having staff wear personal protection equipment while caring for all residents if there is a COVID-19 case in the facility, and establishing policies and training for recognizing COVID-19 symptoms and caring for residents with respiratory infection.

Industry sources said a number of long-term care facilities failed to pass muster on issues dealing with personal protection equipment.