COVID-19 outbreaks at nursing homes follow years of infection control problems

Описание: ST CHARLES, Mo. — In these strange times, Annette Jansen recognizes that being a good daughter means she looks like a burglar.

“I might get the police saying there's a peeping Tom out there,” she said during a recent visit to Frontier Health and Rehabilitation in St. Charles County.

For two months, Jansen has been visiting Frontier to look in the windows. She’s trying to get a glimpse of her mother, Leona Behrens, a Frontier resident who recently tested positive for COVID-19.


“I don't know from the outside where she's at,” said Jansen. “If she's alert enough, I can use a dry erase board.”

Lifting her mother’s mood is just part of the reason she makes these trips. Jansen said she is concerned that she can’t verify how the staff are caring for her.

“I'm not sure that they really did contain it right off the bat," said Jansen. “My mom had a roommate that was positive and they kept her in there with just a curtain."

Frontier Health and Rehabilitation has reported that 20 of its residents died from COVID-19 since the first diagnosed case on March 23. It’s one of the 76 nursing homes and group living facilities that have seen an outbreak of COVID-19 in the St. Louis area, according to the state's health department.

Kay Van Wey, a medical malpractice attorney, said the risks to nursing home residents are nationwide.

“The nursing home industry has been a very troubled industry for many years. We should be ashamed in the United States at how poorly they care for our loved ones,” said Van Wey.

Nursing home histories show COVID-19 risks
The evidence of that, she adds, can be seen in a facility’s inspection record.

“If they had a history of poor compliance and poor safety practices before COVID, a lot of times that has continued. And that's where we're seeing a large cluster of these cases,” said Van Wey.

The I-Team looked at the inspection history for three facilities with the highest published numbers of resident deaths to COVID-19 in the St. Louis region.


Out of St. Louis area facilities in Missouri that have shared their case numbers with the public, Frontier Health and Rehabilitation has had the most deaths. In at least one Centers for Medicare & Medicaid Services (CMS) inspection every year since 2015, Frontier’s documented deficiencies included infection control issues, often related to staff hand-washing.

In a statement from Frontier on May 13, a representative wrote, “None of the deficiencies cited in our past surveys has ever resulted in any patient harm. All deficiencies cited in the most recent survey (November 2019) were corrected through additional staff training to the satisfaction of the inspectors by early January 2020, well before the first positive coronavirus case occurred at Frontier on March 23.”

Edwardsville Care Center in Madison County, Ill., has seen 17 residents die of COVID-19. The facility has also had an infection control deficiency in its inspection records every year since 2016. Those records from the Centers for Medicare & Medicaid Services mention outbreaks of urinary tract infections in 2017 and a contagious fungal infection in 2018.

Grandview Healthcare in Franklin County, Mo., has had at least 11 residents die of COVID-19. CMS cited the nursing home for infection control deficiencies every year since 2015.

5 On Your Side asked for a statement on these inspections from Edwardsville Care Center and Grandview Healthcare for this story. Neither facility has provided one.

A new national focus on nursing homes
In a wave of surveys completed by Centers for Medicare & Medicaid Services in the last week of March, 36% of nursing homes were not following handwashing guidelines and 25% were not using personal protective equipment the right way.

“My hope is that the pandemic will shine a light on the poor care and the really poor job that many nursing homes do taking care of residents and that someone will call for national reform,” said Van Wey.

CMS suspended routine inspections on March 20 in order to focus on high-risk facilities and look exclusively at nursing home infection control. The agency issued guidance to nursing homes on how to manage protective equipment and prevent infection. One step the organization recommended was for facilities to start assessing themselves and have documentation to show the CMS surveyors when they arrive.

CMS Administrator Seema Verma recently told reporters, “Nursing home residents and their families who want to be sure a nursing home is safe should not hesitate to ask staff directly: What are the results of your CMS self-assessment?”

When asked whether they have been conducting these self-assessment surveys, Frontier and Edwardsville say they have but would not share them with 5 On Your Side.