The U.S. Government Accountability Office (GAO) analysis of the data from the Centers for Disease Control and Prevention (CDC) of data from May 2020 through January 2021 shows that nursing homes commonly experienced multiple COVID-19 outbreaks. The GAO found that nursing homes had an average of about three outbreaks during the review period, with 94% of nursing homes experiencing more than one COVID-19 outbreak.
The CDC definition of an outbreak starts the week a nursing home reports a new resident or staff COVID-19 case and ends when there are two weeks with no new cases. The GAO reviewed data from 13,380 nursing homes. The number of COVID-19 outbreaks in this time span for these nursing homes were as indicated:
- No outbreaks: 64 (0.5%) nursing homes
- 1 outbreak: 761 (6%) nursing homes
- 2 outbreaks: 2,586 (19%) nursing homes
- 3 outbreaks: 4,026 (30%) nursing homes
- 4 or more outbreaks: 5, 943 (44%) nursing homes
For each nursing home’s longest-lasting COVID-19 outbreak, GAO found that about 85 percent (11,311 nursing homes) had outbreaks lasting 5 or more weeks. Conversely, for about 15 percent of nursing homes (2,005 homes), the longest outbreak was shorter in duration, lasting between 1 and 4 weeks, with 267 of those homes able to control their outbreaks after the initial week. The average number of COVID-19 cases per outbreak for nursing homes with a long-duration outbreak was 56, while the average for nursing homes with a short-duration outbreak was 13. For both long- and short-duration outbreaks, over half of the nursing homes (66 percent, or 8,720 homes) reported that these outbreaks began with a staff member who tested positive the first week.
The GAO included data from Medicare and Medicaid certified nursing homes that each passed CDC and Centers for Medicare & Medicaid Services (CMS) quality checks during the review period.
The GAO full report can be accessed at: GAO-21-367, COVID-19 IN NURSING HOMES: Most Homes Had Multiple Outbreaks and Weeks of Sustained Transmission from May 2020 through January 2021.
Discussion Points:
- Review your Infection Control Plan and your policy and procedure on the COVID-19 vaccination. Ensure that both include the most up-to-date information from the CDC. Develop a process for ensuring that all required education and vaccination data is accurately recorded and is reported timely per CMS requirements.
- Train all staff on your Infection Control Plan and your COVID-19 policies for vaccination and prevention of the spread of the virus. Provide education to residents, resident representatives, and staff prior to offering the COVID-19 vaccine. Train appropriate staff on the need to record and report vaccination status for residents and staff alike per CMS guidelines. Place training documentation in each employee’s education file.
- Periodically audit to ensure that all staff are following your Infection Control Plan, and that staff are aware of the benefits and risks associated with the COVID-19 vaccination. Audit vaccine education records, consent completion, and administration rates and provide additional education where needed. Monitor to ensure that vaccination reporting occurs each week as required beginning Sunday June 13, 2021.
