Health

Infection Lapses Rampant in Nursing Homes But Punishment Is Rare

Published

8 years ago

December 27, 2017

By Jordan Rau, Kaiser Health News

Basic steps to prevent infections — such as washing hands, isolating contagious patients and keeping ill nurses and aides from coming to work — are routinely ignored in the nation’s nursing homes, endangering residents and spreading hazardous germs.

A Kaiser Health News analysis of four years of federal inspection records shows 74 percent of nursing homes have been cited for lapses in infection control — more than for any other type of health violation. In California, health inspectors have cited all but 133 of the state’s 1,251 homes.

Although repeat citations are common, disciplinary action such as fines is rare: Nationwide, only one of 75 homes found deficient in those four years has received a high-level citation that can result in a financial penalty, the analysis found.

“The facilities are getting the message that they don’t have to do anything,” said Michael Connors of California Advocates for Nursing Home Reform, a nonprofit in San Francisco. “They’re giving them low-level warnings year after year after year and the facilities have learned to ignore them.”

Infections, many avoidable, cause a quarter of the medical injuries Medicare beneficiaries experience in nursing homes, according to a federal report. They are among the most frequent reasons resideents are sent back to the hospital. By one government estimate, health care-associated infections may result in as many as 380,000 deaths each year.

The spread of methicillin-resistant Staphylococcus aureus (MRSA) and other antibiotic-resistant germs has become a major public health issue. While Medicare has begun penalizing hospitals for high rates of certain infections, there has been no similar crackdown on nursing homes.

As average hospital stays have shortened from 7.3 days in 1980 to 4.5 days in 2012, patients who a generation ago would have fully recuperated in hospitals now frequently conclude their recoveries in nursing homes. Weaker and thus more susceptible to infections, some need ventilators to help them breathe and have surgical wounds that are still healing, two conditions in which infections are more likely.

“You’ve got this influx of vulnerable patients but the staffing models are still geared more to the traditional long-stay resident,” said Dr. Nimalie Stone, the CDC’s medical epidemiologist for long-term care. “The kind of care is so much more complicated that facilities need to consider higher staffing.”

The Centers for Medicare & Medicaid Services (CMS), which oversees inspections, has recognized that many nursing homes need to do more to combat contagious bugs. CMS last year required long-term care facilities to put in place better systems to prevent infections, detect outbreaks early on and limit unnecessary use of antibiotics through a stewardship program.

But the agency does not believe it has skimped on penalties. CMS said in a statement that most infection-control violations have not justified fines because they did not put residents in certain danger.

For instance, if an inspector observed a nurse not washing his or her hands while caring for a resident, the agency said that would warrant a lower-level citation “unless there was an actual negative resident outcome, or there was likelihood of a serious resident outcome.”

In November, CMS waived penalties for 18 months against facilities that violate the new stewardship rule. The industry had said nursing homes needed more time to prepare. (The moratorium does not affect California’s antibiotic stewardship requirement, which took effect last January.)

Holly Harmon, the senior director of clinical services at the American Health Care Association, a nursing home trade group, said the industry has made strides in combating infections through better training and encouragement for staff members to look for gaps in infection control and to speak up about them.

The percentage of nursing home residents with urinary tract infections — the only type of infection all nursing homes must report to Medicare — has dropped by more than half since 2011.

“Infection prevention control is a priority,” Harmon said. “The path really is focused on continuous improvement.”

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OPINION: California’s Legislature Has the Wrong Prescription for the Affordability Crisis — Gov. Newsom’s Plan Hits the Mark

Last month, Gov. Newsom included measures in his budget that would encourage greater transparency, accountability, and affordability across the prescription drug supply chain. His plan would deliver real relief to struggling Californians. It would also help expose the hidden markups and practices by big drug companies that push the prices of prescription drugs higher and higher. The legislature should follow the Governor’s lead and embrace sensible, fair regulations that will not raise the cost of medications.

Published

1 month ago

June 18, 2025

Oakland Post

Rev. Dr. Lawrence E. VanHook. Courtesy of Rev. Dr. Lawrence E. VanHook.

By Rev. Dr. Lawrence E. VanHook

As a pastor and East Bay resident, I see firsthand how my community struggles with the rising cost of everyday living. A fellow pastor in Oakland recently told me he cuts his pills in half to make them last longer because of the crushing costs of drugs.

Meanwhile, community members are contending with skyrocketing grocery prices and a lack of affordable healthcare options, while businesses are being forced to close their doors.

Our community is hurting. Things have to change.

The most pressing issue that demands our leaders’ attention is rising healthcare costs, and particularly the rising cost of medications. Annual prescription drug costs in California have spiked by nearly 50% since 2018, from $9.1 billion to $13.6 billion.

Some lawmakers, however, have advanced legislation that would drive up healthcare costs and set communities like mine back further.

I’m particularly concerned with Senate Bill (SB) 41, sponsored by Sen. Scott Wiener (D-San Francisco), a carbon copy of a 2024 bill that I strongly opposed and Gov. Newsom rightly vetoed. This bill would impose significant healthcare costs on patients, small businesses, and working families, while allowing big drug companies to increase their profits.

SB 41 would impose a new $10.05 pharmacy fee for every prescription filled in California. This new fee, which would apply to millions of Californians, is roughly five times higher than the current average of $2.

For example, a Bay Area family with five monthly prescriptions would be forced to shoulder about $500 more in annual health costs. If a small business covers 25 employees, each with four prescription fills per month (the national average), that would add nearly $10,000 per year in health care costs.

This bill would also restrict how health plan sponsors — like employers, unions, state plans, Medicare, and Medicaid — partner with pharmacy benefit managers (PBMs) to negotiate against big drug companies and deliver the lowest possible costs for employees and members. By mandating a flat fee for pharmacy benefit services, this misguided legislation would undercut your health plan’s ability to drive down costs while handing more profits to pharmaceutical manufacturers.

This bill would also endanger patients by eliminating safety requirements for pharmacies that dispense complex and costly specialty medications. Additionally, it would restrict home delivery for prescriptions, a convenient and affordable service that many families rely on.

Instead of repeating the same tired plan laid out in the big pharma-backed playbook, lawmakers should embrace Newsom’s transparency-first approach and prioritize our communities.

Let’s urge our state legislators to reject policies like SB 41 that would make a difficult situation even worse for communities like ours.

About the Author

Rev. Dr. VanHook is the founder and pastor of The Community Church in Oakland and the founder of The Charis House, a re-entry facility for men recovering from alcohol and drug abuse.

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Oak Temple Hill Hosts Interfaith Leaders from Across the Bay Area

Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.

Published

1 month ago

June 14, 2025

Oakland Post

Troy McCombs (from the state of Washington), Elder Mark Mortensen (from Irvine, CA), Michael Pappas, Rev. Ken Chambers, Dr. Ejaz Naqvi, Elder Sigfried Nauman (from the state of Washington), and Richard Kopf. Courtesy photo.

Special to the Post

Interfaith leaders from the Bay Area participated in a panel discussion at the annual meeting of communication leaders from The Church of Jesus Christ of Latter-day Saints held on Temple Hill in Oakland on May 31. Distinguished faith leaders Rev. Ken Chambers, executive director the Interfaith Council of Alameda County (ICAC); Michael Pappas, executive director of the San Francisco Interfaith Council; and Dr. Ejaz Naqzi, president of the Contra Costa County Interfaith Council addressed the group on key issues including homelessness, food insecurity, immigration, and meaningful opportunities to care for individuals and communities in need.

Chambers, said he is thankful for the leadership and support of the Church of Jesus Christ Latter-Day Saints’ global ministry, which recently worked with the interfaith congregations of ICAC to help Yasjmine Oeveraas a homeless Norwegian mother and her family find shelter and access to government services.

Oeveraas told the story of how she was assisted by ICAC to the Oakland Post. “I’m a Norwegian citizen who escaped an abusive marriage with nowhere to go. We’ve been homeless in Florida since January 2024. Recently, we came to California for my son’s passport, but my plan to drive for Uber fell through, leaving us homeless again. Through 2-1-1, I was connected to Rev. Ken Chambers, pastor of the West Side Missionary Baptist Church and president of the Interfaith Council of Alameda County, and his car park program, which changed our lives. We spent about a week-and-a-half living in our car before being blessed with a trailer. After four years of uncertainty and 18 months of homelessness, this program has given us stability and hope again.

“Now, both my son and I have the opportunity to continue our education. I’m pursuing cyber analytics, something I couldn’t do while living in the car. My son can also complete his education, which is a huge relief. This program has given us the space to focus and regain our dignity. I am working harder than ever to reach my goals and give back to others in need.”

Richard Kopf, communication director for The Church of Jesus Christ in the Bay Area stated: “As followers of Jesus Christ, we embrace interfaith cooperation and are united in our efforts to show God’s love for all of his children.”

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“Unnecessary Danger”: Gov. Newsom Blasts Rollback of Emergency Abortion Care Protections

Effective May 29, CMS rescinded guidance that had reinforced the obligation of hospitals to provide abortion services under the Emergency Medical Treatment and Labor Act (EMTALA) when necessary to stabilize a patient’s condition. Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.

Published

1 month ago

June 14, 2025

Oakland Post

iStock.

By Bo Tefu, California Black Media

Gov. Gavin Newsom is criticizing the Centers for Medicare & Medicaid Services (CMS) for rolling back federal protections for emergency abortion care, calling the move an “unnecessary danger” to the lives of pregnant patients in crisis.

Newsom warned that the rollback will leave patients vulnerable in states with strict or total abortion bans.

“Today’s decision will endanger lives and lead to emergency room deaths, full stop,” Newsom said in a statement. “Doctors must be empowered to save the lives of their patients, not hem and haw over political red lines when the clock is ticking. In California, we will always protect the right of physicians to do what’s best for their patients and for women to make the reproductive decisions that are best for their families.”

The CMS guidance originally followed the 2022 Dobbs decision, asserting that federal law could preempt state abortion bans in emergency care settings. However, legal challenges from anti-abortion states created uncertainty, and the Trump administration’s dismissal of a key lawsuit against Idaho in March removed federal enforcement in those states.

While the rollback does not change California law, Newsom said it could discourage hospitals and physicians in other states from providing emergency care. States like Idaho, Mississippi, and Oklahoma do not allow abortion as a stabilizing treatment unless a patient’s life is already at risk.

California has taken several steps to expand reproductive protections, including the launch of Abortion.CA.Gov and leadership in the Reproductive Freedom Alliance, a coalition of 23 governors supporting access to abortion care.