A growing problem exists in American nursing homes. There has been a tremendous increase in infectious bacterial infections, drug-resistant infections, and diseases spreading throughout facilities. While that thought is frightening enough for our loved ones who are in long-term care facilities, the problem is worsened by the fact that these outbreaks often go unreported or are reported late, resulting in more residents of nursing homes being infected than should occur. Most states require that outbreaks such as these be reported to the state health agency within 24 hours of when the outbreak becomes known to the facility, yet this simply does not happen and virtually nobody is being punished or held accountable for this serious problem.
This issue was recently brought to light in an article that appeared in Reuters Magazine (Dec. 22, 2016). The article, titled “How hospitals, nursing homes keep lethal ‘superbug’ outbreaks secret,” authored by Deborah J. Nelson, David Rohde, Benjamin Lesser and Ryan McNeill, explored numerous cases of bacterial outbreaks in nursing homes and hospitals in the last few years. While the number of outbreaks around the country cannot possibly be known for the reasons discussed below, the Reuters’ investigation determined that there were at least 300 superbug outbreaks in public health facilities between 2011 and 2016, and this information was simply gleaned from the study of incomplete records from 29 states. Inspection of death certificates of long-term care residents who died between 2003 and 2014 revealed a 62 percent increase in deaths associated with superbug infections.
Dr. Nelson and her cohorts, in their investigation, addressed that the problem of countless outbreaks is made worse for a number of reasons that include:
• The lack of a continuity in the Centers for Disease Control (CDC) reporting, tracking and sharing of information with regard to outbreaks;
• The reliance of CDC on local health departments to report the outbreaks to it and to handle and follow up on those outbreaks;
• Vague, uncertain and unenforced rules on what must be reported and when;
• The fact that many health departments see themselves merely as a facilitator to the facility in addressing outbreaks;
• Presence of some state laws that protect the identities of the facilities where there are outbreaks;
• The lack of punishment of facilities that fail to report or are slow in reporting, despite the presence of civil remedies under most states’ laws;
• The denial of medical professionals to concede the outbreaks are causative factors in the deaths of many patients, choosing instead to point to other comorbidities as the reason the aged and infirmed died; and
• The failure of many facilities that lack a properly trained education infection-prevention officer to monitor, track and report outbreaks at the facilities.
The authors investigated several incidents of outbreaks. The primary ones that were focused on were:
• A January 2014 outbreak of Clostridium difficile (c. diff.) at Casa Maria nursing home in New Mexico: In this incident, the New Mexico regulations required that a nursing home notify state public health officials within 24 hours of an outbreak in a public health facility, but the outbreak was not reported until March 2014. By the time it was reported, nine residents had contracted c. diff. By June 15 residents had contacted it, and eight had died. The public was not advised of the outbreak.
• A September 2014 outbreak of c. diff at St. Mary’s Regional Medical Center in Reno Nevada, where 15 or more patients became infected and three died. The state health department conceded that the outbreak was reported much too late.
• Between 2008 and 2011, as many as 21 patients were infected with Acinetobacter baumanii (A. baumanii) at St. Anthony’s Medical Center in St. Louis, Missouri. The outbreak was never reported until it was discovered by a family member whose father died following surgery at the hospital.
• In 2016, more than 22 patients were sickened and seven died in an Ohio hospital and seven long-term care facilities as a result of A. baumanii. The public was never notified of the multiple identified cases. A family member of the last person to die was only told that he died from a “mysterious infection.”
• An outbreak of Klebsiella pneumonia in January 2011 in West Virginia. This outbreak became known only after a local hospital, Berkeley Medical Center, notified state health agents of the increased diagnoses. An investigation revealed that more than nine people had contracted the infection at a local nursing home, but it was only reported as “LTCF A,” rather than by the name of the facility. By the time all infected persons were identified, the list was two-feet long. Reuters was able to identify the facility as Heartland of Martinsburg. A local health official expressed her frustration that she could not, by law, let people know of the problem in this facility. This outbreak resulted in litigation, and the nursing home and hospital pointed the finger at one another, contending that the other was responsible for the outbreak.
While other facility outbreaks were discussed by Reuters, the authors/investigators bring to light a serious problem that needs to be addressed more seriously by state health officers, the CDC, and lawyers who investigate hospital and long-term care facility illnesses and deaths.
If you need more information on this subject, contact Ben Locklar at 800-898-2034 or by email at Ben.Locklar@beasleyallen.com. Ben handles Nursing Home Litigation for our firm.
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