Health

Infection Lapses Rampant in Nursing Homes But Punishment Is Rare

Published

7 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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Activism

A Student-Run Group Provides Critical Support Services to Underserved Residents

Those visiting The Suitcase Clinic can get legal advice, sign up for food assistance, receive housing resources, get medical help, or enjoy a hot, fresh meal. They can also get haircuts and foot washes from the student volunteers. Nilo Golchini, executive director of the clinic, said one of the goals for most of the students working there is helping bridge the gap of trust that exists between many unhoused people and the healthcare and social welfare systems.

Published

10 hours ago

December 18, 2024

Oakland Post

UC Berkeley Law Students help a clinic visitor with legal advice at their Tuesday night services. The Clinic offers a variety of resources, including medical, to those in the community who have little access to these services. Photo by Magaly Muñoz

Part One

By Magaly Muñoz

Every Tuesday evening, the dining hall of First Presbyterian Church fills up with dozens of people eating, laughing and moving from table to table, receiving much-needed services from UC Berkeley students – just a few blocks away from the university’s campus.

Individuals seeking support services can be found in this multi-stationed room on the south end of the church talking to law students, student case managers, or receiving medical attention in a corner by healthcare professionals.

This weekly event is hosted by Cal students through a volunteer-run program called The Suitcase Clinic.

The clinic, founded in 1989, was intended to offer free resources to underserved communities in Berkeley and surrounding cities. The majority of the clinic’s clientele are unhoused or low-income people looking for extra support.

Those visiting the clinic can get legal advice, sign up for food assistance, receive housing resources, get medical help, or enjoy a hot, fresh meal. They can also get haircuts and foot washes from the student volunteers.

Nilo Golchini, executive director of the clinic, said one of the goals for most of the students working there is helping bridge the gap of trust that exists between many unhoused people and the healthcare and social welfare systems.

During their tenure in the program, many of the students say they become strong advocates for homelessness rights.

Visitors of the Suitcase Clinic can receive haircuts and foot washing by student volunteers every Tuesday evening. Photo by Magaly Muñoz.

“We’re also standing in solidarity with them. So, it’s not saying, ‘I’m going to help you, but I’m also going to stand with you,’” Golchini said.

Student volunteers get extensive training prior to working directly with clients. Those interested have to take a semester-long class to become versed in areas such as outreach, intersectionality, how to interact with unhoused people, how to sign people up for social services. and more.

Volunteers then get to pick from three different clinics: General, Women’s, or Youth and LGBTQ+.

The General Clinic is the most popular among visiting residents, while Women’s and Youth/LQBTQ+ have more specialized services for attendees.

The Women’s Clinic has many of the similar services to General, but also includes nail painting, childcare, and massages.

The Youth and LGBTQ+ Clinic offers a safe space for young people navigating living on the streets, with services that include housing referrals, wellness and recreation classes and employment resources.

Golchini explained that it’s important for them to keep these clinics separate because the different demographics experience poverty and homelessness differently than those who visit the General Clinic.

Suitcase Clinic student workers posing for a photo with a frequent clinic attendee. The Clinic is open to Berkeley unhoused and low-income residents who need medical or legal service, or a hot meal. Photo by Magaly Muñoz.

“We’re able to provide spaces where people can come in and feel safe and not feel like they’re constantly worried that something’s going to happen to them,” she said.

An outreach team also visits encampments every other Saturday in the Berkeley area to provide hygiene kits and encourage people to visit the in-person clinic, if possible.

However, Golchini said engagement has been low for some time now due to a recent decision by the U.S. Supreme Court that allows cities to ban and cite people for sleeping on the streets.

She said a lot of their clientele got displaced to other cities over time, making it difficult to stay in contact with the services the Clinic was providing for them.

But that hasn’t slowed down the students at the Clinic, if anything, it has pushed them to do more for the community they serve.

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Activism

Delta Sigma Theta Alumnae Chapters Host World AIDS Day Event

With members from Berkeley Bay Area, Oakland East Bay (OEB) and Hayward Tri-City chapters present, the event opened with Oakland City Councilmember Treva Reid sharing data and legislation that has passed to address the safety, health, and well-being of Black women in the state of California. Attendees were able to learn directly from expert guest speakers, including Shimere Harrington from ViiV Healthcare, Barbara Green-Ajufo, an epidemiologist from UCSF Center for AIDS Prevention Studies (CAPS), and Dot Theodore, director of the HIV Care Program Division of Center for Disease Control and Prevention (CDC) for Alameda County.

Published

1 week ago

December 10, 2024

Oakland Post

Petrina A. Perteet, Takija Gardner and Oakland City Councilmember Treva Reid at the World AIDS Day event on Dec. 1. Photo by Kevin Hicks.

By Don-Neva E. Johnson and Petrina Alexander Perteet
Special to The Post

The International Awareness and Involvement (IA&I) committees of East Bay chapters of Delta Sigma Theta Inc. proudly hosted a successful World AIDS Day event on Dec.1, bringing together community members, healthcare professionals, and advocates to raise awareness and support the fight against HIV/AIDS.

Attendees were able to learn directly from expert guest speakers, including Shimere Harrington from ViiV Healthcare, Barbara Green-Ajufo, an epidemiologist from UCSF Center for AIDS Prevention Studies (CAPS), and Dot Theodore, director of the HIV Care Program Division of Center for Disease Control and Prevention (CDC) for Alameda County.

The speakers provided valuable insights into the current state of HIV/AIDS, advancements in treatment, and the importance of prevention and support.

L-R Petrina A. Perteet, Dr. Natalie Wilson, Don-Neva Johnson, Tracy Diop, Sonji Walker and Takija Gardner were part of the World AIDS Day event. Photo by Kevin Hicks.

“The outcome of this day is more than what we could have hoped for, and we are deeply grateful for the participation of our distinguished speakers and the support of our sponsors,” said Don-Neva Johnson and Tracy Diop, IA&I committee chairs for Berkeley Bay Area and Hayward Tri-City.

“Their contributions helped us create an informative and empowering event for our community,” said event organizer Dr. Natalie Wilson, associate professor of UCSF School of Nursing and IA&I committee chair.

Held at the Samuel Merritt Health Education Center at 400 Hawthorne Ave. in Oakland, the event was made possible by the generous support of sponsors ViiV healthcare, Gilead Sciences, and Good Health WINs. Attendees received gift bags and had the opportunity to engage with educational tables from Gilead, participate in a Q&A session with speakers led by Wilson.

Delta Sigma Theta Incorporated is an organization of college-educated women committed to the development of its members and offer public service with a primary focus on the Black community. We are dedicated to empowering our communities through education, advocacy, and support around the world.

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Activism

Outgoing D.A. Pamela Price Releases Report on County Gun Violence Epidemic

The 84-page report is divided into two parts: the Public Health Impact of Violence and the Contribution of Structural Inequalities; and the Public Safety Impact of Gun Violence and the Regulation of Firearms. Each section documents trends in rising gun violence in the wake of the COVID-19 pandemic, with special attention to the rise in gun-related deaths of women and children in Alameda County. Each section advises innovative approaches for the County to address gun violence and build safe communities.

Published

1 week ago

December 8, 2024

Oakland Post

Exclusive interview with County D.A. Price days before recall election. Photo by Ken Epstein.

Pamela Price was recalled in the election on Nov. 5. File photo.

By Post Staff

Criminal Justice Reformer District Attorney Pamela Price, who is leaving office this week after losing a recall election, released a comprehensive report on the gun violence epidemic and public health emergency in Alameda County: “Tackling Gun Violence Epidemic in Alameda County: A Public Health Emergency (2019-2023).”

This report represents an unprecedented collaboration between public safety and public health partners and provides data and recommendations to guide the County’s continued work to reduce violence while advancing justice reform.

Each section documents trends in rising gun violence in the wake of the COVID-19 pandemic, with special attention to the rise in gun-related deaths of women and children in Alameda County. Each section advises innovative approaches for the County to address gun violence and build safe communities.

“Between 2019 to 2023, an average of three residents were killed by firearms each week in Alameda County, and behind every statistic is a shattered family and community,” said Price.

“Under my administration, the DA’s office has taken bold steps to combat gun violence while promoting equity and healing for survivors,” she said.

The report highlights strategies for keeping guns out of the hands of dangerous people. Last month, the DA’s office secured a $5.5 million grant from the California Judicial Council to help improve compliance and case management for gun cases and gun relinquishment orders —the removal of guns from people prohibited from possessing a firearm – with law enforcement and court partners.

This effort builds on Price’s work in 2023 and 2024 in attacking the gun violence epidemic.

“We launched an innovative Gun Violence Restraining Order Outreach Project to educate communities about the availability of tools to remove guns and ammunition from people who are a danger to themselves and others and the intersectionality of domestic violence and gun violence and convened gun violence roundtable conversations with our law enforcement partners and collaborated with the Alameda County Public Health Department to produce this comprehensive report,” she said.

“We supported Oakland’s CEASEFIRE program through its transition and implemented a pilot Mentor Gun Diversion Program with our collaborative court partners, offering non-violent youth in possession of a gun pathways to interrupt the potential for escalating harm.” added Price.