Report identifies 95% of VA nursing homes had at least one infection control deficiency in years before COVID-19 pandemic, with 81% having deficiencies in multiple years
Washington (February 8, 2021) – Following a request by Senators Edward J. Markey (D-Mass.) and Elizabeth Warren (D-Mass.) and Committee on Veterans’ Affairs Chair Jon Tester (D-Mont.), the Government Accountability Office (GAO) has now released a report revealing pervasive infection control deficiencies at U.S. Department of Veterans Affairs (VA) nursing homes in the years leading up to the coronavirus pandemic. The report, which analyzed available data on VA-operated community living centers (CLCs) from Fiscal Years 2015 through 2019, showed that 95 percent of CLCs had at least one infection control deficiency during the five-year review period. Approximately 62 percent of the inspected CLCs had infection prevention and control deficiencies in consecutive fiscal years and an additional 19 percent of CLCs had multiple nonconsecutive infection prevention deficiencies, suggesting that these issues were ongoing.

“The COVID-19 pandemic has shown us all the lifesaving importance of infection prevention and control. This report documents that, during the crucial years leading up to the coronavirus pandemic, the VA did not do enough to ensure that VA-operated nursing homes were taking the necessary precautions to protect our veterans, facilities, and staff,” said Senator Markey. “We will continue to work to ensure that the VA is taking every step possible to prevent infections in our nursing homes and community living centers.”

“Nursing homes and long-term care facilities emerged as one of the most vulnerable settings for outbreaks throughout the COVID-19 crisis,” said Chairman Tester. “This report shows the previous Administration’s failure to implement necessary precautions and follow-up on known infection control deficiencies that placed veterans and their providers at greater risk of exposure to the coronavirus. Moving forward, I remain committed to working with the Biden Administration on ensuring that veterans and nursing staff across the Department’s long-term care facilities have access to the resources and protection they need in the face of this pandemic.”
“Veterans and their families should be able to count on the VA to monitor the quality of care in community living centers at all times but especially during this deadly pandemic when residents are most vulnerable," said Senator Warren. "This report shows that infection prevention and control deficiencies were prevalent for years in VA-owned and -operated facilities. We ask that the VA take swift action to implement necessary precautions to meet quality standards and keep our veterans safe in community living centers during the COVID-19 pandemic and beyond.”
A copy of the GAO report can be found HERE.
The lawmakers originally requested the GAO initiate a review of the quality rating system for community living centers (CLCs) operated by the VA in September 2019, following years of poor quality ratings at these facilities compared to private CLCs and reports documenting subpar care and limited VA oversight. Following the emergence of the COVID-19 pandemic, the Senators requested GAO also focus its attention on infection control practices at CLCs, and have requested a report on practices at State Veterans Homes as well.