Why GAO did this study. Implementing proper infection prevention and control practices can be critical for preventing the spread of infectious diseases. Infection prevention and control has been a long-standing concern in the nation’s more than 15,000 nursing homes—one that the COVID-19 pandemic has brought into sharper focus. Some infection prevention and control practices in nursing homes, such as social isolation, may negatively affect resident mental and physical health. The CARES Act directs GAO to monitor the federal pandemic response. GAO was also asked to review federal oversight of nursing homes in light of the pandemic. Among other objectives, this report: (1) describes what data reveal about any changes in resident health before and during the pandemic and (2) examines infection prevention and control actions CMS and CDC have taken in nursing homes before and during the pandemic. GAO (1) reviewed CMS and CDC documents, (2) analyzed CMS resident health data from 2018 through 2021, and (3) interviewed CMS, CDC, state survey agency, and nursing home officials in a non-generalizable sample of eight states selected for variation in factors such as geographic location. What GAO recommends. GAO is making three recommendations to CMS related to the role of the infection preventionist and clarifying infection prevention and control guidance. HHS agreed with our first recommendation, but neither agreed nor disagreed with our other two recommendations.
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