Updated March 15, 2020 - 1:37 pm
More than 80 percent of Nevada’s nursing homes have failed to meet federal standards for infection prevention and control in the past three years, Medicare data shows.
Records show 90-plus citations ranging from employees failing to wash their hands and don proper protective equipment to entire facilities operating with out-of-date or incomplete infection prevention and control programs, all recorded during health inspections.
Additionally, approximately one-third of Nevada’s nursing homes were rated “below average” or “much below average” by Medicare.
While the data indicate nearly all the problems have been corrected, the cited shortcomings underline potential weaknesses in keeping the novel coronavirus from spreading in facilities housing some of Nevada’s most vulnerable residents. The data show the state’s Medicaid- and Medicare-certified nursing homes have a total of more than 7,000 certified beds for patients.
Gov. Steve Sisolak on Thursday announced new safety protocols for the facilities, including visitation limits and health screenings prior to entry. In Nevada, 21 cases of COVID-19 had been identified as of Saturday afternoon; none have resulted in death.
COVID-19, a respiratory illness caused by the novel coronavirus, had killed 25 people at one Seattle-area nursing home and infected 47 of the facility’s employees as of Friday night. At least 10 long-term care facilities in the Seattle area have reported positive cases.
“It is not lost on me that some of these restrictions are not ideal for residents and family members, but they are critical to ensure older and medically vulnerable Nevadans remain safe,” Sisolak said.
Local facility takes precautions
At least one local facility has elected to adopt even more stringent precautions. Mountain View Care Center in Boulder City on Thursday stopped allowing visitors at its facility and is screening employees for COVID-19 symptoms before they are allowed in the building each day.
“It’s heightened alert right now,” Mountain View administrator Laurie Hansen said.
The Centers for Medicare & Medicaid Services, which oversees the nation’s nursing homes, this month directed inspectors to focus “exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse.”
Medicare data shows 55 of Nevada’s 66 federally certified nursing homes were cited once or more for deficiencies related to infection prevention and control between 2017 and 2019. More than half of the facilities were located in the Las Vegas Valley.
“Infectious diseases are a serious risk in nursing homes,” said Brian Labus, an assistant professor of epidemiology at UNLV. “They can spread quickly and potentially kill a lot of people because it’s a particularly vulnerable population.”
Inspections yield citations
In March 2018, an inspection found the Delmar Gardens of Green Valley nursing home in Henderson was nottracking cases of communicable diseases and infections within its facility. The same facility, which Medicare has rated “much below average,” was also cited in 2017 after a nurse prepared a resident’s medication without wearing gloves.
In nearby Boulder City, Mountain View was cited last November for failing to disinfect shower chairs and shower beds after residents used them. An inspector noted feces and urine stains on the equipment. Regulators have rated the facility “below average.”
Hansen said her staff now deep cleans shower chairs twice a day and certified nursing assistants keep a log to ensure the equipment is clean whenever they finish using it. She said Mountain View has been inspected three more times since November and has received no additional citations related to infection control.
In Reno last October, inspectors found a patient with a drug-resistant infection was allowed to eat in the dining room of Sierra Ridge Health and Wellness Suites, despite infection control policy dictating he should have been isolated in his room. Medicare has placed the facility in a program for nursing homes with a history of serious quality issues.
TLC Care Center in Henderson was cited four times, including for multiple occasions of a nurse failing to wash their hands while changing a patient’s dressings and multiple occasions of a nurse not wearing protective gear inside the room of an isolated patient. Despite having the most infection control-related citations among Nevada nursing homes, the facility was rated “average” by Medicare.
The data indicate all the problems at the facilities were fixed. Delmar Gardens of Green Valley and Sierra Ridge Health and Wellness Suites did not return a request for comment Thursday. TLC Care Center administrator Dan Hills declined to comment on Friday morning.
‘Not business as usual’
Labus said it is critical that nursing homes correct any shortcomings in infection prevention and control, before a disease like COVID-19 has a chance to proliferate. People over 60 and those living with severe chronic illness are more likely to become severely ill, according to the CDC.
“At this point it’s not business as usual. You have to go above and beyond with your infection control protections,” he said. “So if a facility is not meeting its day-to-day routine obligations for infection prevention, we’re obviously concerned they won’t meet these enhanced things we’re doing for coronavirus.”
COVID-19 has led multiple states, including Nevada, to adopt new precautions at nursing homes during the coronavirus outbreak. The Department of Veterans Affairs this week announced a no-visitors rule at more than 130 of its nursing homes nationwide.
While declaring a state of emergency Thursday, Gov. Sisolak announced that long-term nursing homes and similar facilities must limit visitors to two “essential individuals” per resident at a time. Prior to entry, visitors will be screened for symptoms of COVID-19 and to identify if they have traveled to any high-risk areas recently. Nursing homes must also limit their community outings, Sisolak said.
According to data from the Center for Disease Control and Prevention, roughly 5 million Americans are admitted to or reside in long-term care facilities such as nursing homes, skilled nursing facilities and assisted living facilities. There are between 1 million and 3 million serious infections in these facilities every year, resulting in as many as 380,000 annual deaths.
Nevada nursing homes face problems for infection prevention, control
From 2017 through 2019, Nevada’s nursing homes were cited more than 90 times for deficiencies in infection prevention and control.
|Name/Location||Infection-Control Citations||Medicare Facility Rating|
|TLC Care Center, Henderson||4||Average|
|Canyon Vista Post-Acute, Las Vegas||3||Above Average|
|Mission Pines Nursing & Rehabilitation Center, North Las Vegas||3||Much Below Average|
|Mountain View Care Center, Boulder City||3||Below Average|
|Mountain View Health & Rehab, Carson City||3||Much Below Average|
|Rosewood Rehabilitation Center, Reno||3||Much Above Average|
|Spanish Hills Wellness Suites, Las Vegas||3||Much Below Average|
|Torrey Pines Post Acute And Rehabilitation, Las Vegas||3||Below Average|
|Advanced Health Care Of Las Vegas||2||Much Above Average|
|College Park Rehabilitation Center, North Las Vegas||2||Average|
|Delmar Gardens Of Green Valley, Henderson||2||Much Below Average|
|El Jen Convalescent Hospital And Retirement Center, Las Vegas||2||Average|
|Harmony Manor Skilled Nursing Facility, Winnemucca||2||Much Below Average|
|Highland Manor Of Mesquite||2||Above Average|
|Horizon Health And Rehabilitation Center, Las Vegas||2||Much Above Average|
|Horizon Ridge Skilled Nursing & Rehabilitation Center, Henderson||2||Much Above Average|
|Kindred Hospital (Flamingo Campus), Las Vegas||2||Below Average|
|Lakeside Health & Wellness Suites, Reno||2||Much Below Average|
|Las Ventanas Retirement Community, Las Vegas||2||Above Average|
|Life Care Center Of Las Vegas||2||Below Average|
|Life Care Center Of South Las Vegas||2||Much Below Average|
|Marquis Care At Centennial Hills, Las Vegas||2||Above Average|
|Marquis Plaza Regency Post Acute Rehab, Las Vegas||2||Above Average|
|Neurorestorative 4 Kids, Las Vegas||2||Much Above Average|
|North Las Vegas Care Center,||2||Much Below Average|
|Ormsby Post Acute Rehab, Carson City||2||Much Below Average|
|Pahrump Health And Rehabilitation Center||2||Below Average|
|The Heights Of Summerlin, Llc, Las Vegas||2||Below Average|
|White Pine Care Center, Ely||2||Much Below Average|
|Wingfield Hills Health & Wellness, Sparks||2||Above Average|
|Advanced Health Care Of Henderson||1||Much Above Average|
|Alta Skilled Nursing And Rehabilitation Center, Reno||1||Much Above Average|
|Battle Mountain General Hospital||1||Average|
|Boulder City Hospital||1||Below Average|
|Caremeridian-Buffalo, Las Vegas||1||Much Above Average|
|Carson Nursing And Rehabilitation Center, Carson City||1||Above Average|
|Gardnerville Health & Rehab Center||1||Much Below Average|
|Gaye Haven Intermediate Care Facility, Las Vegas||1||Much Above Average|
|Harmon Hospital, Las Vegas||1||Below Average|
|Hearthstone Of Northern Nevada, Sparks||1||Average|
|Highland Manor Of Elko||1||Average|
|Lake Mead Health And Rehabilitation Center, Henderson||1||Much Below Average|
|Las Vegas Post Acute & Rehabilitation||1||Much Below Average|
|Lefa Seran, Hawthorne||1||Average|
|Life Care Center Of Reno||1||Above Average|
|Neurorestorative Nevada, Reno||1||Too New to Rate|
|Nevada State Veterans Home, Boulder City||1||Much Above Average|
|Premier Health & Rehabilitation Center Of Las Vegas||1||Below Average|
|Royal Springs Healthcare And Rehab, Las Vegas||1||Much Below Average|
|Sage Creek Post-Acute, Las Vegas||1||Much Above Average|
|Saint Joseph Transitional Rehabilitation Center, Las Vegas||1||Above Average|
|Sierra Ridge Health And Wellness Suites, Reno||1||Special Focus Facility Program|
|Silver Hills Health Care Center, Las Vegas||1||Much Above Average|
|Silver Ridge Healthcare Center, Las Vegas||1||Average|
|Welbrook Centennial Hills, Las Vegas||1||Much Above Average|
|Advanced Health Care Of Reno||0||Much Above Average|
|Advanced Health Care Of Summerlin, Las Vegas||0||Much Above Average|
|Carson Tahoe Transitional Rehabilitation Center, Carson City||0||Too New to Rate|
|Desert Hills Post-Acute & Rehabilitation Center, Las Vegas||0||Much Below Average|
|Grover C Dils Medical Center, Caliente||0||Much Above Average|
|Highland Manor Of Fallon||0||Above Average|
|Kindred Transitional Care & Rehabilitation (Spring Valley), Las Vegas||0||Average|
|Northern Nevada State Veterans Home, Sparks||0||Too New to Rate|
|Pershing General Hospital, Lovelock||0||Average|
|South Lyon Medical Center, Yerington||0||Above Average|
|Trellis Centennial, Las Vegas||0||Too New to Rate|
Source: Medicare.gov, Nursing Home Compare
Contact Michael Scott Davidson at email@example.com or 702-477-3861. Davidson is a member of the Review-Journal’s investigative team, focusing on reporting that holds leaders and agencies accountable and exposes wrongdoing. Follow @davidsonlvrj on Twitter. The Associated Press contributed to this report.