From the U.S. Government Accountability Office, www.gao.gov Transcript for: Citations for Infection Control Deficiencies Were Common at VA Community Living Centers Prior to COVID-19 Description: The Department of Veteran Affairs owns and operates 134 nursing home style facilities called community living centers where disabled and aging veterans can receive short and long term care services. However, several news stories have prompted questions about how the VA is monitoring and controlling the spread of infectious diseases at these facilities. This concern has been further highlighted by the coronavirus pandemic. We talk with GAO's Sharon Silas to find out more. Related GAO Work: GAO-21-195R, VA Heath Care: Community Living Centers Were Commonly Cited for Infection Control Deficiencies Prior to the COVID-19 Pandemic Released: February 2021 [Intro music:] [Sharon Silas:] Nearly all the community living centers had issues with infection prevention and control in the 5 years leading up to the COVID-19 pandemic. [Holly Hobbs:] Hi, and welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Holly Hobbs. The Department of Veteran Affairs owns and operates 134 nursing home-style facilities called community living centers, where disabled and aging veterans can receive short and long term care services. However, several news stories have prompted questions about how the VA is monitoring and controlling the spread of infectious diseases at these facilities. This concern has been further highlighted by the coronavirus pandemic. Today, we talk with Sharon Silas--an expert on veterans' healthcare issues and a director on our Health Care Team--about a new report that examines deficiencies in effective controls at VA Community living centers prior to COVID-19. Thank you for joining us, Sharon. [Sharon Silas:] Thanks for having me. [Holly Hobbs:] So, Sharon, how was the VA protecting veterans at community living centers from getting infectious diseases like COVID-19? [Sharon Silas:] Well, VA is responsible for overseeing the quality of nursing homes that are provided for veterans residing in community living centers. And they primarily do this through regular inspections, which determine whether or not community living centers are meeting quality standards. So, one of those quality standards they review is the community living centers' infection and control programs and practices, ensuring that those are in place and that staff are properly following the practices. [Holly Hobbs:] What kinds of practices are staff supposed to follow? [Sharon Silas:] So, for a community living center that is not meeting the standard, it would mean that staff were not taking proper precautions when providing care to residents who have been identified as a risk for transmitting an infection. So, this could be things like staff failing to wear gloves or gowns correctly, or failing to wash their hands after interacting with a resident with an infection that could be transmitted to other residents. And, these are the types of programs and practices that are being used to help prevent and control the spread of COVID-19 in nursing homes. [Holly Hobbs:] And, for this report, what specifically did we look at? [Sharon Silas:] So, we were asked to look at the data on the quality of care at community living centers and to also look at how VA is using this data to oversee care. Part of the ongoing work, we review data on the types and numbers of quality issues or deficiencies identified in these inspections. And as we were getting this work, we recognized that some of the deficiency information we were collecting was really relevant to the spread of COVID-19. [Holly Hobbs:] So, what did we find? [Sharon Silas:] What we specifically found in our review was that 95% of the community living centers inspected between 2015 and 2019 were cited for infection control deficiencies. We also found that there were a total of 365 deficiencies for that time period, and inspectors classified all 365 deficiencies as not severe--meaning that inspectors determined that there was no actual harm that occurred from the situation that they had observed. And then, we also learned that the community living centers tended to have these issues more than once in our 5 year review period. So, for example, 62% of the community living centers had these deficiencies cited in consecutive years. [Holly Hobbs:] How do VA community centers like these compare to what's going on in private nursing home centers? [Sharon Silas:] VA community living centers aren't unique in the situation. GAO also looked at these types of deficiencies in community nursing homes prior to the pandemic earlier this year. And we found that these types of deficiencies were also common in community nursing homes prior to the pandemic. [Music] [Holly Hobbs:] So, we know that the coronavirus is especially threatening to vulnerable populations like those with disabilities and the elderly. And this is the population of veterans being served at VA community living centers. But it sounds like we found widespread deficiencies in controlling for infectious diseases at these facilities. Sharon, in our review, which I know predates COVID, did we see any steps that the VA was taking to address these deficiencies? [Sharon Silas:] VA requires the community living centers to develop a corrective action plan to address any deficiencies that were identified in the inspections. And, those corrective actions can include things like educating staff on how to prevent the spread of infection, performing weekly monitoring to make sure the policies are being followed, and then also it could be things such as identifying an infection control champion or leader for each unit of the community living center. [Holly Hobbs:] And, last question, what's the bottom line of this report? [Sharon Silas:] Clearly, the data says that nearly all the community living centers had issues with infection prevention and control in the 5 years leading up to the COVID-19 pandemic. That means that ensuring community living centers have programs and practices in place to prevent the spread of infectious diseases is really critical to protecting our most vulnerable veterans. [Holly Hobbs:] That was Sharon Silas, talking about GAO's recent review of infection control deficiencies within VA Community living centers. Thank you for your time, Sharon. [Sharon Silas:] Thank you. [Holly Hobbs:] And, thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts and make sure you leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at GAO.gov.