Steps to Improve COVID-19 and Infectious Disease Response at Long-Term Care Facilities, March 25

SALEM, Ore. – The Secretary of State Audits Division released an advisory report today identifying several steps the Oregon Department of Human Services, Oregon Health Authority, and the Oregon Legislature could take to improve infection control in long-term care facilities — which includes nursing facilities, assisted living and residential care facilities, and memory care units. The improvements identified in the report could help the COVID-19 response, as well as responses to other illness outbreaks common to these facilities, like flu and norovirus.  Among the improvements recommended and challenges identified in the report: Additional monitoring could strengthen facilities’ compliance with infection control protocols. The state could do more to monitor and publicly report vaccinations within these facilities, including among staff. With the COVID-19 response being a priority, complaint investigations, recertification and licensing inspections have slowed or even halted. Oregon has minimal state regulations on staffing, infection control, emergency preparedness, and staff and resident vaccination reporting for assisted living and residential care facilities. “COVID-19 has stressed every system in our nation and laid bare challenges and inequities that existed long before the pandemic,” said Secretary of State Shemia Fagan. “This is a moment for all of us to take stock and ensure we are improving the vital systems and services that Oregonians count on to provide care and support. The goal of this advisory report is to offer concrete steps to improve the safety of these facilities, for the residents and the workers providing their care.” For this advisory report, the Oregon Audits Division reviewed infection control in long-term care facilities to identify gaps in Oregon’s laws, rules, and practices that, if addressed, could help the state further contain the COVID-19 virus and prevent future communicable disease outbreaks. Audit staff focused on oversight of 685 long-term care facilities including nursing facilities, which are regulated by the federal and state government, and community-based care facilities, which are regulated only by the state. Community-based care — assisted living and residential care — includes almost all the state’s memory care units. Today’s report is a research-based project, not an audit under government auditing standards. This reporting method allowed for a timelier project to recognize the impact on state agencies’ bandwidth as they respond to COVID-19. The report has undergone the same quality assurance process as audit reports from the Audits Division.