Oregon auditors: Some virus deaths in senior care preventable

(Update: More details of audit findings)

More monitoring needed; notes 'minimal state regulations'

SALEM, Ore. (AP) — State auditors say Oregon health officials’ failure to adequately prepare for COVID-19 likely contributed to some senior care home coronavirus deaths early in the pandemic.

The two state agencies responsible for responding to the pandemic wasted “valuable time” in the first few months after Oregon’s first case as they tried to figure out how to work together, the Secretary of State Oregon Audits Division found in a report released Wednesday.

The Department of Human Services and the Oregon Health Authority did not plan “basic elements for responding together,” the auditor’s office wrote. “These elements were developed after the response began, delaying actions that may have prevented illness and death among long-term care residents and staff.”

The Oregonian/OregonLive reports more than 90 people eventually died in outbreaks that began while state agencies were building a new administrative system.

About half of all COVID-19 deaths in Oregon were long-term care residents, auditors said, compared to just over a third nationally. As of March 14, 1,210 people in congregate care had died.

Auditors listed a number of suggestions. Going forward, the state should track how many workers get vaccinated and find a way to potentially make that data public, citing troubling trends showing that health care workers have been declining to get shots.

The state should also do better to involve Oregon’s top advocate for seniors, the long-term care ombudsman. And, auditors wrote, health officials could visit facilities more often to ensure they are complying with infection control rules.

In their response to the findings, the directors of the health authority and human services listed steps they’ve taken to curb the pandemic’s toll on long-term care. That included opening seven COVID-19 recovery units, enacting a statewide mandate that senior care staff get tested at least monthly, and pre-emptive inspections to check that facilities were following infection-control practices.

---

Secretary of State's Office news release:

New Secretary of State Report Outlines Steps to Improve COVID-19 and Infectious Disease Response at Long-Term Care Facilities

SALEM, Ore. -- The Secretary of State Audits Division released an advisory report Wednesday 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.

Long-term care facilities include nursing facilities, assisted living and residential care facilities, and memory care units.

The report says the improvements identified could help in the COVID-19 response, as well as responses to other illness outbreaks common to thee 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 of the state’s memory care units.

Wednesday’s report is a research-based project, not an audit under government auditing standards, the agency noted. 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.

To read the full advisory report, click here.