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Stein L, Fraser J, Penzenstadler N et al. USA Today. March 10, 2022.

Nursing home residents, staff, and care processes were particularly vulnerable to COVID-19. This collection of resources examines data and documentation involving one nursing home chain to reveal systemic problems that contributed to failure. It shares family stories that illustrate how COVID affected care in long-term care environments.

Community Living Centers: VA Needs to Strengthen Its Approach for Addressing Resident Complaints.

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Washington, DC: United States Government Accountability Office; November 30, 2021. Publication GAO-22-105142.

Patient complaints have the potential to be used for care improvement as they surface problems in health facilities. This report examined complaint response processes in Veterans Affairs nursing homes and found them lacking. Five recommendations submitted to drive improvement underscore the value of adherence to policy and the transfer of complaint experiences to leadership.

How nursing homes’ worst offenses are hidden from the public.

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Gebeloff R, Thomas K, Silver-Greenberg J. New York Times. December 9, 2021.

Nursing homes harbor numerous challenges to patient safety and they should be transparently reported and acted upon to ensure improvement. This news investigation discusses a gap in the reporting and inspection of nursing home incidents that undermines the ability of the US nursing home rating system to inform consumer long term care facility choice.

Phony diagnoses hide high rates of drugging at nursing homes.

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Thomas K, Gebeloff R, Silver-Greenberg J. New York Times. September 11, 2021.

Nursing home medication misuse is a contributor to resident harm. This story highlights system influences such as staffing shortages, reporting failures and normalization of prescribing behaviors that coincide with the misuse of antipsychotic medications and overdiagnosis of schizophrenia.

Cancer diagnoses delayed among prisoners in Washington state.

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Medscape Medical News. May 12, 2021.

Delays and mistakes in health care for distinct patient populations hold improvement lessons for the broader system. This news story highlights problems in correctional system cancer diagnoses and treatment that may indicate other types of prison care delivery problems.

In U.S. nursing homes, where Covid-19 killed scores, even reports of maggots and rape don’t dock five-star ratings.

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Silver-Greenberg J, Gebeloff R. New York Times. March 13, 2021.

The value of rating systems can be challenged by bias and misinterpretation due to a variety of factors. This article outlines how nursing home patients fell victim to both systemic and care failings in the US nursing homes, yet their facilities still ranked high in a national rating system. The authors discuss failures including the lack of data auditing and a focus on ratings rather than quality.

How the pandemic defeated America.

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Yong E. The Atlantic. September 2020

This article takes a holistic view of the multiple preventable failures of the U.S. in managing the COVID-19 pandemic, raising several patient safety issues from the metasystems perspective. The piece highlights systemic problems such as lack of transparency, investment in public health and learning from experience.

As coronavirus ravaged nursing homes, inspectors were not being tested.

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Dolan J, Mejia B. Los Angeles Times. 2020;July 24.

Worker safety has ramifications for patient care in both routine and crisis situations. This story highlights a testing gap that has the potential to degrade efforts to minimize the spread of COVID-19 in nursing homes: the lack of coronavirus testing of inspectors visiting the facilities to assess infection prevention readiness.

The U.S. is repeating its deadliest pandemic mistake.

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Khazan O. The Atlantic. 2020;July 6.

Residential care facilities have been particularly challenged by COVID-19. This article outlines how lack of access to protective equipment, staff training, accurate statistics and effective employee testing have hindered the ability of nursing homes to protect patients and staff from the virus.

Care Compare.

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Centers for Medicare and Medicaid Services.

The Centers for Medicare & Medicaid Services (CMS) support transparency through the provision of publicly available information on the quality of health care service in the United States. This portal enables access to comparative quality and safety data from doctors & clinicians, hospital, nursing home, home health, hospice, inpatient rehabilitation facilities, long-term care hospitals, and dialysis facilities to support informed consumer health care provider selection activities.

Keeping Nursing Home Residents and Staff Safe in the Era of COVID-19.

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National Academy of Medicine. April-June 2020.

Nursing homes are care environments that are particularly challenged by the COVID-19 pandemic. This webinar series covered topics such as keeping nursing home residents and the staff that care for them safe, practice integration in skilled nursing facilities, communication and collaboration in times of crisis, testing and SARS-CoV-2 transmission prevention tactics.

Nursing home workers warned government about safety violations before COVID-19 outbreaks and deaths.

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Ellis B, Hicken M. CNN. May 14, 2020.

Long-term care and skilled nursing facilities care for a patient population particularly vulnerable to COVID-19 infection. This article discusses an analysis of a large nursing home system and gaps in its workforce safety program. Problems highlighted included communication practices that fall short of what is needed to assure staff safety as they care for nursing home residents.

People with disabilities fear pandemic will worsen medical biases.

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Shaprio J. National Public Radio. April 15, 2020.

Access to care has been strained by the COVID-19 pandemic. This radio segment discusses how implicit biases can affect care of patients with disabilities. It highlights how preconceptions about this patient population could limit their access to treatments should they become ill.

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