People age 65 and older are at higher risk for COVID-19, the disease caused by the new coronavirus. As are people with chronic medical conditions such as heart disease, diabetes, kidney disease and respiratory illness. Both groups are heavily represented among the nation’s 1.3 million nursing home residents. That concentration is a key reason why 1 in 5 U.S. deaths from COVID-19 have occurred in nursing homes and other long-term care facilities, but it’s not the only one. Certain conditions at nursing homes can exacerbate the spread of the disease:

• shortages of coronavirus tests
• shortages of or lack of access to personal protective equipment (PPE) such as masks and gowns
• allowing staff who work/treat infected patients to also come in contact/work/treat patients who do not have corona, thereby exposing non-infected patients to the potential risk of contracting corona
• employees who work in multiple facilities, increasing chances for exposure
• residents who are infected with coronavirus sharing rooms with others who are not infected
• transfers of residents from hospitals and other settings
• exposed residents to those with corona should have been isolated until tested and testing determined positive or negative

These factors make nursing homes potential breeding grounds for viral and bacterial diseases, especially given chronic problems with infection control that predate the pandemic. According to a recent federal report, 4 in 5 nursing homes surveyed between 2013 and 2017 were cited for deficiencies in infection prevention and control. Half were cited more than once during that time.