More than 1,300 U.S. nursing homes had infection rates of at least 75% or more in the first year of the COVID-19 pandemic, according to a report published Thursday by the Office of Inspector General (OIG) for the Department of Health and Human Services.

The OIG used data from 15,086 nursing homes nationwide and identified facilities with extremely high infection rates during the surges of cases in the spring and fall of 2020. For-profit nursing homes made up "a disproportionate percentage of the nursing homes with extremely high infection rates during both surges," according to the report.

Nursing homes with extremely high infection rates "experienced dramatic increases in overall mortality [not limited to deaths of beneficiaries who had or likely had COVID-19]," according to the report, and facilities "were not prepared for the sweeping health emergency that COVID-19 created," the OIG said.

In light of its findings, the OIG recommended that the Centers for Medicare & Medicaid Services should examine nursing staff requirements and revise them, if necessary; improve how surveys identify infection control risks to nursing home residents; and strengthen guidance on assessing the scope and severity of those risks.

It also recommended that the Centers for Medicare & Medicaid Services target nursing homes in most need of infection control intervention and provide enhanced oversight and technical assistance to these facilities as appropriate.

"Significant changes are needed to protect the health and safety of residents and better prepare nursing homes for current and future health emergencies," the OIG said.

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