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Hundreds of Texas nursing homes violated infection control standards during COVID-19

According to state records, 556 Texas long-term care facilities violated infection control standards at least 1,435 times between early March and mid-August.

AUSTIN, Texas — Hundreds of Texas nursing homes violated standards for controlling infectious diseases since the start of COVID-19 pandemic, according to records from the Texas Health and Human Services Commission.  

What the KVUE Defenders uncovered leaves family members like Cissy Sanders wondering if their loved ones died because nursing homes failed to follow protocol.

“I had so many sleepless nights in the month of months of April and May because I was anticipating getting a call from Riverside saying that my mom had spiked a fever in the middle of the night,” Sanders said.

Sanders’ mom is a resident at Riverside Nursing and Rehabilitation Center in South Austin. Records show 63 residents there have tested positive for COVID-19 and 12 have died. Sanders’ mom hasn’t caught the virus, but the numbers alone scare her.

“It makes me angry and it makes me not have confidence in the management of the nursing home,” Sanders said.

The KVUE Defenders have been tracking the spread of COVID-19 inside Texas nursing homes and assisted living facilities since the spring.

Credit: KVUE

As of Wednesday, statewide data shows 31,952 residents have been infected with the virus and 4,745 have died from it. That means about 27% of all Texans who died from COVID-19 were in long-term elder care facilities.

Those residents were already the most susceptible population to the virus because of preexisting medical conditions and age. But KVUE’s investigation uncovered another possible explanation.

“Infection control has been a problem in Texas nursing homes for at least the last five or six years,” American Association of Retired Persons (AARP) representative Amanda Fredriksen said.

AARP is a nonprofit group that’s been advocating for senior citizens for more than 60 years. Fredriksen said the virus should not have ravaged as many facilities as it did.

The KVUE Defenders obtained records from the Texas Health and Human Services Commission showing 565 Texas nursing homes and assisted living facilities violated infection control standards at least 1,435 times between early March and mid-August.

Thirty-eight of those elder care facilities in the 12-county KVUE viewing area account for 82 violations.

Credit: KVUE
According to data from the Texas Health and Human Services Commission, more than 500 long-term care facilities had more than 1,400 violations between March and August.

West Oaks Nursing and Rehabilitation Center tops the list in Central Texas with eight violations. In April, inspectors noted “the facility failed to establish and maintain an infection control program,” and “the facility did not keep a resident apart from the others if the resident has an infection that can spread.”

The KVUE Defenders reported in the spring how family members were concerned about the safety of their loved ones in West Oaks when confirmed cases of COVID-19 in the facility first surfaced.


“It’s a serious problem, particularly when we think about a virus like COVID that has such a high mortality rate for this this demographic,” Fredriksen said.

Riverside in Austin had three violations. Back in April, inspectors noted, “The facility failed to have an infection control program that allows it to investigate, control and prevent infections,” and, “The facility failed to have and implement written policies for infection control.”

A spokesperson for Regency Integrated Health Services, which runs both Riverside and West Oaks, provided the following statement:

“We are currently reviewing the information found in the database. In March, all of our facilities implemented enhanced infection control protocols that have consistently been updated as new guidelines from federal, state, and local health authorities change. Riverside has not had any reported cases of COVID since early June. West Oaks is currently accepting patients with COVID 19 from the community and hospitals all of whom are cared for on a dedicated unit."

Included in these important protocols are the following:

  • Staff is required to wear masks upon entry to the facility until the end of their shift as well as full personal protective equipment when appropriate for the resident’s presumed level of exposure
  • Staff and essential medical professionals are assessed and screened prior to entering the facility; if they present with any sign or symptom of illness, they are sent home until they are medically cleared to return to work
  • Separate intake units for new admissions and those with signs and symptoms of an infection that pending COVID-19 test results.
  • Installation of isolation barriers and dedicated units to separate any potential COVID-19 infections from other patients
  • We have installed high efficiency MERV 13-rated HVAC filters installed throughout the facility to block the smallest microscopic particles and airborne droplets
  • Cleaning and sanitizing are occurring regularly and daily throughout the facility
  • Our clinical team has implemented COVID-19 specific infection surveillance protocol and is monitoring our residents frequently for potential changes in condition
  • Frequent handwashing
  • Frequent use of hand sanitizer

“Do you think that there is a correlation here between so many infection control violations and how quickly the virus spread through and killed inside these same facilities?” the KVUE Defenders asked.

“Absolutely,” Fredriksen said.

Advocates like Fredriksen want lawmakers to step in.  

“When there are repeated violations and the government hasn't acted, the regulatory authority, including the state of Texas, is not doing its job,” U.S. Rep. Lloyd Doggett (D-35) said.

Doggett said he’s drafting new legislation, which would require monthly reports from the federal government on infection control violations in nursing homes. It would also call for an independent group to look at the data and make policy recommendations.

“This was a problem before the pandemic. But with the pandemic, like everything else, it just raises the danger immensely and it allows the transmission of disease from one person to the other,” Doggett said.

KVUE also asked the Texas Health and Human Services Commission for a comment. A spokesperson told us it is investigating all long-term care facilities with COVID-19. It is reviewing infection control and other health practices, making recommendations, imposing citations if necessary and requiring facilities comply with health and safety requirements.

“This is a requirement for public health and elected officials to … take whatever necessary steps … to make sure that nursing home residents and staff do not die again,” Sanders said.

Congressman Doggett said he intends to have that federal legislation filed by January.

Meanwhile, KVUE has made it easy for you to check whether your loved one’s nursing home or assisted living facility has violated infection control standards during the pandemic.

You can view the numbers we collected from the data HHSC provided to us below, showing how many violations each nursing home has received.


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