Finding a suitable nursing home for an older loved one is an arduous and time-consuming process. Nursing homes can be the best fit for an elderly family member’s care, but fears of elder abuse, medical mistakes, and the recent problem of MRSA infections make the choice even more difficult. Very difficult.
First, what is MRSA? MRSA is well known as a deadly problem for hospitalized people with open wounds or those recovering from surgery. This type of MRSA is known as hospital-acquired MRSA.
A new study from the University of California, Irvine shows that the vast majority of surveyed nursing homes tested positive for the drug-resistant MRSA bacteria. Researchers surveyed 22 facilities and found 20 to have strains of methicillin-resistant Staphylococcus aureus (MRSA). MRSA is the bacterial strain that no longer responds to the antibiotics used to treat staph infections. Once it gets going, it’s a beast of a task to fight it off. What we now know – and suspected all along – is that nursing home patients are particularly at risk, even more so than other patients of the same age who are not in nursing homes.
The UC Irvine study focused on the rapid growth of community-associated MRSA. This MRSA variation is a new breed of the bacteria that afflicts healthy people. Community-associated MRSA originates in the general population outside of a nursing home or hospital environment and is later introduced to the closed population. The UC Irvine researchers noted that 25% of all MRSA infections found in their study were community-associated.
Most previous studies have examined MRSA within the hospital context. This new study has confirmed that the nursing home environment is conducive to spreading MRSA as residents were less likely to have MRSA when they were admitted than later in their nursing home stay.
The UC Irvine researchers also found that community-associated MRSA was more prevalent in nursing homes with younger populations. This might seem initially surprising and is likely due to two factors. First, these younger individuals are more likely to be active outside of the nursing home in places like schools and gyms where it is easy to come in contact with MRSA. Second, once inside of the nursing home, these younger patients are more likely to be active throughout the nursing home, thus taking the MRSA to all corners of the facility. Researchers also believe that community-associated MRSA will rapidly spread in hospitals because nursing home patients are often admitted directly from their nursing home.
Essentially, nursing homes breed MRSA because they encourage residents to be social and MRSA is as easy to spread as the common cold. While MRSA can be spread to new carriers by skin-to-skin contact, being a carrier does not mean you will also have an infection. MRSA must enter the body through some sort of wound or skin opening. MRSA can lead to pneumonia, abscesses, and bloodstream infections.
Taking this new report into consideration, nursing homes will have to re-evaluate their standard procedures if they are going to successfully combat community-associated MRSA. I hope they are up to this challenge because The last thing residents and families need is one more nursing home problem to worry about.
The full report is available in the March issue of Infection Control and Hospital Epidemiology.
Verdicts and Settlements involving MRSA infections in nursing homes
- 2020, New York: $145,000 Settlement. A nursing home resident died after she suffered a MRSA infection, dehydration, bedsores, malnutrition, and acute kidney malfunction. Her estate alleged that the facility violated New York public health codes. The facility denied liability, contesting her injuries’ severity and scope. This case settled for $145,000.
- 2019, Pennsylvania: $300,000 Settlement. A nursing home resident died from sepsis complications shortly after being admitted to a nursing home. At the time, he was recovering from a below-the-knee amputation. The staff noticed his leg, finger, and heel wounds. Throughout his stay, the man developed MRSA, bedsores, infections in his wounds, and pneumonia. He was then admitted to the hospital, where the hospital staff diagnosed him with bedsores, osteomyelitis. The man experienced respiratory distress shortly after and died shortly after. His estate alleged that nursing home’s owners mismanaged and understaffed the facility caused the man’s poor treatment that allowed his condition to worsen and to result in his death.
- 2019, New Mexico: $11,000,000 Verdict. A 90-year-old nursing home resident died after she suffered bedsores on both her heels that were MRSA-infected. The facility admitted the woman, who was recovering from a fractured left hip. She had no bedsores at the time. Her family had her from discharged upon discovering bedsores on her heels that were eventually diagnosed as Stage III-IV. Her bedsores were also diagnosed as being MRSA-infected. The woman’s estate alleged the facility failed in providing a safe environment for her to recover, failed to prevent her bedsores, and failed to properly nourish her. The facility denied liability, arguing that the woman did not develop bedsores at their facility and that they occurred after she was removed. A jury ruled in favor of the estate and awarded a $5,000,000 verdict.
- 2017, Pennsylvania: $1,000,000 Settlement. A nursing home resident died after he developed bedsores, osteomyelitis, MRSA, UTIs, pneumonia, sepsis, malnutrition, dehydration, and weight loss. He was in and out of the hospital, being re-admitted to the facility each time throughout his stay. His estate alleged that the facility hired and trained incompetent staff, failed to provide proper care, failed to implement hygiene standards, failed to adequately nourish and hydrate the deceased, and failed to treat his bedsore. The facility denied liability, claiming his conditions caused his death and not their negligence. The case settled for $1,000,000.
- 2016, Pennsylvania: $625,000 Settlement. An 83-year-old nursing home resident died after he developed bedsores, MRSA, UTIs, pneumonia, dehydration, and malnutrition. One of his bedsores necessitated a flap closure procedure at a local hospital for treatment. While hospitalized, the hospital staff failed to rotate him every few hours. He also developed a UTI infection that they improperly treated. His estate sued both the nursing home facility’s owner and the hospital’s owner. They alleged that they improperly hired, trained, and supervised their staff, failed to provide adequate care, and failed to prevent bedsores. This case settled for $625,000.
- 2016, California: $970,000 Settlement. A 93-year-old nursing home resident alleged that she developed bedsores during her hospital and nursing home stays. She initially developed stage I bedsores to her sacrum and buttocks at the hospital, where she was recovering from surgery. The woman was then admitted to a nursing home, where she developed additional bedsores to both her thighs. Her sacrum and buttock bedsores eventually progressed into stage IV and were infected with MRSA. As a result, she was now bedridden and could not fully recover from her wounds. She alleged that both facilities failed to properly nourish and hydrate her. The woman claimed that the hospital staff failed to take proper measures to prevent her bedsores. She also claimed that the nursing home staff negligently left her laying in her feces and urine. The woman alleged that this aggravated her bedsores and caused them to become infected. The case settled for $970,000.