The rise and spread of drug-resistant germs, including infections and funguses, has been tied to nursing facilities and long-term care facilities. Due to lack of staff training on infection procedures, understaffing, and not being equipped to deal with serious infections, patients wind up being cycled through the hospital and back again. As a result, these dangerous germs spread not just within the facility, but also to hospitals—with devastating results.

One drug-resistant fungus in particular has proven to be difficult to control: Candida auris (C. auris). This fungus is so difficult to get rid of that some facilities won’t accept patients with it, but the many facilities that do take on patients with this type of fungus aren’t capable of properly caring for them. Instead, residents find themselves in a facility where the fungus is transmitted from patient to patient.

Nursing home residents are particularly vulnerable to infections due to weakened immune systems, advanced age, immobility, medications, and close contact with other patients. Without effective infection prevention programs in place, residents are prone to contracting these drug-resistant germs.

Nursing homes have a responsibility to provide a particular level of care for residents and providers must be prepared to meet that standard. Under Federal Rule § 483.80 facilities must “maintain an infection prevention and control program.” According to studies, many facilities are failing their residents on this end.

The American Journal of Infection Control published a study showing over a quarter of nursing-home patients are colonized with drug-resistant infections. While they may not present symptoms, these patients can still transmit the infection to others. For those with weaker immune systems, the results can be life-threatening.

An inquiry by the New York State Department of Health showed which factors are contributing to this issue, exposing that long-term hospitals who were struggling to contain C. auris weren’t taking basic measures to prevent its spread. Common precautions, such as disposable gowns and latex gloves, weren’t in place, and in some facilities, there were no hand sanitizers. All of these missing methods of prevention are recommendations from the New York State Department of Health to help prevent the spread of C. auris.

Additional studies worldwide, including in Italy and Britain, support claims that negligence and lack of prevention programs, and proper enforcement of them, are significant contributors to the spread of deadly drug-resistant germs.