Nine U.S. eldercare facility operators have been cited since March 1 for coronavirus mitigation failures that put residents’ health and safety in “immediate jeopardy,”  according to a ProPublica investigation published Friday. But government inaction is the root cause of these problems, according to industry experts and advocates.

Inspection records obtained from the Centers for Medicare and Medicaid Services show actions and inactions that likely contributed to infection transmission, the news outlet reported. Among other problems, cited facilities lacked personal protective equipment, failed to maintain social distancing among residents, had inadequate staff and did not act quickly when residents showed symptoms.

While infection control lapses are a long-standing industry problem, the devastation wrought on nursing homes by the coronavirus pandemic has been exacerbated by federal neglect, according to healthcare policy expert David Grabowski, Ph.D. 

“I think the primary story is that the federal government has largely failed our nursing home residents and their staff, the Harvard professor told ProPublica. “The government’s inaction has led to far more care issues than the COVID-related violations CMS has identified to date.”

Meanwhile, eldercare association Leading Age said CMS should be doing more to assist the industry.

“CMS guidance has been limited and vague in response to the detailed questions we receive from members on a daily basis,” a spokeswoman told the news outlet. “Oftentimes, CMS has referred to CDC guidance, which offers recommendations — not requirements.”

The American Health Care Association and state health advocates are also continuing to push officials for better access to testing and PPE.