Unnecessary trauma: Fire ants in nursing homes

Nursing home patient with with fire ant stings.
(Laquna Ross)

This week Vietnam veteran Joel Marrable died at a Georgia VA Hospital following a vicious attack by fire ants.

According to his daughter, Mr. Marrable was found by staff last week covered with ants. Even worse, family wasn't notified by the hospital after the attack. His daughter learned of the incident only after inquiring about the red bumps on her father's body. Although Mr. Marrable's death has not been directly blamed on fire ants, the incident was traumatizing to all involved.

This story would be more shocking to me, except I have been involved in at least two lawsuits where fire ants attacked patients unable to respond or call for help. And despite the fact that stinging cases are often hushed up, many other incidents occur every year.

It doesn't have to be this way. Fire ants are highly manageable given our scientific understanding of fire ants, and today's pesticide tools. But fire ant management always requires attention to detail. It also requires cooperation and communication between the health care facility and its pest control provider. 

If your company provides pest control for health care facilities, here are some essential elements needed to keep your customer (and you) out of the headlines.

• Ensure the facility has a policy regarding indoor ants. The plan should include clear staff instructions on how to immediately report signs of ants to your company. 
• Be sure your staff is always updated on what wings/rooms house high-risk patients.
• Require patients to be immediately removed from any room with ants to another ant-free location. In this Georgia incident, the patient was returned to his original room only to have fire ants return and attack again a second day. No patient should be returned to an infested room until the indoor and outdoor areas around the room have been inspected, treated and cleared by a pest control professional.  
• Clean infested rooms with a soap solution and disinfect before allowing any patient to return.  Holes and suspected ant entry points should be either sealed or treated. Cleaning with soap removes traces of trail pheromone that might lure other ants back into the room.
• Conduct periodic staff training classes to let nurses and other caregivers know how to identify fire ants. In this week's incident it is telling that none of the staff interviewed referred to the ants as fire ants, only "ants."  Fire ants pose perhaps the greatest immediate health threat to aphasic patients, and should not be difficult to recognize with training. 
• Inspect outdoor areas regularly for fire ants, and train maintenance staff to recognize and report evidence of fire ant nesting around the facility. 
• Fire ant infestations inside a building can almost always be traced back to a fire ant mound or colony outdoors. It's important to know who is responsible for grounds treatment ahead of time. When one contractor is assigned duty for indoor pest control and another for outdoor pest control, blame-shifting is inevitable. The losers in this game are the patients. Ideally, one contractor should be responsible for both indoor and outdoor fire ant control, so there is no confusion.  
• Don't rely solely on mound treatments for fire ant control. Broadcast applications of either baits or residual insecticides are always a better option. Fire ant baits are ideal for large turf areas and are typically applied once or twice a year. Residual granular insecticides containing fipronil or bifenthrin can be used annually in landscape areas immediately adjacent to buildings.  The idea is to keep fire ant mounds as far away from the building as possible. Fire ant control should start at the property line, not the final two feet to the building.  
• Don't allow unlicensed applicators to apply insecticides for fire ants. In Texas, pest control at health care facilities must be performed by a licensed pest control technician or certified applicator. This includes control of ants and other insects, pest birds, plant diseases, rodents, and weeds.
• Document everything you do in writing on your service report. Document both pesticide and non-pesticide-related actions taken during the visit. Be specific about what pests are found during inspections. Remember, there is no such thing as just an "ant."  Fire ants should be clearly identified. Assume that any of your service tickets could be examined by a lawyer some day. 

If doing pest control around nursing home facilities sounds risky, it is. But a conscientious company can succeed at this business. And a nursing home can be one of the most rewarding accounts you have.  As a friend and colleague points out, the biggest risks happen with "low-bid contractors who are not willing to address underlying problems."  

Mr. Marrable's daughter told the Washington Post that her father "deserved better" than the treatment he received in his last days. Let's make sure all our sensitive accounts, like nursing homes, get the good service they deserve.

For more information about fire ant control in nursing homes, see Extension factsheet ENTO-022.