Infection Control in Long-Term Care
Infection Control in Long-Term Care: Why It Still Matters Every Day
Infection control has always been one of the most important responsibilities in long-term care. For residents, even a minor illness can become life-threatening. For staff, infection prevention touches every part of the day, from medication passes to meal service to simple moments of helping someone get comfortable. Good infection control isn’t just a regulatory requirement. It’s a foundation of safety and dignity.
And yet, infection control remains a persistent challenge nationwide. Facilities manage increasing resident acuity, workforce shortages, high turnover, and changing expectations from CMS. These pressures create gaps that may be small gaps at first, but can escalate quickly without clear procedures and reliable staffing patterns.
What the Data Shows
CMS data show many overall deficiencies among facilities, but generally only a small percentage are infection-related. Even so, a single lapse is important to a resident, their loved ones, and the other residents and staff in a facility. Infection control deficiencies often indicate things like:
- missed hand hygiene
- improper PPE use
- environmental cleaning issues
- isolation precautions that weren’t followed
- gaps in staff training, especially during turnover
When infection prevention weakens, residents feel it first. Outbreaks spread faster. Recovery takes longer. Emergency transfers increase. Families worry more. And staff morale suffers when they feel unprepared or unsupported.
Why Infection Control Challenges Persist
Every facility knows infection control is important. The barrier isn’t knowledge. It’s operational day-to-day reality.
1. Staffing instability
Training consistency is hard to maintain when turnover is high or agency use increases. Even well-run facilities struggle with getting every temporary staff member aligned with internal processes.
2. Higher resident acuity
More chronic conditions, more wound care, more tubes and ports. More opportunities for infection.
3. Complex and evolving guidance
CMS updates expectations. States update expectations. Survey teams adjust focus. Facilities are often adapting in real time.
4. Documentation gaps
Many infection control citations come down to missing documentation—not missing care.
5. The pressure of daily workload
Staff do not intentionally skip safety steps. They are overwhelmed.
What Strong Infection Control Often Looks Like
Facilities that perform well in infection control tend to have a few things in common:
- Stable staffing
Higher retention leads to fewer training lapses. - A visible, empowered Infection Preventionist
Not just on paper. Present in the building. Accessible. Respected. - Routine observation and coaching
Not punitive. Collaborative. - Consistent onboarding and competency checks
Especially for agency/temporary staff and new hires. - Clear communication across departments
Housekeeping, nursing, dietary, and maintenance all aligned on the same practices. - Simple, living workflows
Easy to follow, easy to update, easy to teach.
How Leaders Can Strengthen Infection Control Now
Small, consistent steps build a safer environment for residents:
- Review internal policies and make sure they match CMS and state expectations
- Reinforce foundational practices like hand hygiene and glove changes
- Give staff real-time feedback, not only corrective feedback
- Ensure agency/temporary workers receive orientation that covers infection control basics
- Watch for PPE fatigue, especially during busier shifts
- Support the Infection Preventionist with time, training, and authority
Even small improvements can reduce the risk of outbreaks and improve resident outcomes.
What You’ll See in Future Posts
The Infection Control category in the Resource Center will include:
- Trends from CMS data
- Common citation patterns
- Practical steps facilities can take today
- Explanations of new regulatory guidance
- Insights that support safer, more stable care environments
The goal is simple: help facilities strengthen the systems that protect residents every day.
The Impact of Infection Control
To see how infection control issues appear across your state, visit the Reports page for expanded, data-driven insights.
FAQ
Infection control is the set of practices that prevent the spread of illness within a long-term care facility. It includes hand hygiene, PPE use, cleaning procedures, isolation precautions, staff training, and strong oversight from an Infection Preventionist.
Residents often have complex medical needs or weakened immune systems, making even minor infections dangerous. Effective infection control protects their safety, health, and overall quality of life.
Survey teams frequently cite issues such as missed hand hygiene, improper glove or PPE use, incomplete cleaning procedures, inconsistent documentation, and gaps in staff training, especially during periods of high turnover.
High turnover and frequent agency/temporary staff use create inconsistencies in training and workflow. When staffing is unstable, infection control practices are harder to reinforce and monitor, increasing the risk of incidents.
Key steps include reviewing internal policies, reinforcing core practices, supporting the Infection Preventionist, improving onboarding for new and agency/temporary staff, and offering real-time coaching rather than only corrective feedback.
Visit the Reports page to see statewide patterns, data insights, and additional context designed to help facilities improve resident safety.
Sources
- Centers for Medicare & Medicaid Services (CMS). State Operations Manual: Infection Control Requirements for Nursing Homes (Appendix PP).
https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/nursing-homes - Centers for Medicare & Medicaid Services (CMS). Nursing Home Care Compare Data Catalog (Staffing, Quality Measures, Inspections, Penalties).
https://data.cms.gov/provider-data/topics/nursing-homes - Centers for Disease Control and Prevention (CDC). Infection Prevention and Control Guidance for Healthcare Settings.
https://www.cdc.gov/infection-control/hcp/index.html