Long-Term Care Settings

Long-term care facilities (LTCFs) may be defined as institutions, such as nursing homes and skilled nursing facilities that provide healthcare to people who are unable to manage independently in the community. This care may represent custodial or chronic care management or short-term rehabilitative services. Approximately 3.2 million Americans lived in U.S. nursing homes and skilled nursing facilities participating in the Medicare and Medicaid programs at some point during 2008. In addition, nearly one million persons reside in Assisted Living Facilities. The growing complexity of care being delivered in LTCFs has led to increased recognition for improved infection control and prevention of healthcare-associated infections in LTCFs over the last 2 decades.

Long-Term Care Toolkit

• Long-Term Care Assessment Toolkit

Guidelines and Recommendations

• CDC. Healthcare Infection Control Practices Advisory Committee (HICPAC) Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009
• Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
• Siegel JD, Rhinehart E, Jackson M, et al. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007
• Siegel JD, Rhinehart E, Jackson M, et al. The Healthcare Infection Control Practices Advisory Committee (HICPAC). Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006
• CDC. Influenza Vaccination of Healthcare Personnel
• CDC. Sehulster L, Chinn RYW, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Environmental Infection Control in Healthcare Facilities MMWR 2003;52 (RR10):1–42.
• CDC. Boyce JM, Pittet D. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Hand Hygiene in Healthcare Settings [PDF - 496 KB] MMWR 2002;51
• CDC. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Infection Control in Healthcare Personnel, 1998 [PDF - 1.04 MB]
• Immunization of Healthcare Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee

Additional Guidelines to Clinical Practice Consensus Guidelines

• CMS 2009 Nursing Home Compendium [PDF - 14.41 MB]
• CMS 2009 Nursing Homes - Issuance of Revisions to Interpretive Guidance at F Tag 441, as Part of Appendix PP, State Operations Manual (SOM), and Training Materials [PDF - 1.1 MB]
• Smith PW, Bennett G, Bradley S, Drinka P, Lautenbach E, Marx J, Mody L, Nicolle L, Stevenson K; SHEA/APIC Guideline: Infection Prevention and Control in the Long-Term Care Facility. Infect Control Hosp Epidemiol 2008;29:785–814
• Kevin P. High, Suzanne F. Bradley, Stefan Gravenstein, David R. Mehr, Vincent J. Quagliarello, Chesley Richards, and Thomas T. Yoshikawa Clinical Practice Guideline for the Evaluation of Fever and Infection in Older Adult Residents of Long-Term Care Facilities. Clinical Infectious Diseases. 2009;48:149–171
• Loeb M, Bentley DW, Bradley S, Crossley K, Garibaldi R, Gantz N, McGeer A, Muder RR, Mylotte J, Nicolle LE, Nurse B, Paton S, Simor AE, Smith P, Strausbaugh L. Development of Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term–Care Facilities: Results of a Consensus Conference, Infect Control Hosp Epidemiol 2001;22:120–124
• Lindsay E. Nicolle, MD; David W. Bentley, MD; Richard Garibaldi, MD; Ellen G. Neuhaus, MD; Philip W. Smith, MD; the SHEA Long‐Term–Care Committee Antimicrobial Use in Long-Term–Care Facilities. Infect Control Hosp Epidemiol 2000;21:537–545
• McGeer A, Campbell B, Emori TG, Hierholzer WJ, Jackson MM, Nicolle LE, Peppler C, Rivera A, Schollenberger DG, Simor AE, et al. Definitions of Infections for Surveillance in Long-Term Care Facilities, AJIC 1991 [PDF - 116 KB] Am J Infect Control. 1991 Feb;19(1):1-7

For more information and additional resources, please use one of the following:

1. Your state health department.
2. Infection control practitioners from institutions in your area.
3. The area chapter of the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC). (For information about APIC local chapters, call the APIC headquarters in Washington, D.C., at 202-789-1890).