New Guidance Bolsters Infection Control in Nursing Homes

Society for Healthcare Epidemiology of America

The Society for Healthcare Epidemiology of America (SHEA), in collaboration with the Association for Professionals in Infection Control and Epidemiology (APIC), the Infectious Diseases Society of America (IDSA), the Post-Acute and Long-Term Care Medical Society (PALTmed), and the American Geriatrics Society (AGS), today released Multisociety Guidance for Infection Prevention and Control in Nursing Homes.

The new guidance updates earlier guidance, published as the SHEA/APIC guideline: infection prevention and control in the long-term care facility, July 2008. The updated guidance provides a framework to help nursing homes prevent and control infections while maintaining the social and rehabilitative goals of residential care.

Why Now

  • COVID-19 lessons: Devastating morbidity and mortality underscored the urgent need for stronger infection prevention to protect nursing home residents.
  • Evolving resident population: More complex medical needs and higher exposure to devices increase infection risks in nursing home residents.
  • Expanding services: Growth of ventilator-dependent units further raises infection challenges.
  • Regulatory priority: CMS has made infection prevention in nursing homes a national focus.

Key Recommendations from the Updated Guidance

  • At least one dedicated infection preventionist per facility (full-time for >100 beds; 0.5 FTE for smaller facilities).
  • Stronger support and accountability from administrative and medical leadership.
  • Improved healthcare personnel vaccination rates that support workforce illness prevention.
  • Clear outbreak management strategies, including precautions, PPE, and visitation policies.
  • Infection prevention input on environmental systems such as water, air handling, and cleaning practices.
  • Collaboration with public health and infectious diseases experts as part of routine operations.

"Nursing homes are unique. Vulnerable people live and receive medical care, but it's also important for the environment to feel homelike. This guidance offers practical, evidence-informed strategies to keep both short-stay and long-stay residents safe while supporting the comfortable environment they deserve," said Lona Mody, MD, MSc, lead author of the guidance.

About the Document

Multisociety Guidance for Infection Prevention and Control in Nursing Homes was developed by experts in geriatrics, infectious diseases, infection prevention, and epidemiology, and has been reviewed and endorsed by leading professional societies.

The full guidance is published in Infection Control & Hospital Epidemiology (ICHE), SHEA's flagship scientific journal.

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