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), released on October 28, 2025 its Multisociety Guidance for Infection Prevention and Control in Nursing Homes, which updates earlier guidance that was published in July 2008. The updated guidance was developed by experts in geriatrics, infectious diseases, infection prevention, and epidemiology, and has been reviewed and endorsed by leading professional societies. The updated guidance provides a framework to help nursing homes prevent and control infections while maintaining the social and rehabilitative goals of residential care.
Recommendations and implementation suggestions in the updated guidance address infection prevention and control (IPC) leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining a home-like care space while sustaining necessary IPC measures. The guidance covers the role of regulatory bodies like the Centers for Medicare and Medicaid Services (CMS) and recommendations from the Centers for Disease Control and Prevention (CDC). It should serve as a resource for IPC program leaders in nursing homes who are aiming to enhance infection prevention efforts.
The stated reasons for updating the guidance are:
- 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.
The key recommendations from the updated guidance are:
- 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.
The lead author of the updated guidance stated: “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.”
If you or a loved one may have been injured (or worse) in a nursing home in the United States due to nursing home infection, nursing home staff shortage, nursing home understaffing, nursing home pressure ulcer (nursing home bedsore), nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a nursing home malpractice lawyer in your state who may investigate your nursing home injury claim for you and represent you or your loved one in a nursing home case, if appropriate.
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