Infection Control in Nursing Homes

Nursing homes must run an infection prevention and control program. Learn what CDC and federal rules require and what families can watch for.

Category: safety-and-health · Updated 2026

Infections spread quickly in communal settings, and nursing home residents are often more vulnerable because of age, chronic illness, and shared equipment. Federal rules require certified nursing homes to maintain an infection prevention and control program and an antibiotic stewardship program, under 42 CFR §483.80. The CDC publishes core practices that describe what effective infection control looks like, from hand hygiene to environmental cleaning.

This guide explains the requirements, the everyday practices, and the questions families can ask to gauge how seriously a facility treats infection control.

What the federal rule requires

Under 42 CFR §483.80, a certified nursing home must have an infection prevention and control program designed to prevent, recognize, and control the spread of infections. It must include written standards, surveillance, and an antibiotic stewardship program, and it must designate one or more trained infection preventionists. Surveyors review this program during inspections, and infection control deficiencies can be cited. CMS also tracks infection data and, in recent years, required reporting of certain infections.

Core practices to look for

Hand hygiene stations and consistent hand washing by staff before and after resident contact
Standard precautions and the right use of gloves, gowns, and masks
Cleaning and disinfection of high-touch surfaces and shared equipment
Proper handling of urinary catheters and other invasive devices
Antibiotic use reviewed by the stewardship program, not prescribed reflexively
Vaccination programs for residents and staff
Isolation and cohorting plans for outbreaks
Tracking and trend analysis of infections in the building

The CDC's core practices for infection prevention in long-term care describe these as the foundation of a safe environment. See CDC long-term care infection prevention.

Catheters, antibiotics, and resistant organisms

Concern	What good practice looks like
Urinary catheters	Used only when necessary and removed as soon as possible
Antibiotics	Prescribed for documented infection, reviewed for necessity and duration
Resistant organisms	Screening and precautions when indicated, with clear communication
Outbreaks	Rapid isolation, notification, and coordination with public health

Avoiding unnecessary catheters and antibiotics is central to preventing infections. CMS quality measures and the antibiotic stewardship rule give facilities tools to track this.

Questions to ask on a tour

Who is the infection preventionist, and how are they trained?
What is your hand hygiene compliance rate, and how is it monitored?
How do you track infections, and how do you spot an outbreak?
What is your antibiotic use rate, and how does the stewardship program work?
How do you handle a resident with a resistant organism, and how do you tell families?
What happens during a respiratory illness season, including visitation rules?

How families can help

Wash your hands when you enter and leave a unit, stay home if you are sick, keep vaccinations current, and ask before bringing food or outside equipment. If you notice poor hand hygiene or soiled equipment, report it calmly to the charge nurse and, if it continues, to the administrator or ombudsman. Infection control is a shared responsibility, and families often see the day-to-day details that surveys cannot.

Sources: CDC long-term care infection prevention; CDC infection control; 42 CFR §483.80. Health content is informational only and not medical advice.

Related guides

Frequently asked questions

Are nursing homes required to have an infection preventionist?

Yes. Federal rules require certified nursing homes to designate one or more trained infection preventionists and to maintain an infection prevention and control program. Surveyors review it during inspections.

How are outbreaks handled?

Facilities should isolate affected residents, notify families and public health authorities as required, and adjust visitation and staffing to stop spread. Ask for the facility's outbreak plan.

What is antibiotic stewardship?

It is a program to ensure antibiotics are used only when needed, at the right dose and duration. Overuse drives resistant infections, which are harder to treat. Federal rules require this program in certified nursing homes.

Can visitors spread infections?

Yes. Visitors should follow hand hygiene and any isolation rules. During outbreaks, facilities may restrict visitation under specific guidance. Ask what rules apply.

Where can I find a facility's infection-related citations?

Infection control deficiencies appear in the inspection results on Care Compare. You can also ask the facility for its most recent infection control review and the plan of correction.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is informational and is not medical advice. Processing date: 2026-10-05.

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