Why has there been an increase in the number of nursing home residents who suffer from infections? After all, nursing homes aren’t hospitals filled with sick people.

The fact is that 1.6 million to 3.8 million nursing home infections — such as pneumonia, urinary tract infections, and Clostridium difficile, aka C. diff — occur each year in long-term care facilities.1 And the U.S. Centers for Disease Control has cited statistics that nearly 380,000 Americans die of infections each year.

Risk Factors for Nursing Home Infections

It’s the communal nature of nursing homes that accounts for the easy transmission of infections. Residents eat together in the dining room and join in social activities such as bingo or movies in a common room. What’s more, elderly residents are particularly at risk for infections. Aging causes diminished immune response and cognitive deficits that make it difficult to consistently use basic sanitary routines such as hand washing. Difficulty producing an effective cough to clear secretions and the use of urinary catheters, indwelling venous catheters, and feeding tubes all increase the risk of acquiring an infection in a nursing home.1 Once residents contract infections, the nursing home is most likely to transfer patients to a hospital for treatment.

Duty of Nursing Homes

What can residents and families expect from nursing homes, knowing the fatal risk that infections pose to your loved ones? Regulations require all nursing homes to have an infectious control program designed to “provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection” (see 42 CFR § 483.65).

At a minimum, every nursing home should have policies and procedures to identify risk factors for infection and interventions to reduce those risks. Many facilities designate a committee and often an individual nurse to track the incidence of infections in the facility.


The types of nursing home negligence cases I see most often involve the caregivers’ failure to properly recognize the early signs and symptoms of infections and advise the resident’s physician to begin treatment. If you suspect that an infection was not timely recognized in your loved one, give us a call to discuss.

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1. Smith, Bennett, Bradley, Drinka. SHEA/APIC Guideline: Infection prevention and control in long-term care facilities. Am J. Infect. Control 2008;36: 504-35