Infection Prevention Regulatory Changes in Long Term Care

Author: Caitlin Stowe MPH, CPH, CIC, CPHQ, VA-BC

Categories: General Infection Prevention June 1, 2017

There are some big changes coming to the long term care (LTC) landscape, courtesy of the Center for Medicare and Medicaid Services (CMS). Since 2002, LTC providers have been following the Nursing Home Quality Initiative, which reimburses these facilities based on certain quality metrics including staffing, pain control, vaccination, and pressure ulcer development. This information is posted on CMS’ nursing home compare website and allows consumers to see how their local care facilities perform. However, in September 2016, CMS finalized a rule that will require massive changes in current LTC facilities.[1]

The CMS final rule is a three phase implementation, and all changes must be implemented by November 2019. One of the biggest changes falls under the quality assurance and performance improvement (QAPI) arena, which is part of the Affordable Care Act (ACA), especially when it comes to infection prevention. [1]

  • Phase I (implemented in November 2016): Mandated that a facility have an infection control and prevention program.
  • Phase II (must be implemented by November 2017): Requires facilities to have a robust antibiotic stewardship program, as well as an annual infection prevention assessment in place.
  • Phase III (must be implemented by November 2019): Requires a designation of an Infection Prevention and Control Officer that has training specific to infection prevention for each facility, and this officer must be a member on the facility’s quality committee.

While these regulation changes may seem minor on paper, they are a major cultural change from how LTC facilities currently operate. Many LTC facilities lack the staffing and financial resources to implement some of these mandates.

Facility administrators are known to wear multiple hats, but have not had any specialized training on infection prevention. Add in the need to create an antibiotic stewardship plan, a quality committee, and beefing up the infection control program, it is going to create a hardship for many facilities, who are already struggling to stay afloat. While these changes are necessary for efficiency and improved patient safety, unless the implementation timeline is changed or there’s financial help from the government to implement these changes, we may see facilities fail to meet the directives or even be forced to close their doors.

Many organizations, including Association for Professionals in Infection Control (APIC), the Agency for Healthcare Research and Quality (AHRQ), and various departments of health have many resources available online for LTC providers. These resources can include various toolkits for healthcare associated infection reduction, guides for establishing an infection control program, and specialized infection prevention training. Additionally, PDI’s clinical science liaisons can offer education pertaining to the unique challenges around environmental disinfection, hand hygiene, and skin antisepsis that LTC facilities face. We would love to partner with you to prepare you for these new regulations.


Caitlin Stowe MPH, CPH, CIC, CPHQ, VA-BC
Caitlin Stowe PDI Clinical Research Manager Clinical Affairs Research Manager, PDI


Caitlin started her career at the early age of 12, working in her parents’ medical practice. During graduate school, she got the chance to shadow an infection preventionist, and was hooked. Caitlin has practiced in a variety of infection prevention roles and settings since 2009.

Caitlin joined PDI in 2016 as a clinical science liaison (CSL), and provided clinical expertise to customers in the Midwest region of the country. She was promoted in 2019 to PDI’s first Clinical Affairs Research Manager.

Currently, Caitlin manages the clinical evidence portfolio for all post-market PDI products.


Phone: 615-920-6603

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Spending time with my family


Nova Southeastern University
Doctor of Philosophy in Health Science – In progress

University of South Florida
Master in Public Health in Global Communicable Disease

University of South Florida
Graduate Certificate in Infection Control

University of Central Florida
Bachelor of Science in Liberal Studies

Certification in Public Health (NBPH) – CPH
Certification Board of Infection Control (CBIC) – CIC
Certified Professional in Healthcare Quality (NAHQ) – CPHQ
Certification in Vascular Access (VACC) – VA-BC

Why I love what I do

I have always loved learning, especially about science. When I found infection prevention, the combination of statistics, disease transmission, and education sounded like the perfect career to me. I have enjoyed every step of my infection prevention journey, and transitioning to industry and then research, has really allowed me to evolve my skill set. I love being able to help our customers by acting as a resource they can use when they have questions.

Areas of Expertise

Emerging Pathogens
Infection surveillance technology

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