Information for Long-Term Care Facilities

Long-term care facilities may be defined as institutions, such as nursing homes and skilled nursing facilities that provide health care to people (including children) who are unable to manage independently in the community. This care may represent custodial or chronic care management or short-term rehabilitative services.

Influenza can be introduced into a long-term care facility by newly admitted residents, health care workers and by visitors. Spread of influenza can occur between and among residents, health care providers, and visitors. Residents of long-term care facilities can experience severe and fatal illness during influenza outbreaks.

Vaccination Recommendations


If possible, all residents should receive an influenza vaccine annually before influenza season. In the majority of seasons, influenza vaccine will become available to long-term care facilities beginning in September.  Influenza vaccination should commence as soon as vaccine is available. Informed consent is required to implement a standing order for vaccination, but this does not necessarily mean a signed consent must be present.

When a new patient or resident is admitted after the influenza vaccination program has concluded in the facility, the benefits of vaccination should be discussed, educational materials should be provided, and an opportunity for vaccination should be offered to the new resident as soon as possible after admission to the facility.

Health Care Personnel

CDC and the Advisory Committee on Immunization Practices (ACIP) recommends that all health care personnel get vaccinated annually against influenza.

Influenza Vaccination Information for Health Care Workers


When to suspect an influenza outbreak in long-term care (LTC) facilities:

If there is one laboratory-confirmed influenza positive case along with other cases of respiratory infection in a unit of a long-term care facility, an influenza outbreak might be occurring.

Outbreak control

  • If you suspect an outbreak of influenza-like illness is occurring, please contact local public health, or the Center for Acute Disease Epidemiology (CADE) at 800-362-2736. The influenza surveillance coordinator or CADE staff will help facilitate outbreak investigation and control.
  • CADE or local public health staff will work with facilities to collect specimens for patients with influenza-like illness, without other apparent cause and submit specimens to the State Hygienic Laboratory at the University of Iowa (SHL)
  • Administer antiviral prophylaxis to residents and health care personnel in accordance with current CDC recommendations during influenza outbreaks.
  • Vaccinate all unvaccinated residents and staff with the current season influenza vaccine unless medically contraindicated.
  • Reinforce respiratory hygiene/cough etiquette in long-term care facilities.
  • Implement droplet precautions during the care of a resident with suspected or confirmed influenza.
  • Cohort and/or isolate ill residents as appropriate.
  • Restrict ill personnel from patient care. Restrict personnel movement from areas of the facility having outbreaks to areas without patients with influenza.
  • Limit visitation and exclude ill visitors. Consider restricting visitation of all visitors via posted notices.
  • Limit new admissions.

Additional Resources

(515) 242-5935  |  1(800) 362-2736  |  Submit questions online at "Contact Us"