6/15/2026 | 2:45 PM-3:15 PM
Strengthening Infection Prevention in Long-Term Care: Bridging Gaps for Sustainable Success
Session Description: When IPC programs became a required CMS standard for long-term care facilities (LTCFs) during the COVID-19 pandemic, most facilities were unprepared to meet the standard. In 2023, Tennessee Department of Health (TDH) IPs conducted 2,636 IPC consultations in response to outbreaks of multi-drug-resistant organisms (MDROs) and COVID-19 clusters. These facilities, often strained by staffing shortages, limited resources, and high turnover, face persistent challenges in sustaining strong IPC programs. These ongoing challenges continue to elevate the risk of infectious disease transmission among residents, staff, and visitors. Notably, Tennessee’s CMS Survey Agency ranked IPC as the second most cited health-related deficiency in nursing home inspections in both 2022 and 2023.
In response, the Tennessee HAI/AR Program launched the Infection Prevention Assessment-Based Quality Initiative (IPAQ), a voluntary, year-long project started in January 2024. Fifty-two LTCFs enrolled, exceeding the initial goal of 25 facilities, with over 10% in rural, underserved areas. Each received three onsite assessments covering four required Centers for Disease Control and Prevention (CDC) Infection Control Assessment and Response (ICAR) Core Modules and four elective modules. A key outcome was the identification of common gaps, which shaped 2025 TDH Education Priorities. Since February 2025, over 60 facilities have received targeted Environmental Services (EVS), and IPC education based on these findings.
To evaluate impact, pre- and post-assessment surveys and ICAR results were compared with 2024–2025 CMS survey data from participating facilities to assess whether the IPAQ initiative contributed to statistically significant reductions in CMS health deficiency citations related to IPC. This educational session provides attendees with a framework for designing large-scale, IPC assessment-based education tailored to high-risk facilities. The model is adaptable and can be implemented across individual units, hospitals, or broader healthcare systems.
Donna Russell
Infection Prevention Program Manager, Tennessee Department of Health
Ms. Russell serves as the Infection Prevention Program Manager for the Tennessee Department of Health Healthcare Associated Infections and Antimicrobial Resistance Program, leading a team of 8 Infection Preventionists. Ms. Russell began her career as a Registered Nurse in 1993, practicing in Critical Care, Organ Procurement, and Surgical and Emergency Department settings. She has returned to university many times, completing a Master of Public Health – Infection Prevention & Control and a Graduate Certificate in Epidemiology in 2025, a Master of Business Administration – Health Care Management in 2018, and a Bachelor of Science in Nursing in 2010. Ms. Russell has specialized in Infection Prevention and Control for 16 years, first in an acute care setting, transitioning to public health in 2020 at the start of the COVID-19 pandemic. She has maintained her Certification in Infection Control and Epidemiology (CIC) since 2014, Certification in Healthcare Emergency Preparedness (CHEP) and her Certification in Public Health (CPH). Ms. Russell has served as Secretary (2021-2023), 2024 President-Elect, 2025 President and 2026 Immediate Past President for the Middle Tennessee APIC Chapter #85.