A Roadmap to Implementing Antimicrobial Stewardship Principles in Long-Term Care Facilities (LTCFs): Collaboration Between an Acute-Care Hospital and LTCFs

Abstract

The Centers for Medicare and Medicaid Services (CMS) finalized a rule in October 2016 mandating long-term care facilities (LTCFs) to have antimicrobial stewardship programs (ASPs) in place by 2017. Although guidance exists for establishing ASPs in LTCFs, limited data exists on the "how". As comprehensive ASPs already exist in many acute-care hospitals (ACHs) and, with the known "sharing of patients" between both settings, extending ACH ASP expertise to LTCFs will not only aid LTCFs in complying with the CMS mandate, but will likely also facilitate in decreasing multi-drug resistant organisms and Clostridumdifficile infection rates in patients of both organizations. In this report, we provide a roadmap on how to implement ASPs in LTCFs, using examples from our own ACH's collaboration with local LTCFs to develop and sustain LTCF ASPs. We discuss critical elements to achieving successful LTCF ASPs, including the potential barriers and how to overcome them.