The Skilled Nursing Facility (SNF) Infection Control Assessment and Response (ICAR) Program is a collaboration between the Los Angeles County Department of Public Health (LAC DPH) and LAC SNFs to work towards the common goal of improving safety and quality of care for residents, staff, and visitors. The LAC DPH Acute Communicable Disease Control Program (ACDC) Long Term Care team assesses a facility’s Infection Prevention and Control (IPC) practices following a standardized gap assessment based off the Centers for Disease Control and Prevention (CDC)’s ICAR tool in order to provide feedback to the facility on how they can improve their IPC practices.

This program aims to assist facilities with implementing IPC best practices and improving IPC programs. Our purpose is to serve one of the most vulnerable populations (e.g., nursing home residents) by serving their providers – the SNFs.

Please note: We are not inspectors or surveyors, so this is not a licensing or certification visit, but an opportunity to share information and provide consultation.

All LAC SNFs (excluding Long Beach and Pasadena) are eligible to participate in the SNF ICAR Program.

• Participating in the SNF ICAR program involves an in-person site visit from LAC DPH’s ACDC Long Term Care Team. ICARs are used to systematically assess a healthcare facility’s IPC practices and guide quality improvement activities (e.g., by addressing identified gaps).
  • The site visit involves direct observations of hand hygiene (HH), personal protective equipment (PPE), environmental cleaning and disinfection, transmission-based precautions, and other aspects of infection prevention.
  • The visit will be conducted by our staff, along with your infection preventionist (IP) team, utilizing audit tools developed the California Department of Public Health (CDPH) and the CDC.
  • SNF ICAR visits usually take approximately 3-4 hours.
• On the day of the visit, our team will directly observe IPC practices, identify gaps, and provide recommendations for improvement in real time.
• After the visit, the facility will receive a detailed infection control summary and written recommendations including the completed LAC DPH SNF ICAR tool. Follow-up visits may be indicated depending on the outcome of the visit.

• A no-cost, comprehensive IPC assessment and consultation with experienced public health infection preventionists and nurse consultants.
• Improvement and expansion of your facility’s culture of safety.
• Improvement in facility-wide hand hygiene adherence.
• Improvement in environmental cleaning and disinfection adherence, including how to properly use fluorescent markers.
• Effectively implement appropriate transmission-based precautions.
• Strengthen your antimicrobial stewardship program.
• Decreased healthcare-associated infections (HAIs).
• Learn how to effectively work with local public health LAC DPH, CDPH, and the CMS quality improvement organization (HSAG) to improve IPC and resident quality of care.
• Learn how to effectively use IPC resources and tools available to SNFs.

• Complete a pre-visit survey
• Leadership support from the facility administrator, director of nursing, director of staff development, medical director, and corporate suite leaders (if applicable) to ensure the facility IP team is able to effectively and sustainably implement IPC best practices
• Share identified gaps in infection prevention and control practices and procedures with your staff and leadership
• Implement recommendations and feedback from LAC DPH
• Conduct regular adherence monitoring and provide feedback of results to staff
• Share progress with your staff and leadership. Provide periodic updates to encourage sustained commitment to infection prevention.
• Leverage the facility’s QAPI program as a mechanism for implementing ICAR feedback and sustain improvement in IPC practices long after LAC DPH’s ICAR visit.

Sign-up is now available. Please click here to sign-up.

We look forward to hearing from you soon!

• LAC DPH Recommended Infection Prevention and Control (IPC) Training for Skilled Nursing Facilities
• CDC resources from CDC ICAR facilitator Guide
• LAC DPH Transforming Nursing Home Care Together (TNT) Program Homepage: for educational webinars on quality improvement or, what is more widely recognized in nursing homes, quality assurance process improvement (QAPI), please refer to unit 1 of the TNT program. For quality improvement/QAPI tools and resources, please refer to the Resources section.