Decision-makers at long-term care (LTC) facilities face significant challenges around filtration planning. The process involves understanding the regulatory environment, assessing risks unique to their facility, balancing performance with system capacity and developing a process that remains consistent over time. In a comprehensive learning resource from Brookaire, our experts bring together all those elements and outline a practical framework for LTC environments.
The Role of Filtration in Long-Term Care
For many LTC environments through the United States, air filtration represents a first line of defense against disease. For both residents and care teams, the importance of effective filtration planning is significant:
- For residents: Filtration systems remove particulates, allergens and contaminants that can affect vulnerable residents. Even relatively low concentrations of airborne pollutants may trigger respiratory distress or worsen chronic disease.
- For care teams: Consistent indoor air quality reduces fatigue, irritation and sickness-related absences. Given that these professionals spend approximately 40 hours per week in these spaces, it is vital that air filtration is planned to protect not just residents, but the caregivers themselves.
By controlling particulate levels and reducing microbial load, properly managed filtration contributes to better outcomes for residents while creating a more stable environment for staff. Crucially, it also supports operational priorities such as compliance, sustainability and cost efficiency.
Understanding Regulatory Expectations in Your LTC
Healthcare-adjacent facilities, including long-term care, are guided by several key standards. As a decision maker responsible for air filtration planning, it is vital that you are aware of - and act on - all of them:
- ASHRAE Standard 170 sets requirements for filtration and ventilation in healthcare environments.
- CDC Environmental Infection Control Guidelines highlight the role of HVAC systems in reducing airborne infection risks.
- CMS regulations establish life safety conditions that incorporate air quality measures.
- Local codes may add further requirements depending on region. For more advice on local codes, reach out to one of our air filtration experts who may be able to help.
For most long-term care spaces, MERV 13 filtration is considered a basic minimum. However, this doesn't mean that MERV 13 will be optimum for every space across your facility. As an example, higher efficiency filters such as HEPA are required in certain zones including isolation rooms or treatment areas.
Facility managers should review requirements regularly, as guidance evolves in response to public health needs.
Facility-Specific Risk Assessments
No two long-term care facilities are identical. By conducting a thorough risk assessment, you can identify the unique conditions that will shape your filtration requirements. Factors to evaluate include:
- Resident health: Populations with higher rates of respiratory illness require tighter particulate control.
- Building design: Airflow patterns vary across common areas, nursing stations and private rooms.
- Location: Facilities in urban areas may be exposed to higher particulate loads, while rural sites may experience pollen or dust.
- System capacity: Legacy HVAC systems may lack the fan power to handle higher-efficiency filters without modification.
This information should help guide your decisions on filter specifications, changeout intervals and zoning strategies.
Layered Filtration Approaches
A single filter stage rarely provides sufficient protection in LTC settings. A layered approach ensures efficient capture across particle sizes while minimizing stress on HVAC systems.
Pre-filters (MERV 8–11): These filters will capture larger debris and protect higher-grade filters from early clogging.
Final filters (MERV 13+): This second layer will provide the main line of defence, removing fine particulates linked to health risks.
HEPA filtration: As a final layer, using HEPA filters in critical spaces such as isolation rooms or areas where procedures generate aerosols would enhance your overall filtration strategy.
This arrangement balances cost, performance, and service life. It also makes maintenance more predictable, since pre-filters can be replaced more frequently while final filters remain in service longer.
Managing Pressure Drop
Higher-efficiency filters increase resistance to airflow. If your systems aren't prepared to handle the additional load, airflow can be reduced, energy costs can rise and comfort levels may decline for residents and staff alike.
Before upgrading to higher-grade filters, your facility teams should evaluate system capacity and available static pressure. Installing differential pressure gauges helps track filter loading in real time. This data allows filters to be changed when they approach the end of their service life, rather than on a fixed schedule. The result is fewer premature replacements, better use of resources and more stable system performance.
Our pro tip? In older systems where upgrades are difficult, portable HEPA units can provide additional protection without overburdening central HVAC equipment.
Infection Control Integration
Filtration is most effective when integrated into a broader infection prevention strategy. Airborne pathogens such as influenza, RSV, and SARS-CoV-2 are of particular concern in LTC facilities, where outbreaks can spread quickly. The recent pandemic was a shocking reminder of this fact, and your approach should take account of these lessons. With these considerations in-mind, your planning should account for:
- Airflow direction: Isolation rooms should be maintained under negative pressure to protect adjacent spaces.
- Pressurization: Administrative and nursing zones may benefit from positive pressure to limit contaminant entry.
- Air changes per hour: Rates should align with ASHRAE 170 recommendations for patient and resident care areas.
- Humidity control: Keeping humidity within the recommended range reduces viability of airborne pathogens.
Portable HEPA units can also serve as a flexible resource during outbreak events, especially in communal spaces.
Maintenance Practices
A filtration plan is only effective if supported by disciplined maintenance. Routine inspection of housings, frames, and gaskets is essential to prevent bypass, which can undermine filter performance.
Changeouts should be based on measured differential pressure rather than calendar dates. This ensures filters are neither removed too early nor left in place beyond their effective lifespan. Incorporating filter performance data into building management systems makes this process more reliable, while also supporting compliance documentation.
Sustainability and Cost Considerations
Sustainability is becoming a central theme in healthcare operations. Filtration planning contributes through choices that reduce waste, extend filter life and optimise energy use.
Facilities like yours can improve sustainability by selecting filters with high dust-holding capacity, which lengthens service intervals. Standardizing specifications across multiple sites reduces the variety of filters in inventory, lowering procurement complexity and storage requirements. Working with suppliers that provide recycling or responsible disposal options further strengthens environmental outcomes - check out our air filter disposal service.
The key takeaway here is that balancing protection, efficiency and sustainability helps you deliver a safer environment without exceeding budgets or environmental commitments.
A Structured Planning Framework
To maintain consistency and compliance across long-term care organisations, filtration planning should follow a structured process:
- Audit: Document current systems, filter types, and service practices.
- Risk assessment: Analyse resident health profiles, building layouts, and environmental exposures.
- System evaluation: Confirm HVAC capacity for higher-efficiency filters.
- Specification: Standardize filter types wherever possible.
- Monitoring: Track differential pressure and IAQ indicators.
- Review: Update plans annually or following system upgrades.
This framework ensures plans remain current, scalable and defensible in regulatory inspections.
Brookaire: A True Partner to Long-Term Care Facilities
A comprehensive filtration plan combines regulatory awareness, risk assessment, layered strategies, and disciplined maintenance. However, it also requires a reliable air filter supplier. Here at Brookaire, we're on-hand to support long-term care facilities with a range of air filters and services such as Job Tagging and Jobsite Delivery. To discuss a new partnership with us, reach out to one of our indoor air quality experts today.