Pneumonia is the leading cause of infections in nursing home residents who require transfer to an acute care hospital. The vast majority of nursing home–acquired pneumonia (NHAP) is caused by bacteria. Recent data indicate that the bacterial etiology of NHAP include predominantly aerobic gram-negative bacilli (44%), with lower percentages caused by Staphylococcus aureus (22%); mixed organisms (20%) and anaerobic bacteria (20%) have also been reported in other studies. Hospitalization of residents with NHAP should be individualized depending on clinical severity, advance directives, institutional capacity to manage sick residents, and local practice patterns. A number of different classes of antibiotics, including fluoroquinolones and third-generation cephalosporins, may be appropriate for treating NHAP. (Annals of Long-Term Care: Clinical Care and Aging 2006;14[4]:26-32)

The Centers for Medicare & Medicaid Services (CMS) released the revised Federal Regulation for pressure ulcer care in long-term care facilities. Although this document took effect November 2004, many facilities are not aware of its impact. The new guidance significantly expands the guidance to state and federal surveyors (F-314 tag) evaluating pressure ulcer care in long-term care facilities. The revised guidance provides a comprehensive review of both prevention and management issues, and stresses the use of evidence-based practice. CMS has significantly raised the bar related to its expectation on health care provider’s delivery of pressure ulcer care. Given the enormity of the document, this article will highlight key aspects related to residents with active pressure ulcers. Moreover, it will review the revised scope and severity for a long-term care facility that has been found noncompliant in pressure ulcer care. (Annals of Long-Term Care: Clinical Care and Aging 2006;14(4):19-24