Long-Term Care Healthcare-Associated Infections in 2025: Analysis of 30,967 Reports From Pennsylvania

Background The Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest patient safety data repository of its kind in the United States. The PA-PSRS database contains over 5.8 million reports, including more than 473,000 long-term care (LTC) healthcare-associated infection (HAI) reports. Methods LTC HAI data from PA-PSRS were extracted on March 1, 2026. Infection counts were calculated based on report submission date, and rates were calculated based on infection confirmation date. Reports from LTC facilities and specific care areas were included in rate calculations if resident and device days were also entered in PA-PSRS for the corresponding month. Results In 2025, Pennsylvania’s LTC facilities submitted 30,967 infection reports to PA-PSRS, a 16.9% increase over the prior year and the fourth consecutive annual increase, with all four increases exceeding 10%. The overall infection rate was 1.25 infections per 1,000 resident days, representing a 15.7% increase from 2024. The 2025 rate also established a significant four-year increasing linear trend since the low point of 0.77 in 2021 (R 2 =0.989, p=0.0005). Infection rates increased across all regions of the state except the Northeast, which remained unchanged, with the largest increase observed in the Southeast region, where the rate rose by 0.26 points (32.9%) from 2024 to 2025. The overall infection rate increased due to rising rates across all infection types, except for device-related bloodstream infections, for which the rate remained the same. Respiratory tract infections had the largest increase in both number and percentage, driven largely by influenza, which rose by 1,652 reports (117.7%). Reports of gastrointestinal infections increased as well, attributable to an 84.7% increase in norovirus. Conclusion In 2025, the number of infection reports submitted to PA-PSRS and the overall infection rate increased, due to a rise in all infection types except for device-related bloodstream infections. Respiratory tract infections, particularly influenza, showed the most substantial increase. Plain Language Summary In conjunction with the Patient Safety Authority’s 2025 annual report, PSA took a close look at the 30,967 healthcare-associated infections (HAIs) reported last year by long-term care facilities (e.g., nursing homes) to the Pennsylvania Patient Safety Reporting System (PA-PSRS). The total number of infection reports was a 16.9% increase from 2024 to 2025—the fourth consecutive annual increase—and the overall infection rate (1.25 infections per 1,000 resident days) was a 15.7% increase from the previous year, attributed to rising rates across all infection types, excluding device-related bloodstream infections. Of these, there were notable increases in respiratory tract infections, primarily due to a 117.7% increase in influenza reports, and gastrointestinal infections, which included an 84.7% increase in norovirus.