Liz Shane, MPH, CIC, LTC-CIP, AL-CIP, PMP, CPHQ
Project Manager, Healthcare and Congregate Settings
Chicago Department of Public Health • Illinois
How did you become an infection preventionist and what does your role look like today?
My first role after graduate school was as an Infection Preventionist at an acute care hospital in Lansing, Michigan. I then transitioned to local public health and have worked in multiple health departments in Michigan, Toronto, and Chicago. While I’ve held a variety of titles, including Epidemiologist, Communicable Disease Team Leader, and Quality Improvement Specialist, I returned to infection prevention in 2018 when I helped build and implement an infection prevention program for homelessness services settings in Toronto.
In 2019, I moved to Chicago to be closer to family and joined the Chicago Department of Public Health (CDPH) as an Epidemiologist. A few months after the COVID pandemic started, word got around that I had my CIC, and I was tapped to be an Infection Preventionist on CDPH’s Healthcare Settings Team, focusing on skilled nursing facilities. I’ve remained on the team since 2020 and now serve as the Project Manager overseeing CDPH’s work with long-term care facilities, correctional facilities, shelters, and other community congregate settings.
In my current role, I provide outbreak response support to facilities, conduct infection control assessment and response visits (ICARs), manage the CDPH long-term care web page, develop and share infection prevention and control guidance, serve as a resource to infection preventionists in long-term and congregate care settings, and lead webinars with facility and corporate staff to build infection prevention and control capacity.
Can you share one specific example where your work made a measurable difference?
In July 2025, two residents of a Chicago-based supportive living facility, which operates similarly to an assisted living facility, were diagnosed with invasive Group A Strep (iGAS), triggering a response from the Chicago Department of Public Health. In August and September, two additional residents were diagnosed with iGAS and two asymptomatic carriers were identified through a point prevalence survey (PPS) conducted among all residents and staff. Whole genome sequencing was performed on the isolates, and the degree of genetic relatedness confirmed that intra-facility transmission had occurred.
Although I have managed multiple iGAS outbreak responses in skilled nursing facilities, this was the department’s first iGAS response at a supportive living facility, requiring us to adapt our typical approach. During the outbreak response, I served as the liaison between CDPH and facility leadership and provided intensive support. Activities included conducting a site visit, assisting with several PPSs, confirming that carriers received appropriate treatment, drafting communications for the facility to share with residents, staff, and visitors, and ensuring the facility complied with public health recommendations (e.g., universal masking).
The combination of these targeted interventions successfully controlled the outbreak, and the facility has not had a subsequent case of iGAS since the outbreak ended.
What is the most challenging part of infection prevention in long-term care?
As a public health professional supporting long-term care facilities across the city for the past six years, I have worked with hundreds of infection preventionists. The most common challenge I have seen is frequent turnover among facility infection preventionists and similar leadership positions (e.g., Directors of Nursing). Multiple factors contribute to this high turnover, including infection preventionists being forced to take on additional responsibilities (e.g., working as a floor nurse), limited access to education and training, and insufficient resources and organizational support to implement meaningful improvements.
While Illinois requires that skilled nursing facilities with over 100 beds and/or that provide certain services (e.g., on-site dialysis) have an onsite infection preventionist for 40 hours a week, it would be beneficial for CMS to adopt a similar requirement and explicitly state that the IP is not permitted to perform other tasks outside of their scope. It would also be helpful for additional training opportunities to be made available to long-term care infection preventionists at no cost. Currently, the only comprehensive free training I am aware of is the CDC Nursing Home Infection Preventionist course. Providing stipends or scholarships for the LTC-CIP study materials and exam fees would also be tremendously helpful. Further, developing a mentorship program for more senior infection preventionists to guide novice infection preventionists could also make a meaningful difference.
In the past, CDPH used federal grant funding to purchase and distribute GloGerm kits, pocket-sized alcohol-based hand rub, the APIC Infection Prevention Guide to Long-Term Care, and COVID/influenza rapid test kits to every skilled nursing facility in Chicago. Facilities have consistently praised our team for distributing these items and use the resources to strengthen their infection prevention and control programs. While CDPH is no longer able to financially support purchasing and distributing these supplies, it would be valuable if other organization or government entities could provide similar materials to long-term care facilities.
If you could speak directly to policymakers, what would you want them to understand?
If I could speak directly to policymakers, I would emphasize that effective infection prevention and control programs in long-term care facilities depend heavily on a stable, well-supported infection prevention workforce. The IP role is very demanding, the long-term care resident population can be particularly challenging to work with, and infection prevention and control activities are frequently deprioritized due to multiple competing demands. Protecting some of the country’s most vulnerable residents necessitates that long-term care facilities have dedicated, well-trained, and supported infection preventionists who are provided with the time, resources, and authority to implement effective infection prevention and control programs.