For years, we’ve made the case that the air inside a senior care community is a clinical variable as meaningful to resident outcomes as hand hygiene, surface disinfection, or vaccination rates. What we lacked, until now, was the kind of independent, peer-reviewed, real-world evidence that changes how an industry behaves.
That evidence now exists.
A new prospective controlled cohort study published in the Journal of the American Medical Directors Association (JAMDA) the official journal of PALTmed, the Post-Acute and Long-Term Care Medical Association reports that continuous hydroxyl radical air disinfection, running 24/7 in occupied resident rooms, was associated with a ~48% reduction in clinically suspected respiratory and viral infections over a 24-month study window. In the control unit next door, infection rates stayed essentially flat.
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And it’s not just the clinical community taking notice. McKnight’s Long-Term Care News, one of the most trusted voices in the long-term care industry, picked up the study in early April 2026, signaling that this is no longer an engineering conversation it’s a care conversation.
Here’s what the study found, what it means for operators and clinicians, and how we think the industry should respond.
The research team clinicians at the Golden Care Geriatric Center and Shmuel Harofeh Geriatric Center, with public-health oversight from Ben-Gurion University designed the study the way a skeptical reader would want it designed: two adjacent long-term care units at the same center, identical levels of care, comparable staffing, and the same resident population profile medically complex older adults (mean age 82, 64% women) requiring continuous nursing care.
In January 2023, three ceiling-mounted hydroxyl radical generators were installed in the intervention unit and left to run continuously. The control unit kept its routine care with no added air disinfection. No new protocols. No altered staffing. No room vacancy requirements. No staff compliance burden. The researchers then pulled two consecutive years of electronic medical record data 2022 as baseline, 2023 as the intervention year across 242 resident-years.
The results are clean and hard to argue with. In the intervention unit, the infection incidence rate fell from approximately 1.88 events per resident-year in 2022 to 0.98 events per resident-year in 2023 a decline of roughly 48%. In the control unit, rates were effectively unchanged — 1.61 events per resident-year in 2022 versus 1.57 in 2023.
The reductions were most pronounced where they matter most in long-term care: chest infections and viral infections. These are exactly the illnesses that drive emergency transfers, hospitalizations, functional decline, and family distress in this population.
Long-term care has been waiting eagerly for higher-quality evidence on air disinfection. The field has been genuinely mixed. A 2024 JAMA Network Open randomized trial of in-room portable HEPA purifiers in residential aged care did not show a significant reduction in acute respiratory infections. A 2025 JAMA Internal Medicine trial of germicidal UV light in long-term care did show a benefit. Different technologies, different implementations, different results.
This JAMDA study lands in exactly that gap. It tests a specific technology (continuous hydroxyl radical generation driven by UV-C), in a specific real-world setting (an occupied LTCF unit with medically complex residents), with a concurrent control, over a full 24-month window. It is precisely the kind of evidence the sector has been asking for.
Three things make this study especially relevant for operators and medical directors:
On April 1, 2026, McKnight’s Long-Term Care News – the daily news outlet that sits on the desks (and phones) of long-term care operators, administrators, medical directors, and DONs across the country published its own coverage of the study. Reporter Foster Stubbs summarized the core finding plainly: infections dropped from about 1.88 per resident-year in 2022 to 0.98 in 2023 in the intervention unit, while rates remained stable in the control unit.
He also quoted the authors’ own framing: “Continuous air disinfection may complement infection prevention bundles and mitigate respiratory infectious burden during seasonal surges. Because the technology is designed for use in occupied rooms, it may be operationally feasible for high-risk, resource-constrained long-term care environments.”
That matters. When peer-reviewed evidence is one thing and industry consensus is another, coverage in a trade outlet like McKnight’s is often where the second begins. It’s how a finding moves from “interesting research” to “something we should be evaluating.” For medical directors writing policy, administrators planning capital budgets, and corporate infection preventionists standardizing protocols across portfolios, this is the moment the conversation shifts.
We’ve built our technology on a simple thesis: the air in a healthcare space is a continuously renewed reservoir of pathogens, and it needs a continuously active control. Batch treatments whether UV after hours, fogging between occupants, or filters that only clean air that happens to pass through them can’t address what’s happening in the breathing zone of an occupied room in real time.
Continuous hydroxyl radical generation addresses that gap directly. Hydroxyl radicals are the same oxidative species the earth’s atmosphere uses to break down airborne contaminants. Producing them at low, safe concentrations inside an occupied room, 24 hours a day, creates a persistent environmental pressure against airborne pathogens without asking anything of the staff or the residents.
Published industry estimates place the fully-loaded cost of a clinically managed LTC infection in the $3,000 to $8,000+ range, with the wide band reflecting variation in severity, transfer rates, and facility characteristics.³,⁴,⁵
Applied to the JAMDA study’s observed reduction:
| Facility size | Infections prevented/year (JAMDA rate) | Annual cost avoidance (conservative range) |
| 60 beds | ~54 | ~$162,000 – $432,000 |
| 120 beds | ~108 | ~$324,000 – $864,000 |
| 250 beds | ~225 | ~$675,000 – $1.8M |
| 1,000-bed operator | ~900 | ~$2.7M – $7.2M |
These ranges reflect direct costs only. Indirect impacts survey findings, agency staffing premiums during outbreaks, admission depression following publicized outbreaks, SNF VBP readmission penalties⁹ are real but facility-specific and harder to generalize.
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Respiratory season. The reductions in the JAMDA study were concentrated in chest and viral infections¹ exactly the categories that surge October through March. Facilities beginning evaluation in spring can be operational before the next respiratory season.
Survey pressure. CMS and state surveyors continue to focus on infection-prevention infrastructure.⁶ Peer-reviewed evidence for an environmental control layer strengthens a facility’s documented program.
Multi-site timing. For corporate operators, standardized portfolio rollout typically takes 6–12 months. Starting now means deployment ahead of winter 2026–27.
We help infection-prevention committees, medical directors, and operations teams evaluate whether continuous hydroxyl radical air disinfection fits their facility’s infection-prevention architecture. We’ll run the numbers on your facility and walk your team through the evidence.
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This is what we’ve been building toward. The evidence now says it works. The industry is starting to see it. Every data point in that reduction is a resident who didn’t spike a fever, a family that didn’t get a hospital call, and a care team that stayed in the work of care instead of the work of crisis. The question for every operator reading this isn’t whether continuous air disinfection belongs in the long-term care toolkit it’s how quickly you can get it in place before the next respiratory season.
Read the McKnight’s coverage: Continuous air disinfection reduced respiratory symptoms among older residents, study finds — McKnight’s Long-Term Care News, April 1, 2026.
Read the full study: Nahgulevich T, Kashy L, Davidov O, Levy Y, Svirsky B, Manor Y, Grotto I. Continuous Hydroxyl Radical Air Disinfection and Infection Outcomes in a Geriatric Long-Term Care Department: A Prospective Cohort Study. J Am Med Dir Assoc. 2026;27(5):106148. doi: 10.1016/j.jamda.2026.106148
Talk to our team about what continuous air disinfection could look like in your community. We’ll walk you through the study, the technology, and what deployment looks like in your specific environment.
References
Figures in this article reflect published industry estimates and should be interpreted as ranges rather than facility-specific projections. Actual cost avoidance depends on resident acuity, regional cost variables, existing infection-prevention infrastructure, and implementation scope.
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