Certain HVAC Solutions May Reduce Airborne Infection in Long Term Care 

Infections are the leading cause of death in Long Term Care facilities, accounting for 380,000 deaths annually,1 including influenza, pneumonia and others. Pathogen-carrying droplets or aerosol particles and poor indoor air quality have taken center stage in today’s fight against infection control and prevention in healthcare facilities. It’s crucial to consider modifications to airflow as well as clinically effective HVAC solutions that may reduce the risk of airborne transmission in Senior Living communities.

Let’s evaluate three different HVAC solutions for better infection prevention and improved indoor air quality. These are:

  1. Dilution & Filtration
  2. Ultraviolet Germicidal Irradiation (UVGI)
  3. Needlepoint Bipolar Ionization (NPBI)

HVAC Solution #1: Dilution and Filtration for Particulate Matter Reduction

According to ASHRAE: “Ventilation and filtration provided by heating, ventilating, and air-conditioning systems can reduce the airborne concentration of [viruses] and thus the risk of transmission through the air.”3

Dilution reduces the concentration of particles and pathogens in the air in an indoor space. This can be accomplished simply by opening windows or by adjusting HVAC system air change rates to increase exhaustion of indoor air while bringing in outdoor air. While fresh air doesn’t kill viruses, it dilutes their concentration and reduces the level of exposure for residents, making infections less likely.



Senior Living COVID-19 HVAC


  • Cost-effective
  • Thoroughly tested, documented and well understood


  • Unconditioned spaces can cause thermal stress to vulnerable seniors and increase risk of infection
  • Increasing outdoor air intake in high-pollutant areas can contribute to poor air quality
  • Full make-up air capabilities not standard on many Senior Living HVAC systems
Filtration goes a step further to trap particles and pathogens from outside or recirculated/conditioned air in a filter as they pass through an HVAC system. This is available on most air handlers and as a thin filter for dust on PTACs.

  • Minimum Efficiency Reporting Values (MERV) ratings are a measure of a filter’s ability to capture particles 0.3 to 1.0 microns. MERV values are not standard and will vary from one brand to the next, so it’s important to check brand, system and compatibility. Find MERV Filters here.
  • High Efficiency Particulate Air (HEPA) filters are a type of pleated mechanical air filter and can theoretically remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns. The diameter specification of 0.3 microns responds to the most penetrating particle size (MPPS).4 Generally, your HVAC system needs to be compatible with a HEPA filter or it may not work as effectively. More system power would then be required, resulting in increased energy bills and extra strain and maintenance on your system. Find HEPA filters here.


MERV Filter Indoor Air Quality COVID-19


  • Cost-effective
  • Traps particles and pathogens
  • Thoroughly tested, documented and well understood
  • Enhanced effectiveness when combined with other IAQ technologies like NPBI


  • Does not trap VOCs (odors)
  • Requires regular replacement
  • May decrease HVAC system efficiency if HEPA or higher MERV rating filters are installed

CMP Funding Available now for Indoor Air Quality Improvements

Right now, the Civil Monetary Penalties Reimbursement Program has made available up to $3,000 in funds for air purification and filtration technologies. This funding is available on a first come, first served basis.

Act now to secure your funding today.

HVAC Solution #2: Ultraviolet Germicidal Irradiation (UV-C) for Disinfection

Ultraviolet light has long been known for its disinfection properties. UV-C products emit a specific band of UV light (radiation) that can break down pathogens, and is available in many applications to treat water, surfaces and indoor air. It can be installed in several ways.

Resident Rooms ‒ this portable option can be put into an unoccupied resident room to periodically disinfect surfaces
Cabinets ‒ this large cabinet sucks air through and past UV lights for periodic disinfection; residents may be in the room, but the unit is loud
Upper Room ‒ this positions light at the upper ceiling, giving some benefit at all times, but needs circulation to help ensure contaminated air reaches the unit

UV-C in HVAC Air Handler Units

UV-C for healthcare HVAC systems is typically installed near the primary air conditioning coil. Most airborne pathogens that the UV light is concentrated on or that pass within the UV bulb’s line of sight can be destroyed, and its positioning near the coils provides added sterilization of condensation that forms on coils and fins. Combining with filtration to remove passing dead pathogens makes for an even more effective solution.

UVGI Air Handler HVAC Infection Prevention COVID-19


  • Proven effective 
  • ASHRAE recommended
  • Doesn’t affect system efficiency and airflow
  • Won’t damage unit coils
  • Energy efficient


  • Requires regular cleaning and replacement to maintain efficacy
  • Reactive: only kills what it “sees”
  • Harmful: precautions required to avoid exposure to skin and eyes

HVAC Solution #3: Needlepoint Bipolar Ionization (NPBI™) for More Efficient Filtration

Installed into new or existing HVAC systems, including rooftop units and PTACs, NPBI creates and releases ions into the airstream using your existing HVAC system as the delivery method. When these ions disperse throughout a space, they seek out and form bonds with particles in the air through a process called agglomeration. This creates a snowball effect in which particles begin to cluster together. The larger a cluster of particles becomes, the easier it is for your system to filter it out of the air.
Needlepoint Bipolar Ionization Indoor Air Quality Technology
Unlike some other solutions, NPBI technology addresses indoor air quality in the HVAC system and in the occupied space, as ions are carried by a building’s ventilation system into occupied spaces. Combined with filtration, it is a cost-effective solution for delivering the clean air benefits of ionization.


  • Lab tested to kill or inactivate many viruses, including SARS-CoV-2 
  • Proactive: ions are sent into spaces to find and inactivate pathogens
  • Doesn’t affect system efficiency and airflow
  • Won’t damage unit coils
  • Energy efficient
  • No maintenance required


  • Some older versions of ionization technology could create harmful ozone; confirm with the manufacturer that their technology is certified to not create ozone (Note that Direct Supply’s bipolar ionization technology is UL 2998 Certified to be ozone-free)

Want to learn more about Indoor Air Quality, HVAC Solutions, and Infection Prevention?

Watch our IAQ in Long Term Care Webinar, available now on-demand.

Ready to learn more about HVAC Solutions for better infection prevention in your facility? Call 888-433-3224 or learn more about an Indoor Air Quality solution for your Senior Living communities from Direct Supply.

1 “Long-Term Care Facilities | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, https://www.cdc.gov/longtermcare/index.html. Accessed 25 June 2020.

2 Times, The New York. “43% of U.S. Coronavirus Deaths Are Linked to Nursing Homes.” The New York Times, 27 June 2020, www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html. Accessed 30 June 2020.

3 “COVID-19: Resources Available to Address Concerns.” Home | Ashrae.Org, https://www.ashrae.org/technical-resources/resources. Accessed 25 June 2020.

4 “What Is a MERV Rating? | Indoor Air Quality (IAQ) | US EPA.” US EPA, 19 Feb. 2019, https://www.epa.gov/indoor-air-quality-iaq/what-merv-rating-1.

5 Inactivation results based on sensitivity testing conducted by independent third-party testing laboratory using control chambers. Multiple data points are used to formulate performance validation statements. The technology is used in a wide range of applications across diverse environmental conditions. Results in non-lab environments will vary; clients should evaluate their individual application and environmental conditions when making an assessment regarding the technology’s potential benefits. For all independent laboratory results, contact your TELS representative. The use of this technology is not intended to take the place of reasonable precautions to prevent the transmission of pathogens (including COVID-19). Comply with all applicable public health laws and guidelines as well as CDC guidance.