Indoor air quality (IAQ) is one of those topics that’s easy to underestimate—until a cough spreads across a wing, a resident’s asthma flares up, or a musty smell becomes the “new normal.” In assisted living and nursing facilities, the stakes are higher than in most buildings because residents often have chronic conditions, weaker immune systems, and spend a lot of time indoors. Add in visitors, clinical care, frequent cleaning, and a building that might be decades old, and you’ve got a perfect storm for air quality problems if you’re not proactive.
The good news is that improving IAQ doesn’t have to mean a disruptive, months-long renovation (though sometimes upgrades are worth it). Many of the biggest wins come from consistent maintenance, smart ventilation choices, and a facility-wide culture that treats air like a core part of care. This guide walks through practical steps—some quick, some long-term—to help you reduce contaminants, improve comfort, and support healthier outcomes for residents and staff.
Why indoor air quality matters more in senior care settings
Residents are more vulnerable to everyday airborne irritants
Older adults are generally more sensitive to airborne particles and chemicals. What might be a mild irritation in an office can become a serious trigger in a nursing home: fine particulate matter can aggravate COPD, volatile organic compounds (VOCs) can cause headaches and nausea, and low humidity can dry out mucous membranes that help the body fight infection.
There’s also the reality that many residents have limited mobility and spend more time in their rooms. That means they’re exposed to the same indoor environment for longer stretches each day, so small issues—like a dusty supply vent or lingering cleaning fumes—add up quickly.
Finally, medication regimens and underlying health conditions can make it harder for residents to recover from respiratory illness. Better air quality won’t solve everything, but it can reduce stress on the respiratory system and help create a more comfortable baseline.
Staff performance and retention are tied to comfort and air
IAQ isn’t only a resident issue. Staff members are on their feet, moving between rooms, handling cleaning agents, and working long shifts. If the air feels stale, overly dry, or chemically “sharp,” it can contribute to fatigue, headaches, and more sick days.
Good air quality supports alertness and comfort—two things you want in a care environment. It also affects morale. When a building smells clean (without smelling like chemicals), feels fresh, and doesn’t have hot/cold swings, it sends a message that the facility is well-run and attentive.
From a practical standpoint, fewer odor complaints and fewer comfort calls also reduce the workload on maintenance teams, freeing them up for preventative work instead of constant fire-fighting.
IAQ is part of infection prevention, not separate from it
In senior care, infection prevention is a daily priority. Ventilation, filtration, humidity control, and source control all influence how airborne pathogens move and linger. Even outside of outbreak periods, better ventilation and filtration can reduce the concentration of respiratory aerosols in shared spaces.
This doesn’t replace hand hygiene, surface cleaning, or PPE policies. It complements them. Think of it as another layer in a “stack” of protections—one that works quietly in the background all day long.
When leadership treats air quality as part of clinical risk management (not just building operations), improvements become easier to justify and maintain over time.
Start with a clear picture: assess your building and habits
Do a walkthrough focused on air sources and pathways
Before buying equipment or changing schedules, start with observation. Walk the facility at different times of day and pay attention to odors, humidity, temperature swings, and visible dust. Check areas that often get overlooked: soiled utility rooms, laundry pathways, storage closets, and resident rooms with limited window access.
Also look at how air moves. Are doors typically propped open? Are certain rooms always stuffy? Do you feel a draft under doors or around windows? Air quality is as much about airflow patterns as it is about filtration.
Document what you find and note patterns. For example, if odors spike near shift changes, it might relate to trash handling, laundry movement, or cleaning routines rather than the HVAC system itself.
Measure what you can: CO2, humidity, particles, and pressure
You don’t need a laboratory to get useful data. Portable monitors can track carbon dioxide (CO2) as a proxy for ventilation adequacy in occupied spaces. If CO2 stays high for long periods in lounges or dining rooms, you may need better outdoor air delivery, improved balancing, or scheduling changes.
Relative humidity is another key metric. Too low and you get dryness and irritation; too high and you increase the risk of mold and dust mites. Particulate monitors can help you spot whether certain activities—like vacuuming, laundry handling, or maintenance work—are spiking PM2.5 levels.
In areas with specialized needs (like isolation rooms), pressure relationships matter. Even in non-clinical rooms, pressure imbalances can pull odors from bathrooms or soiled rooms into hallways. If you can’t measure pressure directly, you can sometimes detect issues by noticing persistent odor migration.
Talk to the people who live and work in the building
Residents and frontline staff are often the first to notice air quality issues, even if they don’t use technical language. A resident might say, “My room feels damp,” or “The air feels heavy,” while staff might mention headaches in a particular wing.
Set up a simple feedback channel—something easy like a short form or a logbook for recurring comfort/odor notes. Patterns across multiple reports can point to specific zones or times of day.
When people see their input leading to action, they’re more likely to report early, which helps you address small issues before they become expensive ones.
Ventilation strategies that actually work in real facilities
Prioritize consistent outdoor air and avoid “on-off” ventilation
One of the most common problems in older facilities is ventilation that’s technically present but not consistently delivered. Systems may be scheduled too aggressively to save energy, or outdoor air dampers may be stuck, closed, or poorly controlled.
For resident areas and common spaces, steady ventilation is usually better than cycling. Cycling can lead to periods of stagnant air, especially during high occupancy (like mealtimes or activities). If energy use is a concern, look at options like demand-controlled ventilation in spaces where it makes sense, but be careful: in healthcare-adjacent settings, relying solely on CO2-based control can miss other contaminants.
Make sure outdoor air intakes are clear of obstructions and not pulling in vehicle exhaust or loading dock odors. Something as simple as relocating a smoking area away from intakes can have a noticeable impact.
Balance supply and exhaust so odors don’t travel
Odor complaints are often a pressure problem. If bathrooms aren’t exhausting properly, or if soiled rooms are not kept under negative pressure relative to adjacent corridors, smells can drift and linger.
Start by verifying exhaust fans are working, clean, and actually venting outdoors. Then look at door undercuts and transfer paths. If a room is “too tight” with no pathway for air to move, exhaust won’t perform well, and you’ll get stagnant pockets.
Balancing isn’t glamorous work, but it’s foundational. When airflow direction is correct, you reduce cross-contamination and make the whole building feel fresher without masking odors with fragrances.
Use local ventilation where central systems fall short
Not every facility can overhaul its HVAC quickly. In the meantime, localized solutions can help in targeted areas: portable HEPA units in high-traffic lounges, enhanced exhaust in laundry rooms, or dedicated filtration in therapy gyms.
The key is placement and sizing. A HEPA unit in the corner that’s too small for the room won’t do much. You want enough clean air delivery rate (CADR) to meaningfully reduce particle levels, and you want airflow that doesn’t blow directly at residents (comfort matters).
Local solutions also require maintenance. Filters must be changed on schedule, and staff should understand that a “quiet” unit may still be doing important work even if it’s not obvious.
Filtration upgrades without guesswork
Choose filter ratings based on system capability
Upgrading filters is one of the fastest ways to improve air quality, but it has to be done thoughtfully. Higher-efficiency filters (like MERV 13 and above) capture smaller particles, but they can also increase pressure drop. If your system can’t handle it, airflow may decrease, which can actually make things worse.
Work with an HVAC professional to confirm what your fans and filter racks can support. Sometimes the right move is a moderate upgrade paired with better sealing around filter frames to prevent bypass air (air sneaking around the filter instead of through it).
If you’re unsure where to start, prioritize areas with higher occupancy and more vulnerable residents, then expand facility-wide as you confirm performance.
Prevent filter bypass and sloppy installs
A high-rated filter installed poorly is a missed opportunity. Gaps around the filter frame can allow unfiltered air to pass through, carrying dust and particles into the supply ducts. Over time, that dust can accumulate on coils and in ductwork, reducing efficiency and increasing odor issues.
Train maintenance staff (or vendors) to check for proper fit, correct orientation, and intact gaskets. Keep a simple checklist near mechanical rooms so the process is consistent even when staffing changes.
Also pay attention to filter change intervals. In facilities with lots of laundry lint, construction activity nearby, or seasonal pollen, filters may load faster than expected.
Consider supplemental filtration in problem zones
If certain wings have chronic dust or odor issues, supplemental filtration can help while you investigate root causes. Portable HEPA units are a common choice, but there are also in-duct options like upgraded filter banks or add-on air cleaners.
When using portable units, make them part of a documented plan: where they go, how fast they run, and who changes filters. A unit that’s turned off because it’s “too loud” won’t help anyone.
Supplemental filtration works best when paired with source control—otherwise you’re constantly cleaning up what you could have prevented.
Humidity control: the overlooked lever for comfort and health
Find a realistic target range and monitor it
Humidity is a balancing act. Low humidity can increase throat and nasal irritation and may make some respiratory infections more likely to spread or feel worse. High humidity, on the other hand, encourages mold growth and can make spaces feel clammy.
Many facilities aim for a mid-range relative humidity that supports comfort without increasing moisture risks. The right target can vary by climate, building envelope, and resident needs—so it’s important to monitor and adjust rather than rely on a single “set it and forget it” number.
Use simple sensors in representative zones, not just one sensor in a mechanical room. Resident rooms, dining areas, and therapy spaces can behave very differently.
Stop moisture at the source before it becomes a mold problem
Humidity control isn’t only about HVAC settings. It’s also about water management: leaks behind walls, condensation on cold surfaces, wet carpet from spills, or steam from laundry areas that isn’t properly exhausted.
Have a rapid response plan for water events. The faster you dry materials, the lower the chance of mold. This means having fans, dehumidifiers, and clear procedures ready—especially in older buildings where hidden leaks can go unnoticed.
Also check for chronic condensation on windows and exterior walls. That’s often a sign of insulation gaps, air leakage, or ventilation issues that should be addressed before mold takes hold.
Coordinate housekeeping practices with humidity goals
Cleaning is essential, but it can unintentionally add moisture and chemicals to the air. Wet mopping large areas without adequate ventilation can raise humidity, especially in winter when windows stay closed.
Consider using microfiber systems and controlled-dilution cleaning products that reduce excess water and chemical overuse. Make sure housekeeping closets have proper ventilation and that wet supplies aren’t stored in a way that encourages mildew.
When housekeeping and maintenance teams share the same humidity goals, you reduce the “push-pull” where one team fixes what another accidentally worsens.
Cleaning products, odors, and VOCs: keeping “clean” from smelling harsh
Pick low-VOC products and standardize dilution
A strong “clean smell” often comes from VOCs and fragrances, not cleanliness. In senior care environments, heavy scents can trigger headaches, nausea, or respiratory irritation, and some residents may be especially sensitive.
Switching to low-VOC, low-fragrance products can make a noticeable difference. Equally important is dilution control. Over-concentrated cleaning solutions increase airborne chemicals and leave residues that can continue off-gassing.
Use closed-loop dilution systems where possible, and train staff on why “more” isn’t better. Consistency protects residents, staff, and surfaces.
Time high-odor tasks when fewer people are around
Some tasks—floor stripping, painting touch-ups, adhesive use—are inherently smelly. The goal isn’t to avoid them forever; it’s to plan them. Schedule higher-odor work during lower-occupancy times, and increase ventilation during and after the task.
If a wing has residents with respiratory sensitivity, consider temporarily relocating them or using localized filtration to reduce exposure. Communicate ahead of time so residents and families aren’t surprised by changes in smell or airflow.
Small scheduling tweaks can reduce complaints dramatically without changing the scope of work.
Control odors with source fixes, not masking sprays
Odor masking is tempting because it’s fast. But in care settings, fragrance sprays can add irritants and mix poorly with other smells. Residents may interpret strong fragrances as “something is being covered up,” which can erode trust.
Instead, chase the source: improve bathroom exhaust, fix plumbing traps, clean floor drains, address damp materials, and ensure trash is sealed and moved promptly. If you need odor control, use approaches designed for healthcare environments that neutralize rather than perfume.
When you solve odor sources, you usually improve air quality at the same time—two wins for one effort.
HVAC maintenance routines that prevent air quality drift
Keep coils, drain pans, and condensate lines clean
Even with good filters, HVAC components can become contamination sources. Dirty coils reduce efficiency and can harbor microbial growth. Clogged drain pans and condensate lines can lead to standing water—an invitation for mold and bacteria.
Build coil inspections and drain maintenance into a predictable schedule. If you’re seeing recurring slime or odors, it may indicate poor filtration, excessive humidity, or insufficient drainage slope.
Document findings and corrective actions. Over time, this helps you spot whether problems are seasonal, equipment-specific, or related to building use changes.
Inspect ductwork and diffusers where dust accumulates
Visible dust around diffusers isn’t always a sign of dirty ducts, but it is a sign that particles are present and that airflow patterns may be depositing them. Check diffuser cleanliness, ceiling tiles around vents, and return grilles—especially near laundry areas or entrances where outdoor dust comes in.
If you suspect duct contamination, investigate why. Duct cleaning without addressing root causes can become a recurring expense. Often the real fix is better filtration, sealing, or controlling dust sources (like entry mats and housekeeping practices).
Also watch for disconnected ducts or damaged insulation in mechanical spaces. Those issues can pull in dusty air from attics or crawlspaces.
Don’t forget outdoor air intakes and exhaust terminations
Outdoor air intakes can collect leaves, debris, and even bird nesting materials. If screens are damaged or missing, you can end up with contaminants entering the system. Regular intake inspections are simple and pay off quickly.
Exhaust terminations matter too. If exhaust is short-circuiting back into an intake (because they’re too close or wind patterns push air back), odors and contaminants can re-enter the building.
These are the kinds of “outside the building” checks that get missed—until someone notices the facility smells like the loading dock.
Construction, renovations, and repairs without the dust drama
Use containment and negative pressure for any dusty work
Even small repairs—cutting drywall, sanding, drilling—can release fine particles that travel farther than you’d expect. In facilities where residents have respiratory vulnerabilities, dust control needs to be non-negotiable.
Set up containment barriers, use HEPA-filtered negative air machines, and establish clean pathways for workers and materials. The goal is to keep dust from entering corridors and returns where it can spread through the HVAC system.
Also plan for after-work cleanup. A quick sweep isn’t enough; use HEPA vacuums and wipe surfaces to capture fine particles that settle invisibly.
Choose low-emitting materials when possible
Flooring adhesives, paints, sealants, and composite wood products can off-gas VOCs for days or weeks. When you’re selecting materials for resident rooms or common areas, low-emitting options can reduce complaints and improve comfort.
Ask vendors for product data and consider scheduling time for “flush-out” ventilation after installation. Even a couple of days of increased outdoor air can reduce lingering odors.
If you’re replacing flooring, think about maintenance too. Some surfaces require harsher chemicals to keep clean, which can create an ongoing IAQ burden.
Partner with teams that understand occupied healthcare-like environments
Working in an assisted living or nursing facility is different from working in an empty commercial space. You need contractors and maintenance partners who understand infection control, resident sensitivity, and the logistics of keeping life normal while work happens.
This is where experience in construction & property maintenance for senior care environments can make a real difference—especially when the work involves phasing, containment, and coordination with clinical operations.
If you’re planning a renovation or expansion, it can help to look at examples of similar work to understand what’s possible without disrupting care; you can see our senior living projects to get a feel for how experienced teams approach these settings.
Room-by-room tactics: where air quality problems hide
Resident rooms: control comfort, reduce irritants, respect preferences
Resident rooms are personal spaces, and that means they come with unique sources: personal care products, perfumes, hobby materials, and sometimes small appliances. While you can’t (and shouldn’t) sterilize personal life out of a room, you can reduce irritants by ensuring good airflow, clean diffusers, and prompt response to moisture issues.
Pay attention to rooms that are frequently closed up. If doors stay shut and windows don’t open, ventilation becomes even more critical. Consider quiet supplemental filtration for residents with respiratory conditions, and make sure staff know how to operate it.
Also consider soft goods. Upholstered chairs, curtains, and carpets can hold odors and dust. Regular cleaning schedules and prompt attention to spills can prevent “stale room” complaints.
Bathrooms and soiled utility rooms: keep the airflow direction right
Bathrooms should generally be exhausting consistently. If exhaust is intermittent or weak, odors and humidity can migrate into bedrooms and hallways. Check fan operation, clean grilles, and verify that exhaust actually vents outdoors.
Soiled utility rooms are high-risk for odor and airborne contaminants. Keeping these spaces under negative pressure relative to adjacent corridors helps contain smells and reduces spread. Simple fixes like ensuring doors close properly and that exhaust is not disabled can have a big impact.
Don’t overlook floor drains and plumbing traps. A dry trap can allow sewer gases into the building. Regularly priming drains (or installing trap primers) can prevent recurring odor mysteries.
Laundry areas: lint, humidity, and chemical exposure
Laundry operations generate lint (fine particles), heat, and moisture. If dryers aren’t venting properly, you can get humidity spikes and a “warm, damp” smell that drifts into nearby spaces. Lint buildup is also a safety issue.
Make sure dryer vents are cleaned on schedule, filters are maintained, and the room has adequate exhaust and makeup air. If staff report that the laundry room feels stuffy, it’s often a ventilation imbalance.
Also consider chemical handling. Detergents and disinfectants used in laundry can contribute to VOCs. Proper storage and ventilation in chemical areas reduce exposure and improve comfort.
Kitchens and dining rooms: manage peaks and keep air pleasant
Food service areas can have dramatic air quality swings. Cooking generates particles and odors, and dining rooms can see high CO2 levels during peak occupancy. If ventilation doesn’t keep up, the space can feel heavy and warm.
Ensure kitchen hoods are properly maintained and that grease filters are cleaned regularly. A hood that’s underperforming doesn’t just leave odors—it can increase particulate levels that drift into adjacent areas.
In dining rooms, consider ventilation scheduling that aligns with meal times. If you can boost outdoor air before and during meals, the space will feel noticeably fresher.
Smart monitoring and policies that keep improvements from fading
Create an IAQ playbook your team can actually use
One-off fixes are great, but long-term results come from repeatable routines. An IAQ playbook can be simple: target humidity ranges, filter change schedules, response steps for odor complaints, and protocols for water events.
Keep it practical and role-based. Housekeeping doesn’t need the same details as HVAC technicians, but they do need to know which products are approved, how to report moisture, and why fragrance masking isn’t the go-to solution.
When everyone shares the same playbook, you reduce inconsistent decisions that slowly degrade air quality over time.
Use dashboards to catch problems early
If you already have a building automation system (BAS), consider adding trend logs for humidity, supply air temperature, and outdoor air damper positions. If you don’t, portable sensors can still provide useful data—especially if you review it weekly.
The value of monitoring isn’t just “numbers.” It’s noticing drift: a wing that’s slowly getting more humid, or a lounge that always has elevated CO2. Those trends can point to equipment issues before they become comfort complaints or mold problems.
Share a simplified version of the data with leadership so IAQ stays visible as an operational priority, not just a maintenance detail.
Train staff on the small behaviors that impact air
Air quality is affected by daily habits: propping doors open, blocking supply vents with furniture, storing wet mops in closets, overusing cleaning chemicals, or turning off noisy exhaust fans.
Short, recurring training works better than a once-a-year lecture. A 10-minute huddle that explains “why this matters” can change behavior quickly—especially if staff understand it supports resident comfort and reduces illness spread.
Encourage staff to report issues early. A small leak or a persistent odor in one room is easier to fix than a full wing that smells musty.
When it’s time to bring in outside help (and what to ask for)
Know when the problem is bigger than a quick fix
If you’re dealing with recurring mold, persistent odors that return after cleaning, or ongoing comfort complaints across multiple zones, it may be time for a deeper assessment. That could include HVAC balancing, building envelope review, or a ventilation redesign.
Facilities that have undergone multiple renovations over the years can have complicated airflow paths—ductwork changes, closed-off returns, or equipment that no longer matches the building’s needs. In those cases, “more filters” won’t solve the root cause.
It’s also worth getting help if you’re planning a major renovation while staying occupied. Dust control, phasing, and ventilation planning are specialized skills.
Ask for a plan that blends operations, maintenance, and resident experience
The best IAQ improvements consider the whole ecosystem: clinical schedules, housekeeping routines, visitor traffic, and equipment limitations. When evaluating vendors, ask how they’ll minimize disruption, how they’ll verify results, and how they’ll train your team to maintain gains.
Look for clear deliverables: airflow measurements, filter recommendations tied to actual fan capacity, humidity strategy, and a maintenance schedule that’s realistic for your staffing levels.
If you’re comparing service partners for ongoing support beyond a single project, it can help to view all our property services and use that as a checklist for the kinds of ongoing maintenance and improvement capabilities that matter in senior living environments.
Verify results with follow-up, not just a final walkthrough
Air quality improvements should be verified after changes are made. That might mean repeating CO2 and humidity measurements, checking particulate levels, or simply confirming that odor complaints decrease over time.
Plan a 30- to 90-day follow-up after major changes. Filters may load differently than expected, setpoints may need adjustment, and staff may need reminders about new procedures.
Think of IAQ like any other care-supporting system: it benefits from continuous improvement, not a one-time “fix and forget.”
Practical next steps you can start this month
Pick three high-impact actions and do them consistently
If you’re not sure where to begin, choose three things that are both impactful and manageable. For many facilities, that looks like: (1) verifying outdoor air damper function and ventilation schedules, (2) tightening up filter installation and change intervals, and (3) improving bathroom and soiled room exhaust performance.
These steps don’t require a full renovation, but they can noticeably reduce stuffiness and odors. They also build momentum and trust with residents and staff because improvements show up quickly.
Once those are stable, you can layer in monitoring, localized filtration where needed, and longer-term equipment upgrades.
Make IAQ part of routine rounds
Add a few air-quality checks to existing rounds: look for blocked vents, listen for exhaust fan operation, check for condensation, and note any unusual odors. The goal is to catch small issues early.
Encourage staff to mention air comfort the same way they’d mention lighting or temperature. When air quality becomes a normal topic, it stops being a “mystery problem” and becomes a manageable part of building health.
Over time, these small habits reduce emergency calls and help you plan upgrades strategically rather than reactively.
Communicate improvements to residents and families
Families care deeply about the environment their loved ones live in. Sharing what you’re doing—filter upgrades, ventilation checks, humidity monitoring—builds confidence and reduces anxiety when the facility needs to do maintenance work.
Keep the message simple and resident-focused: fresher air, fewer odors, better comfort, and support for respiratory health. You don’t need to overwhelm people with technical details to be transparent.
When residents and families understand that air quality is being actively managed, they’re more likely to partner with you on things like fragrance sensitivity, keeping vents clear, and reporting issues early.