Guide to Medical Waste Segregation in Long-Term Care Health Care Facility’s

Introduction: Why Waste Segregation Matters in Long-Term Care

Waste management is complicated for long-term care facilities and nursing homes. These healthcare environments produce multiple kinds of waste daily while caring for their residents in an essential way. Proper segregation is more than just a regulatory requirement. In fact, it is essential for resident safety, staff well-being and environment as it goes from regular non-hazardous trash up to potentially dangerous Regulated Medical Waste (RMW).

On average, one Long-term care facility generates around 15-20 pounds of waste per resident per day, based on recent industry data. When not handled properly, that waste can also result in legal liability (failure to comply with the standards at your level of care), higher disposal fees — and the biggest risk of all — risk and safety for residents and caregivers.

Secure Waste has enabled hundreds of long-term care facilities across the U.S. to achieve successful waste segregation programs that safeguard people, protect our planet, and improve the financial bottom line. Our experience managing the disposal of Regulated Medical waste has enabled our clients to reduce disposal costs by as much as 30% without sacrificing the requirements and safety standards.

Overview of Long-Term Care Waste Segregation: This in-depth article will explain the nuances of waste segregation in long-term care facilities and suggest steps to make your facility’s waste management program more effective.

Understanding Waste Classifications in Long-Term Care Environments

Non-Regulated Waste: More Than Meets the Eye

Alarmingly, about 85% of the waste in long-term care facilities is non-regulated waste—stuff we encounter often (paper, cardboard, food waste, trash). Many facilities do not realize that 60% to 80% of this non-hazardous waste stream can be recycled, creating vast opportunities for sustainability projects and cost savings.

Non-regulated waste typically includes:

• Administrative paper waste
• Food packaging
• Resident personal items
• Non-contaminated gloves and masks
• Maintenance materials
• Food waste

Implementing high-quality recycling programs for non-hazardous waste can significantly reduce long-term care facilities’ environmental liabilities, and there is even potential for lowering disposal costs.

Regulated Medical Waste (RMW): The Critical Category

Regulated medical waste (RMW or biomedical waste) is regulated because it can transmit infection or cause injury. RMW is a small portion of the overall waste stream, generally 8-10% of what a long-term care facility produces, but a significant percentage of the total costs associated with waste management and regulatory compliance.

Common examples of RMW in long-term care settings include:

• Blood-soaked bandages and dressings
• Used sharps (needles, lancets, etc.)
• Cultures and stocks from lab procedures
• Isolation waste from infectious patients
• Contaminated PPE
• Pathological waste

RMW is not a small matter to know what can and can not be included in it so that if non-regulated items are thrown out as medical waste (needlessly high costs) or regulated waste is not managed like regular garbage resulting in tremendous compliance problems.

Hazardous Waste Considerations

Apart from RMW, the long-term care facility also has hazardous waste needing special disposal mechanisms in place for them. Due to the chemical nature of these materials, the risks are not biological and instead come in the form of the following items:

• Certain pharmaceuticals
• Chemotherapy waste
• Mercury-containing devices
• Some cleaning chemicals
• Aerosol cans
• Electronic waste

Since each hazardous waste category has different disposal requirements, the facilities need to segregate in that manner to avoid environmental hazards and comply with the laws.

Best Practices for Regulated Medical Waste Segregation

Sharps Waste Management: Preventing Injuries and Infections

Sharps waste is one of the most excellent risked categories of RMW, since they have the potential to cause physical harm and pose a risk of bloodborne pathogens.

Dedicated containers, including the proper sharps management:

• Puncture-resistant
• Leakproof
• Clearly labeled with the biohazard symbol
• Accessible where sharps are used
• Never filled beyond the fill line (typically 75% capacity)

Secure Waste offers FDA-cleared sharps containers that are the perfect size for each care area throughout your facility in various sizes.

We have reusable container programs that will help long-term care facilities save money and the environment and be safer.

Red Bag Waste: Beyond the Basics

Bio-waste that does not belong in the red bag (i.e. not sharps but still needs special treatment) Red bag waste. Although what goes in the red bags is not defined to be exactly the same from state to state, this is how they are normally defined as a general principle:

• Items saturated or caked with blood or body fluids
• Items that would release blood or body fluids if compressed
• Pathological waste

Common mistakes in red bag waste management include:

1. Overclassification: Placing non-contaminated items in red bags, significantly increasing disposal costs
2. Overloading: Filling bags beyond their weight capacity, creating rupture risks
3. Improper closure: Failing to securely tie bags, potentially exposing staff to contents
4. Inadequate container placement: Not having containers readily accessible in appropriate locations

The full facility assessment by Secure waste determines the right type and size bins so that accessibility is on par, while keeping costs a factor.

PPE Disposal: A Post-Pandemic Perspective

Personal Protective Equipment (PPE) use spiked sharply in long-term care facilities as a result of the COVID-19 pandemic, causing fresh problems for waste management. Recommended best practices for PPE disposal at this time are:

• Contaminated PPE: If visibly soiled with blood or body fluids, dispose of as RMW in red bags
• Non-contaminated PPE: Regular trash is appropriate for masks, gloves, and gowns used for standard precautions
• Special considerations: Some states implemented temporary requirements for treating all PPE used in COVID-19 care as RMW; check current local regulations

Clear guidance on what is and isn’t contamination that requires red bag disposal versus what can be regularly discarded amongst staff of course underpins the most cost-efficient PPE disposal.

Pharmaceutical Waste: Beyond the Flush

Long-term care institutions face specific challenges associated with pharmaceutical waste management, having a large amount of prescription medications prescribed to the many patients and potential unused/ expired meds. Proper separation of pharmaceutical wastes is:

• Hazardous pharmaceuticals: Require specific containers and disposal methods (e.g., certain chemotherapy drugs, nicotine products)
• Non-hazardous pharmaceuticals: Should be segregated from other waste but don’t require hazardous waste protocols
• Controlled substances: Subject to DEA regulations requiring documentation of destruction

Improper disposal of pharmaceuticals can result in water supply contamination and liability concerns. Secure Waste pharmaceutical waste program is a solution that complies with all federal, state and local regulations including the specific drug profile of your facility such as collection vehicles and regular collection compacts.

Special Considerations for Post-Pandemic Waste Management

Lessons from COVID-19: Balancing Safety and Efficiency

COVID-19 pandemic presented waste management in long-term care facilities with never before seen difficulties. Some facilities faced significant jumps (600–900%) in volume of waste as a result of improved infection control and PPE use.

As the CDC, waste from COVID-19 care is not typically subject to additional disinfection or special handling beyond routine protocols for RMW. But some state regulations did impose temporary changes that facilities had to move toward handling specific waste streams more differently.

Key lessons from pandemic waste management include:

• The importance of scalable waste management solutions
• The need for clear staff guidance to prevent overclassification
• The value of having a knowledgeable waste management partner

Secure Waste enabled many of the facilities to deal with these challenges by keeping current regulatory guidance and a stable service available as waste volumes popped.

Avoiding Unnecessary Overclassification

Overclassification (treating non-regulated waste as RMW) is one of the most frequent and expansive mistakes in medical waste management One of the most expensive mistakes in waste management is overclassification during a pandemic — many facilities err on the side of caution and throw most waste in red bags for disposal at full price, even at the peak.

Current best practices recommend returning to standard waste segregation protocols:

• Regular trash for non-contaminated items
• RMW only for items meeting specific biological hazard criteria
• Clear visual guides at disposal points to aid staff decision-making

Waste assessment services at Secure Waste allow for identifying opportunities to increase efficiency of the classification and this can lead to RMW volumes of 20–40% less without loss of safety or compliance.

Common Challenges and Practical Solutions

Staff Turnover and Training Considerations

Staff turnover in long-term care produces a sustainability challenge for ensuring waste segregation compliance. New hires may not be entirely familiar with what the proper protocol is and even older staff can benefit from refresher on best practices.

Effective waste segregation training should:

• Occur during initial orientation
• Be reinforced through periodic updates (at least annually)
• Include practical demonstrations and visual aids
• Address common mistakes specific to long-term care settings
• Explain the “why” behind segregation requirements

Secure Waste also provides educational resources which can include online modules, printables and in-person facility specific training. By training our education programs the goal is to make sure that ALL staff (direct care to housekeeping) knows how to properly segregate waste.

Space Constraints and Container Placement

Many long-term care facilities run a tight space race when it comes to waste container locations. Consider strategic placement so you can find a balance between accessibility and aesthetics/practicality.

Best practices include:

• Conducting a workflow analysis to identify key waste generation points
• Right-sizing containers based on volume needs
• Considering wall-mounted options where floor space is limited
• Ensuring clear labeling and signage
• Regular auditing of container usage and adjustment as needed

The facility assessment at Secure Waste maps out waste generation and suggests the right types and sizes of bins for desired degree of efficiency in combination with minimising them to care spaces.

Compliance Monitoring and Documentation

Ongoing compliance monitoring is important for waste management regulatory requirements in healthcare settings to overall, be carried out. Essential for Documentation Practices include:

• Maintaining training records for all staff
• Tracking waste volumes by category
• Retaining manifests and proof of proper disposal
• Documenting regular compliance audits
• Having written policies and procedures for waste management

Secure Waste is a full-service compliance provider for any and all your compliance support needs, including manifest tracking, regulatory updates, audit readiness and more to keep your facility compliant with applicable requirements-wholeheartedly.

Implementing an Effective Waste Management Program

Key Components of a Comprehensive Program

A long term care effective waste management program is not just about container placement and schedules for pick-ups. Comprehensive programs are:

1. Facility-specific waste assessment to identify unique needs and challenges
2. Customized container placement optimized for workflow efficiency
3. Regular staff education on proper segregation practices
4. Clear visual guidance at disposal points
5. Ongoing compliance monitoring and documentation
6. Regular program evaluation and adjustment
7. Cost analysis and optimization strategies

Secure Waste works with facilities to design and deliver programs around each of these components, delivering entire waste management services — not just collection services.

Working with a Specialized Waste Management Partner

When it comes to long-term care facilities, selecting a medical waste management partner is everything. When assessing prospective partners we need to consider:

• Regulatory expertise: Deep understanding of federal, state, and local requirements
• Healthcare specialization: Experience with the unique needs of long-term care
• Service reliability: Consistent, dependable collection schedules
• Emergency response capabilities: Ability to address unexpected waste volume increases
• Education and support resources: Training materials and compliance guidance
• Environmental responsibility: Commitment to sustainable disposal practices
• Cost transparency: Clear pricing without hidden fees

Why Partner with Secure Waste for Your Long-Term Care Facility

For over the past decade, Secure Waste has emerged as a leader in Regulated Medical Waste services to long-term care facilities across the United states. Our unique tactics are as follows:

• Comprehensive compliance guarantee: We stay current on all regulatory requirements so you don’t have to
• Custom container programs: Tailored to your facility’s specific waste profile and space constraints
• Flexible service schedules: Regular pickups adjusted to your needs, with emergency service available
• Staff education resources: Online and in-person training options to support your compliance efforts
• Cost optimization strategies: Identifying opportunities to reduce waste volumes and associated costs

Our recommended path invariably reduces waste management costs by 15–30% with clientsSeeing the same benefits of compliance and safety

Conclusion: Taking the Next Step in Waste Management Excellence

No, that is just waste segregation in a long term care facility and it is more than a regulatory requirement – but an imperative for resident safety, staff protection and operational efficiency over the long term. By adopting the 11 best practices in this guide and partnering with experts in Regulated Medical Waste management, your facility will be at the top of compliance while also bringing down costs to a great extent.

Secure Waste – Tailored waste solutions for newly constructed long-term care facilities and one-of-one’s anywhere your unique challenges face. Our team of professionals is standing by to evaluate your current habits, expose opportunities for enhancement, and help you put action in place benefiting people, planet and your business.

Ready to get wasted waste segregation right in your facility? Call Secure Waste at 877-633-7328 or go to www.securewaste.net to schedule your complimentary waste audit and consultation today.