LTC-CIP Format and Content Areas: Official Outline Guide

What is the LTC-CIP exam and who is it for?

The LTC-CIP is a certification for infection preventionists working in long-term care settings. It is administered by the Certification Board of Infection Control and Epidemiology (CBIC). The credential validates specialized knowledge in preventing and controlling infections in nursing homes, assisted living facilities, and other long-term care environments.

Eligibility requires current employment or experience in long-term care infection prevention and control. Candidates typically include registered nurses, medical technologists, and other healthcare professionals responsible for infection prevention programs. The exam fee is $430 according to the CBIC fee schedule (January 2025). For complete eligibility details, refer to the official CBIC LTC-CIP page.

What is the format of the LTC-CIP exam?

The LTC-CIP exam consists of 150 multiple-choice questions, with 135 scored. The remaining 15 are pretest items that do not count toward your score. The exam is divided into two 90-minute sections, with an optional break between them. Total testing time is 3 hours. The passing score is a scaled score of 700 on a scale of 300 to 900.

Questions are presented in a standard multiple-choice format with four answer options. There are no case simulations or interactive components. The exam is delivered at testing centers or via live remote proctoring, depending on availability. For current delivery options, check the CBIC website.

What content areas are covered on the LTC-CIP exam?

The LTC-CIP exam is based on a detailed content outline developed from a practice analysis of long-term care infection preventionists. The outline is organized into several domains, each with specific tasks and knowledge statements. The exact percentage of questions per domain is published in the official candidate handbook. Below is an overview of the major content areas.

1. Identification of infectious disease processes

This domain covers the basic microbiology and epidemiology needed to recognize and monitor infections. You must understand how to interpret laboratory reports, including culture and sensitivity results, and how to distinguish colonization from infection. Key topics include:

• Common pathogens in long-term care: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridioides difficile, and multidrug-resistant gram-negative bacteria.
• Standard and transmission-based precautions: when to use contact, droplet, and airborne precautions.
• Surveillance definitions: using standardized criteria such as those from the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN) to identify healthcare-associated infections.

Example: A resident has a positive urine culture but no symptoms. You must determine whether this represents asymptomatic bacteriuria (colonization) or a urinary tract infection (infection) based on NHSN criteria. The criteria require specific signs and symptoms, not just a positive culture.

2. Surveillance and epidemiologic investigation

This domain focuses on collecting, analyzing, and interpreting infection data. You need to know how to calculate infection rates, use standardized definitions, and conduct outbreak investigations. Key tasks include:

• Calculating infection rates: incidence density (e.g., number of infections per 1,000 resident-days) and attack rates.
• Creating and interpreting surveillance reports, including run charts and control charts.
• Conducting an outbreak investigation: establishing a case definition, finding cases, analyzing data, implementing control measures, and communicating findings.

Example: You notice an increase in respiratory infections on one unit. You would calculate the attack rate for that unit, compare it to baseline, and review possible sources such as a contaminated nebulizer or a sick staff member.

3. Preventing and controlling the transmission of infectious agents

This is often the largest domain. It covers the practical measures to prevent infections, including hand hygiene, environmental cleaning, and isolation precautions. Key topics include:

• Hand hygiene: when to use soap and water versus alcohol-based hand rub, and the World Health Organization's five moments for hand hygiene.
• Personal protective equipment (PPE): proper donning and doffing, and selection based on the type of precautions.
• Environmental cleaning and disinfection: choosing the right disinfectant for the pathogen (e.g., bleach for C. difficile) and ensuring adequate contact time.
• Antibiotic stewardship: promoting appropriate antibiotic use to reduce resistance.

Example: A resident with C. difficile requires contact precautions. You must ensure staff use soap and water for hand hygiene after care (alcohol rub is not effective against C. difficile spores) and that the room is cleaned with a chlorine-based disinfectant.

4. Education and training

This domain addresses the infection preventionist's role in educating staff, residents, and families. You need to know how to assess learning needs, develop educational programs, and evaluate their effectiveness. Key tasks include:

• Identifying educational needs based on surveillance data and regulatory requirements.
• Developing and delivering training on topics such as hand hygiene, PPE use, and outbreak response.
• Evaluating competency through direct observation, return demonstrations, and audits.

Example: After observing poor hand hygiene compliance among nursing assistants, you develop a targeted training session and later conduct direct observations to measure improvement.

5. Management and communication

This domain covers the administrative and leadership aspects of the role. You must be able to manage an infection prevention program, communicate with stakeholders, and ensure compliance with regulations. Key topics include:

• Regulatory requirements: understanding CMS, OSHA, and state health department regulations related to infection control.
• Reporting: knowing what infections must be reported to public health authorities and how to report them.
• Communication: effectively communicating with administration, clinical staff, and external agencies.
• Program management: conducting risk assessments, developing policies and procedures, and allocating resources.

Example: You must report a case of influenza in a resident to the local health department as required by state law. You also need to communicate the situation to staff and implement control measures.

6. Environment of care

This domain focuses on the physical environment and its role in infection transmission. Key topics include:

• Cleaning, disinfection, and sterilization of equipment and surfaces.
• Handling of linen and waste.
• Air handling and water systems: preventing Legionella and other waterborne infections.
• Construction and renovation: infection control risk assessment (ICRA) during construction projects.

Example: During a renovation, you must conduct an ICRA to determine the necessary barriers and ventilation to protect residents from airborne pathogens like Aspergillus.

How is the LTC-CIP exam scored?

The LTC-CIP exam uses a scaled score. Your raw score (number of correct answers) is converted to a scaled score ranging from 300 to 900. The passing score is 700. This means you do not need a specific percentage correct; the scaled score accounts for the difficulty of the questions. The 15 pretest items are not scored.

Your score report will indicate whether you passed or failed and will provide a breakdown of your performance by content domain. This breakdown can help you identify areas for improvement if you need to retake the exam.

How should you study for the LTC-CIP exam?

Start by downloading the official candidate handbook from the CBIC website. It contains the detailed content outline, which lists every task and knowledge statement you need to know. Use it as your primary study roadmap. Then, gather reference materials such as the APIC text, CDC guidelines, and NHSN manuals.

Create a study schedule that covers all domains, allocating more time to your weaker areas. Practice applying knowledge to scenarios, because the exam tests your ability to make decisions in real-world situations. For example, instead of just memorizing the definition of an outbreak, practice calculating attack rates and determining when an outbreak is occurring.

Consider using a structured study guide to organize your review. The Independent LTC-CIP Study Guide provides a comprehensive review of the content areas, practice questions with detailed explanations, and test-taking strategies. It is designed to supplement your study of the official outline.

What are common mistakes when preparing for the LTC-CIP exam?

One mistake is relying solely on general infection prevention knowledge without focusing on long-term care specifics. The LTC-CIP exam emphasizes settings like nursing homes, where residents may have indwelling devices, chronic wounds, and frequent antibiotic use. Another mistake is neglecting the regulatory and management domains; many candidates focus only on clinical topics but the exam includes questions on reporting, policy development, and communication.

Also, do not underestimate the importance of surveillance definitions. Many questions require you to apply NHSN criteria to determine if an infection is present. Practice using these criteria with sample scenarios. Finally, manage your time during the exam: you have 90 minutes for each section, which averages about 1 minute per question. Flag difficult questions and return to them if time allows.

Frequently asked questions

How many questions are on the LTC-CIP exam?

150 multiple-choice questions, 135 of which are scored.

How long is the LTC-CIP exam?

3 hours, divided into two 90-minute sections with an optional break.

What is the passing score for the LTC-CIP exam?

A scaled score of 700 on a scale of 300 to 900.

How much does the LTC-CIP exam cost?

$430 according to the CBIC fee schedule (January 2025).

Who administers the LTC-CIP exam?

The Certification Board of Infection Control and Epidemiology (CBIC).

Final checklist for exam day

• Confirm your test appointment and location (or remote proctoring setup).
• Bring required identification as specified by CBIC.
• Arrive early to allow time for check-in.
• Use the optional break to stretch and refocus.
• Pace yourself: approximately 1 minute per question.
• Answer every question; there is no penalty for guessing.
• Flag and review questions if time permits.

For the most current information on the LTC-CIP exam, always refer to the official CBIC website.

Official sources

• Certification Board of Infection Control and Epidemiology (CBIC): official LTC-CIP page

Verified on October 10, 2026 against the sources above.