A Trial to Reduce Pneumonia in Nursing Home Residents

Inclusion Criteria: * long term care resident of nursing home * residents age \>65 * residents of nursing home for at least one month * residents having at least one of two modifiable risk factors for pneumonia (i.e., impaired oral hygiene, swallowing difficulty) Exclusion Criteria: * residents housed in nursing home for short term rehabilitation * residents who receive nourishment by tube feeding * residents who have a life expectancy \< 3 months * residents who have been diagnosed with pneumonia within the previous 6 weeks * residents who are currently using oral chlorhexidine * residents who have previously been enrolled in the study * residents, or their designated proxies, who are unwilling to give informed consent * residents who have tracheostomy * residents who are non-english speaking * residents who the administrator leadership of the home felt were not appropriate for the study