Long-term care demographic and industry trends challenge provision of effective care and infection prevention. A systematic review was conducted to identify and evaluate cost estimates reported in the scientific literature of structure and processes intended to prevent infection among residents and staff of long-term care facilities (LTCFs). The small volume of publications regarding cost of infection prevention in LTCFs does not lead to recommendations for specific infection prevention practices. Cost-effectiveness research is needed to inform nurse executives' decisions on how best to prevent infections. Nurse executives should consider costs as well as health outcomes when generating new policy regarding procedures or products related to infection prevention. Administrators should cautiously evaluate the recommendations of published studies containing a cost estimation based on the quality of the estimate in addition to assessing applicability of the results to their own facility and resident population.