BACKGROUND: Influenza causes significant morbidity and mortality in long-term care facilities. Immunization of health care workers has been shown to reduce the impact of influenza in this setting, yet few studies address improvement efforts aimed at long-term care staff immunization. OBJECTIVE: To determine the feasibility of achieving and sustaining high rates of staff influenza immunization for a community-based long-term care facility. METHODS: A needs analysis was conducted to determine the organizational and individual level barriers to influenza vaccination of staff. Systems changes, educational interventions, and reminders were implemented based on the barriers assessment. Staff immunization rates were calculated over a 10-year period from 1996 to 2006. RESULTS: Organizational and individual barriers were identified and targeted. Using data from 1996 and 1997 as a baseline, staff immunization rates improved from 54% to 55% to between 74% and 95% over the past 4 years. CONCLUSIONS: Achieving and sustaining high staff influenza immunization rates is possible in a community-based long-term care facility with an involved quality improvement team and medical director.