Introduction: Hand hygiene using hand rubs is the gold standard technique for preventing acute respiratory infections, gastroenteritis, and the spread of multidrug-resistant bacteria in nursing homes. This surveillance study aimed to quantify adherence to hand hygiene in EHPADs using a proxy indicator based on annual consumption of hand sanitizer. Methods: From March 1 to June 30, 2019, EHPADs in six French regions were contacted to participate in the surveillance study. Organizational information (private/public, integrated into healthcare facilities [HCFs], availability of staff or expertise in infection prevention and control [IPC]), annual HAP consumption (volume of HAP in liters purchased per year), and nursing home activity (total resident-days) were collected for 2017 and 2018. The number of hand rubs performed per day per resident was estimated using the following formula: (volume of hand sanitizer [liters] × 1000) divided by (annual number of resident-days × 3 mL), based on the assumption that one hand rub required 3 mL of hand sanitizer. Statistical analysis was performed using Student’s t-test and analysis of variance. Results: A total of 1,221 nursing homes across six regions participated in the study. The estimated median number of FHA procedures performed per day per resident was 1.47 (interquartile range: 0.98–2.11) in 2017 and 1.49 (IQR: 1.03–2.10) in 2018. Among the 698 (57%) nursing homes that provided organizational data, 58.2% (n = 406) were public facilities, 20.3% were private, and 20.2% were nonprofit. In 73.2% of the nursing homes, a liaison nurse was designated, and a PCI team was available in 63%. Significantly higher PHA consumption was observed in nursing homes with the following characteristics: public status (median: 1.53 applications at a time in 2017/18; vs. 1.04 in 2017 and 1.06 in 2018 for nonprofit nursing homes; p <0.01), presence of an in-house infection control team (2018: 1.66 vs. 1.01 for others; p <0.01); and a designated hygiene officer within the facility (in 2018: 1.60 vs. 1.12 for others; p <0.01). Conclusion: This survey highlights the low level of PHA use in French nursing homes, with fewer than one PHA performed daily per resident in 25% of nursing homes. This monitoring, accompanied by a precise feedback strategy, benchmarking, the development of objectives, and an action plan, can lead to significant improvements.