Introduction: In 2010, a surveillance and reporting system for outbreaks of acute respiratory infections (ARI) was proposed to all nursing homes (Ehpad) in the Pays de la Loire region to improve the management of ARI outbreaks. The objective of this article is to present the regional organization of the surveillance system, as well as an assessment of the impact of its implementation and the impact of circulating viruses on incidence and severity criteria (case fatality rate and hospitalization rate). Methods: A comprehensive approach was proposed to the nursing homes, supplemented by the provision of surveillance and management tools. To assess changes in the management of outbreaks, data from the 2011–2012 season were compared with those from the most recent surveillance season (2016–2017). To compare the impact of circulating viruses, four contrasting winter seasons were selected (influenza B dominant vs. A(H3N2)). Results: An improvement in the implementation of control measures by nursing homes was observed over time, as well as earlier implementation of barrier measures. Influenza vaccination coverage was good among residents and insufficient among staff members. Indicators of outbreak severity were higher during influenza A(H3N2) epidemics. Discussion: Surveillance confirmed the major impact of the influenza A(H3N2) virus in these nursing homes. This system was instrumental in coordinating partner involvement and assisting nursing homes in managing these outbreaks. The system, initially designed as a reporting mechanism to assist nursing homes in distress, evolved into a surveillance tool integrated into regional influenza outbreak surveillance systems.