Mandate from the Department of Health and Human Services to Reduce Legionella Risk in Healthcare Facility Water Systems

With the continuing rise in reported cases of Legionnaires’ disease in the United States, the U.S. Department of Health and Human Services is requiring all healthcare facilities, retirement homes, and assisted-living facilities to develop a water management program to reduce the risk of Legionella growth and spread. The recent outbreaks in Legionnaires’ disease have been linked to minimally maintained water systems in buildings with large or complex water systems, including hospitals and long-term care facilities. So on June 5th, 2017, the Centers for Disease Control and Prevention issued a practical guide titled Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings .

According to the U.S. Department of Health and Human Services, “Legionnaires’ disease is a serious type of pneumonia caused by bacteria, called Legionella, that live in water.” (June 5, 2017). Legionella bacteria in often found in low amounts in source waters like lakes and streams, but it becomes a health risk when it increases in numbers and becomes aerosolized.

Several factors can cause Legionella growth, including:

  • Water main breaks
  • Construction or vibrations that dislodge biofilm
  • Inadequate disinfection in a building’s water system
  • Biofilm growth, which harbors Legionella from heat and disinfectants
  • Water temperatures between 77°F–108°F, which provide the best growth conditions
  • Water stagnation in a building’s water system, which encourages biofilm growth and lowers the temperature and levels of disinfection
  • Scale and sediment, which protects Legionella by using up disinfectants
  • pH falling outside of the range where disinfectants are most effective (usually between 6.5 and 8.5)
  • Changes in municipal water quality that increase sediment, lower disinfectant levels, increase turbidity, or cause pH levels to fall outside of the acceptable range

Creating a water management plan encourages facility managers to examine their water system and identify areas where Legionella can grow or spread. The water management plan then outlines a process for implementing and monitoring control measures, i.e. conducting analyses for temperature, disinfectant levels, and heterotrophic plate counts.

To enforce these new guidelines, the Centers for Medicare and Medicaid Services is requiring all state survey agencies to ensure that hospitals and long-term care facilities have implemented a water management program and are performing routine monitoring and control measures, per a new memorandum dated June 2nd, 2017.

Alloway offers services that can assist you in meeting these new requirements. Once your water management program is in place, our field technicians can provide professional, onsite water quality measurements for parameters like pH and total residual chlorine. Alloway also offers sampling and analysis for various bacteria tests including heterotrophic plate counts, total coliform bacteria, E. coli, and Legionella.

If you would like more information on the services Alloway can provide, please contact us at .

For a copy of Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings from the U.S. Department of Health and Human Services, click this link.

For a copy of the memorandum issued by the Centers for Medicare and Medicaid Services to state survey agency directors, click this link.