Federal Government Now Mandating Water Testing for Legionnaires Disease


Hospitals and nursing homes are now under increased scrutiny to protect their patients in the wake of a recent Centers for Medicare & Medicaid Services (CMS) mandate. The CMS directive requires all Medicare certified healthcare facilities in the United States to have water management policies and procedures that reduce the spread of the potentially fatal Legionnaires disease. Legionnaires is typically spread by breathing in aerosolized water droplets that are commonly linked to large water systems found in hospitals and long-term care facilities. Individuals over the age of 50, smokers, and those with weakened immune systems are most at risk of contracting the disease.

According to the CDC, there was a 286% increase in Legionnaires cases in the United States from 2000 to 2014. Of the approximately 5,000 cases reported to the CDC in 2014, 19% occurred within long-term care facilities, and 15% within hospitals. Nine percent of people diagnosed with Legionnaires die from the disease. A facility manager's knowledge of how to prevent the disease and how to remain in compliance with federal regulations thus grows in importance each year.

All facility managers of hospitals and long-term care facilities must be familiar with certain important federal regulations to keep their patients safe, avoid hefty fines, and to prevent other severe repercussions.

  • 42 CFR § 482.42 - for Hospitals

The hospital must provide a sanitary environment to avoid sources and transmission of infections and communicable diseases. There must be an active program for the prevention, control, and investigation of infections and communicable diseases.

  • 42 CFR § 482.80 - for Skilled Nursing Facilities and Nursing Facilities

The facility must establish and maintain an infection prevention and control program designed to provide safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.

  • 42 CFR § 482.635(a)(3)(vi) - for Critical Access Hospitals (CAH)

The CAH policies must include a system for identifying, reporting, investigating and controlling infections and communicable diseases of patients and personnel.

The CMS stresses in its June 2, 2017 memorandum that Medicare certified healthcare facilities should follow the industry standards developed by the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE). In the coming months, accrediting organizations across the country will assess the compliance of Medicare certified healthcare facilities with the above regulations and industry standards. Facilities that fail to make efforts to minimize the spread of Legionnaires may face harsh penalties and may be found to be in non-compliance with the CMS Conditions of Participation.

With the increased risk of the potentially deadly Legionnaires disease and the additional scrutiny of healthcare facilities, it is more imperative than ever for facilities managers to seek advice to ensure compliance with federal regulations and ASHRAE industry standards.

Governo Law Firm has represented clients in environmental and toxic tort claims for three decades. Mr. Governo has been an ASHRAE member for over a decade. We regularly follow scientific, medical and legal developments in toxic tort claims, including Legionnaires disease, asbestos, chemicals, lead and mold. If you have any questions or would like more information, please contact David Governo at [email protected] or Vincent DePalo at [email protected].