Industrial Utility Efficiency    

CMS Requires Medicare Certified Facilities to Maintain Legionella-Prevention Policies

To reduce cases of Legionnaires’ disease in health care facilities, the Centers for Medicare & Medicaid Services (CMS) announced Medicare certified healthcare facilities must develop and maintain water management policies and procedures to reduce the risk of growth and spread of Legionella, as well as other opportunistic pathogens in building water systems. The directive has an immediate effective date.

Legionnaires’ disease is a serious type of pneumonia caused by bacteria, called Legionella, living in water. Legionella can make people sick when they inhale contaminated water from building water systems not adequately maintained.

The announcement was made in a recent memorandum to State Survey Agency Directors, and includes hospitals, critical access hospitals and long-term care facilities. Most notably, CMS called for the utilization and compliance of ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems, developed to assist designers and building operators in developing a water management plan including practices specific to the systems existing in a particular building, campus or health care facility.

The timing of CMS’ decision is significant, as the CDC released a report last month stating more than 76 percent of Legionnaires’ disease cases acquired from Legionella exposure in health care facilities can be particularly harsh, including possible fatal risks to patients. “Incorporating good design, operations and maintenance procedures that prevent the growth and spread of Legionella is vitally important in all buildings, especially health care facilities. These are regarded as the best methods for preventing this potentially fatal disease,” says Michael Patton, ASHRAE Committee SSPC 188 member. “ASHRAE has been at the forefront of establishing best practices through ASHRAE Standard 188. We are pleased that CMS is taking a strong stance on this issue.”

The CMS memo calls on State Survey Agency Directors to conduct a facility risk assessment, implement a water management program considering ASHRAE Standard 188 and the toolkit developed by the CDC entitled, “Developing a Water Management Program to Reduce Legionella Growth and Spread in Buildings: A Practical Guide to Implementing Industry Standards.” The directive also requires facilities to specify testing protocols.

The CDC toolkit, initially released in 2016 and updated in June 2017, is based upon ASHRAE Standard 188. The toolkit provides a checklist to help building owners and managers identify if a water management program is needed, examples to help identify where Legionella could grow and spread in a building and ways to reduce risk of contamination. “With the release of both the CDC report and CMS memo, it is clear ASHRAE Standard 188 is the best resource available to help health care facilities implement an effective water management program to Legionella infections,” says Patton.

To date, more than 5,000 copies of ASHRAE Standard 188 have been purchased. It can be previewed at no cost at https://www.ashrae.org/Standard188.

 

About ASHRAE

ASHRAE, founded in 1894, is a global society advancing human well-being through sustainable technology for the built environment. The Society and its more than 56,000 members worldwide focus on building systems, energy efficiency, indoor air quality, refrigeration and sustainability. Through research, standards writing, publishing, certification and continuing education, ASHRAE shapes tomorrow’s built environment today.