To reduce cases of Legionnaires’ disease in healthcare facilities, the Centers for Medicare & Medicaid Services has issued a directive for Medicare certified healthcare facilities to develop and maintain water management policies and procedures in order to reduce the risk of growth and spread of Legionella and other opportunisticpathogens in building water systems. The directive has an immediate effective date.

The announcement was made in a recent memorandum to State Survey Agency Directors and includes hospitals, critical access hospitals and long-term care facilities.

CMS called for the utilization and compliance of ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems, which was developed to assist designers and building operators in developing a water management plan that includes practices specific to the systems that exist in a particular building, campus or healthcare facility.

The CMS memo calls on State Survey Agency Directors to conduct a facility risk assessment, implement a water management program that considers 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 and 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.

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