AHCA: CDC Issues Requirements to Reduce & Prevent Legionnaires' Disease

Lisa Volk in Clinical & Quality

On June 2, 2017, the Survey and Certification Group (S&C) at the Centers for Medicare & Medicaid Services (CMS) issued a memorandum, "Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires' Disease (LD)."

The memo provides background on Legionella infections as well as CMS' expectations for Medicare certified healthcare facilities regarding the prevention of Legionella infections. The memo notes that the rate of reported cases of legionellosis increased between 2000 and 2014 and that the bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. The at-risk population includes those who are at least 50 years old, smokers, and those with underlying medical conditions such as chronic lung disease or immunosuppression.

Additionally, the memo states that Legionella outbreaks have been linked to poorly maintained water systems in buildings with large or complex water systems, such as those in hospitals and long term care facilities. CMS is requiring these facilities to develop and adhere to policies and procedures that inhibit microbial growth in building water systems to reduce the risk of growth and spread of Legionella and other opportunistic pathogens in water.

In 2015, the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) published an industry standard calling for the development and implementation of water management programs in large or complex building water systems to reduce the risk of legionellosis. In 2016, the Centers for Disease Control and Prevention (CDC) and its partners developed a toolkit to further implementation of this ASHRAE Standard.

CMS surveyors will review facilities' policies, procedures, and reports documenting water management implementation results; further details of CMS' expectations of facilities are outlined in the memorandum.

For questions or concerns regarding this policy memorandum, please contact Dr. Daniel Schwartz.


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15