Dangerous germs can lurk in the water systems of healthcare facilities, putting the most vulnerable at risk. Examples of these include Pseudomonas, Acinetobacter, Burkholderia, Stenotrophomonas, nontuberculous mycobacteria, various species of fungi and Naegleria fowleri. In recent years, the Centers for Medicare & Medicaid Services (CMS) has turned its focus on reducing the risk of Legionella. CMS’ Survey and Certification Group released a memoin 2017 that requires healthcare facilities to develop policies and procedures to deter the growth of germs in building water systems to reduce the risk of growth and spread of Legionella and other pathogens. A 2018 revision clarified expectations for providers, accrediting organizations and surveyors.
The bacterium Legionella can cause a serious and sometimes fatal type of pneumonia called Legionnaires’ disease. Those at risk include people at least 50 years old, current or former smokers and people with weakened immune systems or medical conditions such as chronic lung disease. Legionella occurs naturally in low amounts in freshwater environments such as lakes and streams and generally does not lead to Legionnaires’ disease. However, when Legionella gets into a building’s water system, it can grow, spread and pose a serious health risk. The bacterium can sicken people when they inhale contaminated water droplets. Transmission can occur from showerheads, cooling towers, humidifiers, hot tubs and decorative fountains.
- Establish a water management program team.
- Describe the building water systems using text and flow diagrams.
- Identify areas where Legionella could grow and spread.
- Decide where control measures should be applied and how to monitor them.
- Establish ways to intervene when control limits are not met.
- Make sure the program is running as designed and is effective.
- Document and communicate all the activities.