United States. The Centers for Medicare and Medicaid Services (CMS) announced that Medicare-certified sanitation facilities must develop and maintain water management policies and procedures to reduce the risk of growth and spread of Legionella and other pathogenic opportunistic diseases in building water systems. The directive has an immediate effective date.
Legionnaires' disease is a serious type of pneumonia caused by bacteria, called Legionella, that live in water. Legionella can make people sick when they inhale contaminated water from building water systems that are not properly maintained.
The announcement was made in a recent memo to the directors of the State Research Agency and includes hospitals, critical access hospitals and long-term care facilities.
CMS requested the utilization and compliance with ASHRAE Standard 188: Legionellosis: Risk Management for the Construction of Water Systems, which was developed to assist construction designers and operators in developing a water management plan that includes practices specific to the systems that exist in a building, campus, or health care center.
The timing of CMS's decision is significant, as the CDC released a report last month stating that more than 76 percent of legionellosis cases acquired from Legionella exposure in health facilities can be particularly harsh, including potential fatal risks to patients.
"Incorporating good design, operations and maintenance procedures that impede the growth and spread of Legionella is vitally important in all buildings, especially in health facilities. These are regarded as the best methods to prevent this life-threatening disease," says Michael Patton, member of ASHRAE's SSPC 188 Committee." ASHRAE has been at the forefront of establishing best practices through ASHRAE Standard 188. We are pleased that CMS is taking a strong stand on this issue."
The CMS memo calls on state inspection agency directors to conduct a risk assessment of the facility, implement a water management program that considers ASHRAE Standard 188 and the toolkit developed by the CDC titled "A Practical Guide to Implementing Industry Standards." The policy also requires installations to specify test protocols.
The CDC toolkit, initially released in 2016 and updated in June 2017, is based on ASHRAE Standard 188 and provides a checklist to help building owners and managers identify whether a water management program is needed. A building and ways to reduce the risk of pollution.
"With the release of the CDC report and cmS memo, it is clear that ASHRAE Standard 188 is the best resource available to help health facilities implement an effective water management program for Legionella infections," Patton says.
To date, more than 5,000 copies of ASHRAE 188 have been purchased. It can be viewed at no cost in https://www.ashrae.org/Standard188.
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