​Hospitals and nursing homes must do more to reduce the risks of people contracting Legionnaires disease in their facilities, according to recent communications from two government agencies. An analysis of 2,809 confirmed cases of Legionnaire diseases revealed that 20% (553 cases) were "definitely" or "possibly" healthcare associated, according to a June 6, 2017, report from the Centers for Disease Control and Prevention (CDC). Among the 85 cases that were definitely associated with a healthcare facility, 78 occurred in a long-term facility and 15 were associated with a hospital. In a June 6, 2017, article on NPR.org, the acting director of the CDC said she was "surprised" by the findings. "We know if those facilities have an effective water-management system they can prevent these infections," she said. CDC also updated its Vital Signs post on Legionnaire disease, noting that it kills 25% of people who contract it in a healthcare facility. CDC's post includes advice on how to establish a water management program team and identify areas, such as ice machines and decorative fountains, in which Legionella bacteria can grow. The Centers for Medicare and Medicaid Services (CMS) on June 2, 2017, issued a memorandum stating its requirements to reduce to Legionella risk in healthcare facilities. CMS said it expects Medicare-certified facilities to have water management policies in place to reduce the risk of Legionella. CMS surveyors will review policies and procedures to verify that facilities conduct risk assessments to identify areas Legionella might grow; implement a water management program that considers advice from both CDC and the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE); and take action when testing shows that Legionella control efforts are failing.

HRC Recommends: Risk managers should ensure that their organization has a Legionella water management program, which includes establishing a team, identifying areas where Legionella could grow and spread, deciding where to apply control measures and how to monitor them, determining how to intervene when control limits are not met, and communicating and documenting all activities.