Water Management Program

Centers for Medicare & Medicaid Services requires Medicare certified healthcare facilities to have water management policies and procedures to reduce the risk of growth and spread of Legionella in building water systems. Surveyors will review policies, procedures, and reports documenting water management implementation results to verify facility compliance.

Our Water Management Programs provide you the following services:

  • A Facility Survey

  • Initial Sample Testing

  • Personal Review of Sample Testing Results

  • Remediation Action Plan (If Necessary)

  • Review of Your Water Management Program

  • Subsequent Retesting Schedule to Ensure Continued Monitoring

  • Access to Private Customer Portal with Water Management Program(s), Scheduling and Communication with Our Team

We Use CDC ELITE Labs for Testing and Results and CDC Approved On-site PCR Testing for Legionella

Although Legionella lives in a wide variety of freshwater habitats, it can be difficult to isolate. The Environmental Legionella Isolation Techniques Evaluation (ELITE) Program was created as a way for laboratories to test their Legionella isolation techniques against standardized samples.

Q: What does it mean if the lab I am using is not on the ELITE Members List?

A: It depends on the reason for testing environmental samples for the presence of Legionella. If you need samples tested during an investigation into cases of disease, you should consider using an ELITE member laboratory. This will ensure that the laboratory understands the extra measures needed to secure an environmental isolate for public health investigations.

Read more from the CDC ELITE website.

Interpretation of Test Results

We provide you a personal review of your facility test results.  We will examine with you all possible treatment solutions and create a firm action response plan for responding to any current or future positive test results.

Each testing sample will yield three data points:

  • High Risk Situation – Positive test results in 30% or more of all samples taken. Disinfection of the potable water system is recommended followed by an immediate re-test for Legionella to determine the effectiveness of the disinfection.  Monthly testing to establish regular monitoring is highly recommended.

  • Low Risk Situation – Positive test results in less than 30% of samples taken.  Disinfection of the potable water system is not recommended unless there are recognized cases of Legionnaires’ disease.  Monthly testing to establish regular monitoring is highly recommended.

  • Very Low Risk Situation – No colonization at any sample site.  Monthly testing to establish regular monitoring is still highly recommended.

20-30% of the 3,000 tests we have performed to date tested positive for Legionella pneumophila serogroup 1.


Legionella will develop either under or adhering to biofilm buildup within the water system.  Effective treatment of Legionella requires the removal of biofilm from the facility water system.  Centers for Disease Control & Prevention recommends the following removal techniques:

  • Superheat the water and flush the water system

  • Superheat the water and pulse flush the water system

  • Oxy Chlorite leading edge technology

  • Hyperchlorination – Increasing the chlorine levels in the water system on a sustained basis

  • Monochloramine added to the water system

  • Chlorine Dioxide added to the water system

  • Application of copper-silver ions

Based on our over 37 years of experience, a single positive test in a facility is frequently corrected by either of the Superheat treatment methods. Cluster groups of positive Legionella (at least three positive Legionella tests in a given area of the facility) typically require Hyperchlorination as the initial option for remediation.  Contact us for questions regarding any of these treatment applications.

Legionnaires’ Disease By The Numbers

Estimated number of Legionnaires’ disease cases each year
Estimated number of deaths from Legionnaires’ disease each year

Legionella Accredited Sources

Use the following links to download information from Legionella accredited sources.

CDC Water Management Program – Resource Page

Click for more information from the Center for Disease Control and Prevention

Requirements for Healthcare Facilities – CMS Regulation Memo

Click to read the CMS requirements to reduce Legionella risk in healthcare facility water systems

Standard 188 – Provided by ASHRAE

ASHRAE provided information regarding Legionella

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