Healthcare Solutions

Healthcare-acquired Legionnaires’ disease has a 25% mortality rate. Special Pathogens Laboratory started as the Veterans Health Administration’s only Legionella reference laboratory, so we share a healthcare perspective. When it comes to protecting healthcare organizations from Legionnaires’ disease, we don’t want you to become one of those statistics. You can rely on our clinical and environmental experience and peer-reviewed research to control infections from Legionella and other waterborne pathogens in your water system.

We worked with infection prevention, engineering, laboratorians, and physicians long before there were water management teams. Our multidisciplinary team collaborates with your team to implement evidence-based services and promote a shared understanding of the challenges, responsibilities, and solutions involved in managing risk.


Our healthcare solutions provide the only approach shown to control risk of Legionella in hospital water systems—a national and international model for prevention and adopted into regulations by New York City and State. From CMS compliance to Legionella and waterborne pathogens testing, we provide all the resources healthcare organizations need to prevent waterborne pathogen infections:

  • Detection: CMS Legionella and waterborne pathogens panel
  • CMS compliance
  • Case investigations
  • Outbreak prevention and remediation
  • Risk assessments
  • Construction-related risk management
  • Water management plans
  • Water management team consultation
  • Implementation and data management
  • Liaison with local and state health departments and other government agencies
  • Third-party review disinfection technology reviews

Centers for Medicare and Medicaid Services

Since 2017, CMS expects Medicare and Medicare/Medicaid certified healthcare facilities to implement water management policies and procedures to reduce the risk of Legionella and other opportunistic pathogens in building water systems. We provide everything you need to protect your patients from these infections and comply with CMS.

CMS Legionella and waterborne pathogens panel

The CMS pathogens panel is specially designed for use in healthcare facilities to evaluate the potential for exposure to six waterborne pathogens: Legionella, Pseudomonas aeruginosa, Stenotrophomonas maltophilia. Acinetobacter species, Burkholderia cepacia, and nontuberculous mycobacteria.

  •   Desktop and onsite risk assessments
  •   ASHRAE 188 water management plans
  •   Implementation management
  •   Legionella resource for water management program team

The Joint Commission

The Joint Commission has beefed up requirements for Legionella water management. The new environment of care requirements go into effect January 1, 2022.

Countdown to January 1, 2022

  • July 1, 2021 : New requirements will appear in the manuals July 1, 2021. The Joint Commission will be providing additional guidance and education later this year.
  • December 31, 2021 : EC.02.05.01 EP 14 (for hospitals and critical access hospitals) and EP 6 (for nursing care centers) require organizations to minimize pathogenic biological agents in cooling towers, domestic hot- and cold-water and other aerosolizing water systems. These two EPs will continue to be scored until December 31, 2021 and will then be deleted.
  • January 1, 2022, The Joint Commission’s new standard on water management programs for Legionella and other waterborne pathogens goes into effect.

 Avoid Deficiencies. Secure Accreditation.

Your current plan may not measure up to The Joint Commission’s new standard. Let our expertise work for you. Special Pathogens Laboratory has been a trusted resource for the healthcare industry for more than 30 years. More than a lab, our Legionella and comprehensive water management services ensure you avoid deficiencies from surveyors. We provide:

  • Expertise in controlling Legionella and waterborne pathogens in hospital water systems
  • Water safety and management plan review
  • Implementation services
  • Onsite risk assessments and audits
  • Legionella and waterborne pathogens testing

 New Water Management  Requirements

Download the prepublication requirements for Environment of Care for:

WICRA for Construction-Related Risks

ICRA won’t protect your patients from water-related infections or outbreaks caused by construction and renovation. So, Special Pathogens Laboratory added the W(ater) to ICRA. Now you can secure patient safety from the consequences of outbreaks. Complement ICRA with WICRA™ and get complete protection from construction-related risks. Learn more (link to WICRA on water management services)

Nontuberculous Mycobacteria

Need assistance to prevent NTM infections? We provide expertise in detecting and managing risk from NTM in water used in medical procedures and equipment. Our study on NTM in heater-cooler devices resulted the 2017 William Rutala Award awarded to Jack Rihs, VP of Laboratory Services. View presentation.

Transplant Units

You protect the patient from contaminated air but not water? Numerous studies show that culturing drinking water before cases occur is the most effective step in recognizing and preventing hospital-acquired Legionnaires’ disease. What’s more, our studies show that point-of-use water filters prevents risk.


Knowledge empowers you to respond not react to risk. We provide ongoing education on Legionella and other waterborne pathogens. Invite us to speak at your next event or learn more and get your questions answered by attending our webinars and seminars:

  • Puzzled by Legionella and Other Waterborne Pathogens? webinars
  • Continuing education through APIC chapters
  • Ongoing education
  • ASSE 12080 Standard Certification Training


  • Research article citations
  • CMS Memo
  • APIC Text chapter
  • WICRA documents

Quick Facts

  • Up to 70% of all hospital water systems are contaminated with Legionella 
  • Legionellais the single most common cause of hospital-acquired pneumonia linked to drinking water. 
  • Among outbreaks, acute care hospitals accounted for 88% of all cases of hospital-acquired Legionnaires’ disease, with a 34% mortality rate. 
  • Legionella species and Legionella pneumophila are the most common causes of Legionnaires’ disease for transplant patients. 
  • 31% fatality rate for cancer and hematopoietic stem cell transplant recipients from Legionella pneumonia.

Complete elimination of Legionella from a hospital water system has not been shown necessary to prevent the majority of cases of Legionnaires’ disease.