Accreditation

CMS tells surveyors to double check for Legionella contamination

Briefings on Accreditation and Quality, August 1, 2017

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On June 2, CMS issued a new memo to surveyors on the importance of reducing cases of Legionella infections. Not long after, the Centers for Disease Control and Prevention (CDC) sent out a Vital Signs report underlining the bacterium’s risk to patients. Accredited facilities should double-check their waterborne pathogens compliance, as surveyors will likely pay more attention to it in upcoming surveys. The contents of this memo go into effect immediately.

First discovered in the 1970s, Legionella bacterium is responsible for legionellosis: a respiratory disease that can cause a type of pneumonia called legionnaires’ disease (LD), which kills about a quarter of the people who contract it. Legionellosis can also cause a flulike illness called Pontiac fever. Legionellosis is especially dangerous for patients older than 50, who smoke, or have chronic lung or immunosuppression conditions.

The bacterium breeds naturally in warm water and can usually be found in the parts of hospital systems that are continually wet. Poorly maintained water systems have been linked to the 286% increase in legionellosis between 2000 and 2014. The CDC says there were 5,000 reported cases of it in 2014 alone, with about 19% of outbreaks in long-term care facilities and 15% in hospitals.

The bacterium is spread through inhalation of aerosolized droplets of contaminated water. People can also get it by drinking contaminated water if some of the droplets enter the lungs. Here’s just a few items that can spread the contamination:

•    Decorative fountains
•    Shower heads and hoses
•    Electronic and manual faucets
•    Hot and cold water storage tanks
•    Water heaters and filters
•    Pipes, valves, and fittings
•    Eyewash stations
•    Ice machines
•    Cooling towers
•    Medical devices (e.g., CPAP machines, hydrotherapy equipment, bronchoscopes, heater-cooler units)

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