On September 10, health officials reported that a fourth person had died due to an outbreak of Legionnaires’ disease at an assisted living facility in upstate New York. The outbreak, which was first reported to the state Department of Health on August 29, has led to 20 hospitalizations since August 30. Albany County officials had previously announced three deaths among ten people who tested positive for the disease.
Albany County Department of Health Commissioner Maribeth Miller confirmed that there were now four fatalities linked to the outbreak. The facility has been under water restrictions since August 30, and water filters are being installed as part of a water treatment program. Health officials are working closely with the facility and local hospitals to ensure that symptomatic individuals receive timely testing and treatment.
Legionnaires’ disease is a severe type of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria, which can reside in plumbing systems. The disease does not spread from person to person, but individuals with weakened immune systems or chronic lung conditions are at higher risk.
On September 10, health officials also confirmed two new positive Legionella test results and are continuing to monitor pending samples. The Department of Health is maintaining close coordination with local hospitals and the affected facility to manage the situation effectively.
Compliance Perspective
Issue
Transmission of Legionella can be aerosol generated or when an individual consumes contaminated drinking water. The Centers for Medicare & Medicaid Services (CMS) requires that each facility establish and maintain an infection prevention and control program. CMS also expects that each nursing facility will have a policy and procedure to reduce the risk of growth and spread of Legionella and other opportunistic pathogens in the building’s water system. Facilities must have water management plans and documentation that, at a minimum, ensure each facility:
- Conducts a facility risk assessment to identify where Legionella and other opportunistic waterborne pathogens (e.g. Pseudomonas, Acinetobacter, Burkholderia, Stenotrophomonas, nontuberculous mycobacteria, and fungi) could grow and spread in the facility water system.
- Develops and implements a water management program that considers the ASHRAE industry standard and the CDC toolkit.
- Specifies testing protocols and acceptable ranges for control measures, and document the results of testing and corrective actions taken when control limits are not maintained.
- Maintains compliance with other applicable federal, state, and local requirements.
Discussion Points
- Review the facility’s Infection Control Plan and the policies and procedures for water management to reduce the risk of growth and spread of Legionella and other opportunistic pathogens in the building water system. Also review and update emergency response plans specific to outbreaks of waterborne pathogens. Ensure that these plans include procedures for immediate response and communication with residents and their families.
- Train all staff on the facility’s Infection Control Plan and water management policy and procedures. A program titled Legionella and Facility Water System Safety is available in Med-Net Academy Prime, Safety Category.
- Periodically audit to ensure that water samples are taken to test for presence of Legionella and other opportunistic pathogens in the facility’s water supply. Confirm that appropriate staff know how to collect and submit samples for testing, and that staff know what to do if the water samples test positive for Legionella or any other opportunistic pathogens. Ensure that a designated registered nurse is competently serving as the facility’s Infection Preventionist.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
