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The Centers for Medicaid and Medicare mandate based on ASHRAE 188 states that hospitals must have a water management team and a water management plan in place to combat the risk of legionella. Hospitals that do not comply risk losing their Medicaid and Medicare reimbursements. CMS has started inspecting.
The mandate does not give guidance or instruction on what types of solutions a hospital should use or when and how they should be testing for legionella. And there are no enforceable codes or regulations for any other building type.
ASHRAE and NSF are working together, creating new guidelines/standards. This effort has the potential to influence additional building types.
In the meantime, the industry currently looks to ASHRAE 188 for guidance in mitigating the risk of legionella. The standard urges organizations to prepare the following: