What Is Legionella and Who Helps Manage the Risk in Ohio
Legionella is a naturally occurring bacteria found in freshwater environments. While it is not harmful in lakes or rivers, it becomes a serious health risk when it grows and spreads through man-made water systems such as plumbing, hot water tanks, cooling towers, decorative fountains, and medical equipment.
When inhaled through small water droplets, Legionella can cause Legionnaires’ disease, a severe form of pneumonia that most often affects older adults, individuals with underlying health conditions, and those living or receiving care in healthcare and senior living environments.
Because of these risks, Legionella prevention and water management are shared responsibilities across facilities, public health agencies, and regulatory organizations.
Who Is Most at Risk for Legionella Exposure
Facilities that serve vulnerable populations are at higher risk for Legionella growth and transmission. These include:
Assisted living and senior living communities
Skilled nursing and long-term care facilities
Hospitals and outpatient healthcare buildings
Behavioral health facilities
Hospitality properties such as hotels and extended-stay lodging
Large commercial and public buildings with complex water systems
These environments often have warm water temperatures, periods of low water usage, and extensive plumbing systems — conditions that can allow Legionella to grow if not properly managed.
The Role of Water Management in Legionella Prevention
Legionella prevention is not achieved through testing alone. It requires a proactive, documented approach that includes:
Water management plans
Legionella risk assessments
Temperature and disinfectant control
Routine monitoring and testing
Clear documentation for inspections and audits
Facilities are expected to understand how their water systems operate, where risk points exist, and how they respond if conditions fall outside safe limits.
This is where regulatory guidance and public health oversight play a critical role.
Organizations That Guide and Oversee Legionella Management
Several organizations help shape how Legionella risk is managed across Ohio and the United States. Each plays a distinct role in setting expectations, guidance, and enforcement.
Public Health Departments
Local and county public health departments are responsible for inspections, investigations, and enforcement at the facility level. They often review water management documentation during inspections or in response to illness reports and outbreaks. Their focus is ensuring facilities can demonstrate proactive control measures and compliance with applicable regulations.
Centers for Disease Control and Prevention
The CDC provides national guidance on Legionella prevention through its environmental infection control recommendations. These guidelines outline best practices for building water systems and form the foundation for many state and local compliance expectations.
Environmental Protection Agency
The EPA oversees drinking water standards and regulations that influence how water is treated and delivered. While the EPA does not regulate Legionella directly, its standards impact water quality, disinfectant levels, and system design.
Ohio Assisted Living Association
OALA supports assisted living providers across Ohio by offering education, advocacy, and training related to regulatory changes, including water safety and infection prevention requirements.
Ohio Health Care Association
OHCA represents skilled nursing, long-term care, and post-acute providers. The association helps facilities understand compliance obligations and best practices related to resident safety, including waterborne pathogen prevention.
ASHRAE
ASHRAE establishes industry standards for building systems, including water system design and operation. Its guidance is widely referenced in Legionella prevention strategies and water management planning.
How Facilities Bring It All Together
While these organizations provide guidance, oversight, and standards, the responsibility for implementation ultimately rests with the facility. Administrators, maintenance teams, and leadership must ensure that water systems are actively managed, monitored, and documented.
This is where experienced water management partners play a critical role — helping facilities translate guidance into practical, site-specific programs that reduce risk, support compliance, and protect residents, staff, and visitors.
