Developments in State Policy
Ohio
This page summarizes two Ohio State regulations addressing Legionella—hospital licensure regulations setting standards and procedures for addressing risk conditions, such as Legionella; and residential care facility regulations requiring effective water management programs that address waterborne pathogens, including Legionella.
I. Hospitals
Citations: Ohio Rev. Code § 3722.06(B)(7) (2021); Ohio Admin. Code § 3701-22-07 (2024).
Available: Ohio Laws (Ohio Rev. Code § 3722.06); Ohio Administrative Rules (Ohio Admin. Code § 3701-22-07)
Summary: Ohio law and rules require hospital licensing to include standards and procedures for identifying, monitoring, managing, reporting, and reducing exposures to risk conditions, such as Legionella, including through environmental facility assessments, water management plans, and disinfection measures.
Key Provisions:
Enacted in 2021, Ohio law requires the state director of health to adopt a hospital licensing rule that includes "standards and procedures for identifying, monitoring, managing, reporting, and reducing exposures to risk conditions, such as Legionella, including through the use of environmental facility assessments, the development of water management plans, and the use of disinfection measures." Ohio Rev. Code § 3722.06(B)(7).
Accompanying rules were adopted in 2024. Each hospital, other than a critical access hospital or a rural emergency hospital, must “[e]stablish and implement an effective water management program to identify hazardous conditions, and take steps to manage the risk of occurrence and transmission of waterborne pathogens, including but not limited to legionella, in building water systems” in accordance with CDC guidance and Environmental Infection Control Guidelines (2019) or its successors. Ohio Admin. Code § 3701-22-07(K)(3). Testing and sampling requirements are set forth, and must conform to CDC guidelines (Routine Testing for Legionella and Legionella Sampling Procedure and Potential Sampling Sites). Ohio Admin. Code § 3701-22-07(K)(3)(a)-(b). When there is a legionellosis presumptive healthcare-associated case, there are two or more legionellosis possible healthcare-associated cases in a twelve-month period, or when a legionellosis outbreak occurs the Ohio department of health and the local health district have jurisdiction, and investigation activities should be coordinated with Ohio department of health Infectious Disease Control Manual and CDC Guidance on Defining Healthcare-Associated Cases and Conducting Investigations) and includes additional requirements detailed in the rule. Ohio Admin. Code § 3701-22-07(K)(4).
II. Residential Care Facilities
Citations: Ohio Admin. Code § 3701-16-12 (2024).
Available: Ohio Administrative Rules (Ohio Admin. Code § 3701-16-12)
Summary: Ohio residential care facility rule requiring effective water management programs that address waterborne pathogens, including Legionella.
Key Provisions:
The rule requires that “[e]ach residential care facility will establish and implement an effective water management program to identify hazardous conditions, and take steps to manage the risk of occurrence and transmission of waterborne pathogens, including but not limited to legionella, in building water systems” in accordance with CDC guidance and Environmental Infection Control Guidelines (2019) or its successors. Ohio Admin. Code § 3701-16-12.
Back to Legionella Management in Building Water Systems: Developments in State Policy