Regulation in Motion: New Legionella Laws You Can’t Ignore

Across the country, cities and states are tightening regulations around Legionella prevention. These updates are driven by a rise in outbreaks, more advanced testing capabilities, and the growing recognition that outdated monitoring schedules leave facilities exposed. The newest example comes from New York City, where officials have enacted stricter testing laws designed to prevent a repeat of deadly Legionnaires’ disease outbreaks.

The increased attention on water safety is reshaping how healthcare and long-term care facilities approach Legionella compliance. This article outlines recent changes, what they mean for facility managers, and how Legionella Specialties helps organizations stay audit-ready under new laws like NYC’s Intro. 1390-A.

The New Standard: Monthly Testing and Mandatory Monitoring

In October 2025, the New York City Council passed Intro. 1390-A, requiring building owners to test their cooling towers for Legionella every 30 days during the operational season. This replaces the previous quarterly testing requirement and is now among the most rigorous mandates in the United States (Habitat Magazine, 2025).

This legislation was introduced after a severe outbreak in Central Harlem, where more than 100 confirmed cases and multiple deaths were linked to contaminated cooling towers across several buildings (HealthBeat, 2025). The city’s response highlights a growing movement toward proactive risk management rather than reactive response.

The Bigger Picture: How Regulation is Evolving Nationwide

While New York leads in enforcement, similar updates are underway across the country. States like Illinois, Michigan, and California are reviewing water safety codes and introducing requirements for Legionella risk management in healthcare settings. These changes align with ASHRAE Standard 188 and Joint Commission Standard ST108, both of which emphasize continuous monitoring, documentation, and response planning.

According to the Centers for Disease Control and Prevention (CDC), Legionella bacteria cause an estimated 10,000 to 18,000 hospitalizations annually in the United States. The EPA also reports that Legionella accounts for 50 percent of all waterborne disease outbreaks and 60 percent of related deaths nationwide (EPA, 2024).

As the regulatory landscape evolves, facilities that rely on outdated quarterly sampling or lack defined water management plans risk falling behind compliance expectations and potentially facing penalties or survey citations.

What This Means for Healthcare and Long-Term Care Facilities

For hospitals, rehabilitation centers, and skilled nursing facilities, these regulations directly impact how water safety programs must be structured and documented. Compliance now extends beyond annual reviews or occasional testing. Facilities must demonstrate:

• Routine Legionella testing from certified laboratories at intervals consistent with local or national standards.

• Comprehensive water management plans that identify system risks, control measures, and corrective actions.

• Accurate and organized recordkeeping that meets Joint Commission and CMS audit expectations.

• Response protocols that define how facilities act on positive test results, temperature fluctuations, or low disinfectant residuals.

  
  

These updates also create new expectations for collaboration between infection prevention, environmental services, and facilities engineering teams. Ensuring communication and documentation flow between departments is now a core component of compliance.

How Legionella Specialties Helps Facilities Stay Ahead

Legionella Specialties partners with healthcare organizations to simplify the compliance process and reduce risk. Our ST108 and ASHRAE 188 alignment programs include:

• Professional Legionella testing and reporting that meets or exceeds new local laws like Intro. 1390-A.

• Creation and ongoing maintenance of a customized Water Management Plan specific to each facility’s plumbing system and risk profile.

• Survey-ready documentation that satisfies Joint Commission and CMS requirements.

• Training and consultation to help facility teams understand their responsibilities and respond effectively to testing results.

Our reporting format includes actionable data summaries, risk assessments, and trend tracking to help clients identify potential problem areas before they lead to compliance issues or outbreaks.

Conclusion and Call to Action

The new wave of Legionella regulations signals a shift from minimal compliance to proactive prevention. Facilities that adapt early will not only meet the legal requirements but also strengthen patient safety and operational reliability.

To see what full compliance looks like, download our sample ST108 Compliance Report or schedule a consultation with the Legionella Specialties team. Together, we can help your facility stay prepared for evolving standards and prevent the next outbreak before it begins.