A regional assisted living and memory care operator in the southeastern United States required urgent environmental consulting support after two confirmed cases of Legionnaires’ disease were linked to the facility’s potable water system. TRC was engaged to assess the facility’s water distribution system, develop a defensible environmental sampling strategy and provide immediate risk mitigation recommendations. Working closely with facility leadership and health authorities, TRC delivered actionable guidance within a critical response window, supporting public health compliance and risk management.
Challenge
Legionella risk presents a significant challenge in senior living environments where complex water systems, aging infrastructure and vulnerable populations intersect. Facilities must respond quickly to confirmed cases reduce risks to residents and staff and demonstrate regulatory compliance.
The client faced several critical challenges:
- Immediate need for environmental consulting support and water testing guidance
- Potential regulatory oversight from state health departments
- Operational disruption related to potable water use restrictions
- Limited internal expertise in Legionella response and environmental sampling
- Pressure to minimize disruption for residents, families and staff while meeting compliance requirements
In many cases, facilities must temporarily discontinue normal potable water use until point-of-use filtration systems are installed. This can require reliance on bottled water for cooking, consumption and hygiene, creating significant operational strain for both staff and residents.
The client required expert guidance to determine whether the building water system posed an ongoing risk and to implement a response strategy aligned with regulatory expectations, supporting efforts to manage risks for residents and staff.
Solution
TRC mobilized quickly to provide environmental health consulting and technical guidance to the facility within 24 hours of engagement.
Our team conducted a rapid review of the building’s potable water system and identified potential risk areas within the distribution network. Based on this assessment, we developed a structured sampling strategy aligned with public health and industry guidance, including CDC recommendations and the ASHRAE 188 framework.
Our scope of work included:
- Review of the facility’s potable water distribution system and risk points
- Development of a targeted Legionella sampling plan aligned with regulatory expectations
- Recommendations for immediate mitigation actions such as system flushing, temperature verification, and fixture prioritization
- Guidance on documentation and communication with regulators and stakeholders
- Development of a Water Quality Management Plan to support ongoing water quality practices
The sampling plan was tailored to the facility’s multi-building layout and varied plumbing conditions. We prioritized outlets based on risk factors such as stagnation patterns, temperature conditions and potential resident exposure.
Our team also provided step-by-step implementation guidance to help facility management coordinate water testing and initiate environmental sampling without delay.
By combining expertise in building sciences and industrial hygiene, we delivered a clear and regulator-ready framework for assessing and mitigating Legionella risk within the facility.
Results
TRC’s rapid response enabled the client to move forward with a structured and compliant Legionella investigation, ensuring timely action during a critical period.
Key outcomes included:
- Delivery of a clear environmental sampling plan within the critical response window, allowing the client to act decisively
- Demonstration of prompt corrective action to regulatory authorities that helped build trust and avoid potential penalties
- Reduction of potential compliance exposure and regulatory risk, ensuring alignment with public health requirements
The facility was able to implement targeted mitigation actions and proceed with environmental testing aligned with best practices for Legionella investigation. This swift action minimized operational disruption and reassured residents, families and staff.
Following whole-building water system sanitization, post-remediation laboratory analysis confirmed that Legionella levels were reduced to undetectable or acceptable thresholds, restoring confidence in the facilities water system.
Beyond the immediate response, the project helped the client establish a stronger framework for ongoing water management and risk reduction. The organization now has documented processes that support regulatory readiness enhance operational practices and reduce future risk.
The engagement also reinforced an important industry lesson. Senior living facilities benefit significantly from proactive water management planning and early engagement with environmental health experts. Clear technical guidance during a public health event can reduce uncertainty, minimize operational disruption and support faster recovery.