Originally published on June 9, 2015 and updated July 9, 2015 and August 20, 2025.
This question has come up several times in phone conversations and webinars: How much will it cost a facility to implement the type of Legionella water management plan that is outlined by the World Health Organization and Veterans Health Administration and in ASHRAE Standard 188?
Let’s break it down into four cost categories:
Cost for Establishing a Water Management Plan
The cost of establishing a program will vary with the size and complexity of a building’s water systems. As an example, consider a 200-bed hospital or a 300-room twin-tower hotel with two domestic hot water systems and one cooling tower system.
Utilizing the LAMPS software will save time and money in setting up the water management plan and will make ongoing implementation of the programming much easier and more successful. The software has training, data management, analytics, and procedures built in. The yearly cost to access LAMPS Complete is currently $2995.
Although most facilities personnel have the knowledge to set up their water management plan in LAMPS, few have the time. Most facilities will be more successful with their water management program – and get it set up much sooner – by having a an authorized LAMPS partner set it up for them. What a partner will charge for setting up the plan will, of course, vary with the size of the property and the number and complexity of the water systems on it. For a 200-bed hospital or a 300-room twin-tower hotel with two domestic hot water systems and one cooling tower system, the price charged by the partner for setting up the plan could vary from approximately $7,000 to $15,000. With the $2995 software cost, the total cost in the initial year would thus be roughly $10,000 to $18,000.
When it comes to risk management plans, higher prices do not always mean higher quality. In fact, some companies charge high prices because of inexperience—they haven’t performed enough surveys or written enough water management plans to be efficient.
Management plans need to be updated periodically, so at least a portion of the initial development cost should be budgeted for re-surveying the water systems and updating control measures yearly.
Cost of Implementing Legionella Control Measures
For a well-maintained facility, implementing the plan will not cost much because many Legionella control measures are simply good maintenance and part of manufacturer recommendations. For example, a cooling tower that is already being properly maintained and treated will need few, if any, additional measures for Legionella control.
Yes, a comprehensive Legionella risk management plan will include several procedures that most facilities are not already doing, especially for domestic (potable) water systems. And, implementing those measures will require additional time for the maintenance personnel. However, a well-maintained 200-bed hospital or 300-room hotel will not likely need to hire additional personnel to carry out and document the measures.
Cost of Validating a Water Management Program
A Legionella risk management plan must be validated to show its effectiveness in controlling Legionella bacteria. Testing water systems for Legionella is not mandatory for validation but provides the most direct and reliable feedback on the control program. It is also the most expensive validation method so let’s look at Legionella testing to estimate a worst-case validation cost.
For the 200-bed hospital or 300-room hotel, collecting 20 to 25 samples four times a year would very likely provide enough data. At a cost of $120 to $250 a sample—depending in part on whether the facility hires a company to collect the samples or collects the samples themselves—the validation cost would range from $9,600 to $25,000 a year.
Cost of Legionella Remediation
Some facilities will require no remediation—zero cost. Some will need to make only minor adjustments in the maintenance or operation of the water systems. For others, the remediation cost will depend on the size of the problem and the proposed solution. I have seen facilities spend more than $400,000 on a problem that could have been solved for about $30,000. No exaggeration. What’s worse is that the $400,000 did not solve the problem. It’s important to get good advice.
Do Legionella risk management programs actually reduce disease and healthcare costs?
Yes.
The Center for Disease Control and Prevention (CDC) has reported that Legionella is not only the number one cause of waterborne disease outbreaks in the United States, it is also the most expensive, with direct healthcare costs from $101 to $321 million annually (CDC 2010. “Waterborne diseases could cost over $500 million annually in US”). Adding indirect costs for lost employee work time and productivity brings the estimated total to well over a billion dollars a year (McCoy W, Pearson W. 2011. ASHRAE Standard 188P: Prevention of Legionellosis associated with building water systems. Presented in Atlanta, GA at the annual convention of the Association of Water Technologies.).
Are water management programs worth the cost for building owners?
Based on its study of Legionnaires’ disease outbreaks from 2015-2019, the CDC concluded that “all of the deficiencies associated with outbreaks could have been prevented by comprehensive, properly implemented water management programs.”
A 2021 study indicated that fully implementing a comprehensive water management plan reduces Legionella in water systems. Facilities that performed control measures on schedule and did more water tests had fewer water samples in which Legionella was found.
Building operators that avoid Legionnaires’ disease cases by properly managing water systems will avert damage to their image, lost revenue, and costly litigation that often follows an outbreak or even a single case of the disease, likely offsetting the cost of a water management program many times over.
Will Legionnaires’ disease definitely occur in buildings that do not implement a water management program? No, but wearing a seat belt makes sense even if you never crash. Moreover, making your building safe is just the right thing to do. Most Legionnaires’ Disease Survivors are furious when they find out they suffered from a disease that could have been prevented – and they thankful for facilities that are doing something about it.
Question: What has it cost your facility to implement a Legionella risk management program? Has it been worth it?
Good article. Appreciate the inclusion of cost data. I would challenge you to offer more specific benefits to Validating the Plan. Adding $8-20K annually to the maintenance costs is not something most hospitality owners are eager to accept. Are there alternatives to reduce this cost?
A water management plan must be validated to comply with ANSI/ASHRAE 188. Also, without validating with reliable testing, one can only guess as to whether the control measures are sufficient. Total bacteria counts provide pretty good Legionella validation for Whirlpool spas but for plumbing systems and cooling towers, data shows that no surrogate test will suffice. A test for Legionella provides the most direct and reliable feedback on Legionella control. To lower costs, a facility could reduce the number of samples collected or the frequency of sampling. However, if the program is reduced to the point of having too little information on which to base decisions, the sampling will have been a total waste of money.