42 CFR §485.725(e) — Standard: Pest Control (Clinics, Rehabilitation Agencies, and Public Health Agencies)

Citation

42 C.F.R. § 485.725(e) (2026). Title 42, Chapter IV, Subchapter G, Part 485 — Conditions of Participation: Specialized Providers; Subpart H — Conditions of Participation for Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services. Source citation as printed in eCFR: [41 FR 20865, May 21, 1976. Redesignated at 42 FR 52826, Sept. 30, 1977. Further redesignated and amended at 60 FR 2326, 2328, Jan. 9, 1995; 60 FR 50447, Sept. 29, 1995; 86 FR 61623, Nov. 5, 2021; 88 FR 36510, June 5, 2023]. Read from the eCFR XML of Part 485 (point-in-time 2026-09-08, per the reference’s source manifest; the XML itself carries no date) on September 11, 2026.

What It Says (Verbatim)

The standard, and the condition it belongs to, in full:

§ 485.725 Condition of participation: Infection control.

The organization that provides outpatient physical therapy services establishes an infection-control committee of representative professional staff with responsibility for overall infection control. All necessary housekeeping and maintenance services are provided to maintain a sanitary and comfortable environment and to help prevent the development and transmission of infection.

(a) Standard: Infection-control committee. The infection-control committee establishes policies and procedures for investigating, controlling, and preventing infections in the organization and monitors staff performance to ensure that the policies and procedures are executed.

(b) All personnel follow written procedures for effective aseptic techniques. The procedures are reviewed annually and revised if necessary to improve them.

(c) Standard: Housekeeping. (1) The organization employs sufficient housekeeping personnel and provides all necessary equipment to maintain a safe, clean, and orderly interior. A full-time employee is designated as the one responsible for the housekeeping services and for supervision and training of housekeeping personnel.

(2) An organization that has a contract with an outside resource for housekeeping services may be found to be in compliance with this standard provided the organization or outside resource or both meet the requirements of the standard.

(d) Standard: Linen. The organization has available at all times a quantity of linen essential for proper care and comfort of patients. Linens are handled, stored, processed, and transported in such a manner as to prevent the spread of infection.

(e) Standard: Pest control. The organization’s premises are maintained free from insects and rodents through operation of a pest-control program.

Three things the sentence does. It sets an outcome (“premises are maintained free from insects and rodents”), it names the means (“through operation of a pest-control program”), and it places both inside the infection control condition rather than the physical environment condition (§485.723), which is where the parallel hospital language for the physical plant sits. It specifies no method, frequency, credential, or record.

Who It Applies To

The standard binds an “organization,” which §485.703 defines, verbatim:

Organization. A clinic, rehabilitation agency, or public health agency.

and each of those, verbatim from the same section:

Clinic. A facility that is established primarily to furnish outpatient physician services and that meets the following tests of physician involvement: (1) The medical services are furnished by a group of three or more physicians practicing medicine together. (2) A physician is present during all hours of operation of the clinic to furnish medical services, as distinguished from purely administrative services.

Rehabilitation agency. An agency that— (1) Provides an integrated interdisciplinary rehabilitation program designed to upgrade the physical functioning of handicapped disabled individuals by bringing specialized rehabilitation staff together to perform as a team; and (2) Provides at least physical therapy or speech-language pathology services.

Public health agency. An official agency established by a State or local government, the primary function of which is to maintain the health of the population served by performing environmental health services, preventive medical services, and in certain cases, therapeutic services.

The subpart’s scope, verbatim from §485.701:

This subpart implements section 1861(p)(4) of the Act, which— (a) Defines outpatient physical therapy and speech pathology services; (b) Imposes requirements with respect to adequate program, facilities, policies, staffing, and clinical records; and (c) Authorizes the Secretary to establish by regulation other health and safety requirements.

In plain terms: the standard applies to the organizations Medicare certifies under Subpart H to furnish outpatient physical therapy or speech-language pathology services, which are clinics meeting the physician-involvement tests, rehabilitation agencies, and public health agencies. Under §485.707, these organizations must also be licensed where state or local law provides for it, so state clinic licensure rules apply on top of this standard.

Who It Does Not Apply To

Part 485 is not the critical access hospital rule. Part 485 is “Conditions of Participation: Specialized Providers,” and its subparts, as published, are:

The common error is to read “42 CFR Part 485” as “critical access hospitals” and conclude that CAHs carry an explicit pest control standard. They do not. §485.725(e) is in Subpart H. The CAH physical plant condition, §485.623 in Subpart F, contains no pest language; its maintenance standard reads, verbatim:

(b) Standard: Maintenance. The CAH has housekeeping and preventive maintenance programs to ensure that— (1) All essential mechanical, electrical, and patient-care equipment is maintained in safe operating condition; (2) There is proper routine storage and prompt disposal of trash; (3) Drugs and biologicals are appropriately stored; (4) The premises are clean and orderly; and (5) There is proper ventilation, lighting, and temperature control in all pharmaceutical, patient care, and food preparation areas.

A CAH pest finding is written by inference under that language, exactly as a hospital finding is written by inference under §482.41; the CAH surveyor manual (Appendix W) and its C-tags were not in the verified source set for this page and are not characterized here.

Hospitals are governed by 42 CFR Part 482, which contains no occurrence of “pest,” “rodent,” “insect,” or “vermin” (0 in the Part 482 eCFR XML), and whose surveyor manual, Appendix A Rev. 238, contains none either (0 in 613 pages). See the Conditions of Participation page and A-0758 does not appear in Appendix A.

Rural emergency hospitals (Subpart E) and community mental health centers (Subpart J) have no pest standard in their subparts; the only occurrences of “pest,” “insect,” and “rodent” in the whole of Part 485 are in §485.725(e) and in one other provision, next.

The One Sibling Provision: CORFs, §485.62(b)(4)

Part 485 contains a second explicit pest provision, in Subpart B, for comprehensive outpatient rehabilitation facilities (CORFs). It is a numbered requirement inside the sanitary-environment standard rather than a standard of its own, verbatim:

§ 485.62 Condition of participation: Physical environment. […] (b) Standard: Sanitary environment. The facility must maintain a sanitary environment and establish a program to identify, investigate, prevent, and control the cause of patient infections. […] (4) Provisions must be in effect to ensure that the facility’s premises are maintained free of rodent and insect infestation.

So the accurate statement is: outside long-term care (42 CFR §483.90(i)(4), tag F925), the federal Conditions of Participation contain exactly two explicit pest provisions, both in Part 485, both for outpatient rehabilitation-type providers, and neither for hospitals or critical access hospitals. §485.725(e) is the only one framed as a freestanding “Standard: Pest control.”

What It Means in Plain Language

For a clinic, rehabilitation agency, or public health agency certified under Subpart H, pest control is a survey item in its own right, inside the infection control condition. The organization must be able to show two things: that its premises are in fact free from insects and rodents, and that a pest-control program is in operation. The second is a documentary question. An organization that has never had a pest problem but has no program is out of compliance with the means the standard names; an organization with a program and a current infestation is out of compliance with the outcome. Because the standard sits in §485.725, the infection-control committee required by paragraph (a) is the body whose policies and monitoring are expected to cover it.

For the same organization’s building, §485.723 (physical environment) separately requires that “the interior and exterior of the building are clean and orderly and maintained free of any defects that are a potential hazard to patients, personnel, and the public,” which is where harborage and entry conditions (gaps, screens, penetrations) are written.

Contrast With the Hospital Side

The hospital side has to reason from “safety and well-being of patients” and “clean and sanitary environment” to a pest observation. Subpart H organizations do not; the regulation names the pests and the program.

Documentation Evidence Required

The regulation specifies none. What demonstrates “operation of a pest-control program” is, in this reference’s judgment, the same record set that satisfies the hospital-side tags and F925: a written program (in-house or contracted) covering the premises; inspection and service records showing findings, non-chemical measures, and any product applied with its EPA registration number and the applicator’s credential; a sighting log with a response route; exclusion and sanitation work orders; and evidence that the infection-control committee reviews the program, since the standard sits in the infection control condition. State pesticide law governs who may apply what; see the Utah applicator rule on this reference for one state’s example.

How Surveyors Evaluate It

CMS’s surveyor guidance appendix for Subpart H organizations, with its tag numbering and interpretive guidance for §485.725(e), was not in the verified source set for this page and is not characterized here: [CONTENT PENDING — SUBPART H SURVEYOR APPENDIX NOT IN THE VERIFIED SOURCE SET]. What can be said from the regulation alone is that the standard has two testable parts, the condition of the premises and the existence and operation of a program, and that a surveyor can fail either.

Confidence Notes

HIGH confidence for every quotation and for the scope statements. §485.725 in full, §485.701, §485.703, §485.62, §485.623, §485.707, and the subpart structure were read from the eCFR XML of 42 CFR Part 485 on September 11, 2026 (367,561 bytes, decoded and validated), and the Part-wide term counts (“pest” 2, “insect” 2, “rodent” 2, “vermin” 0, all in §485.725(e) and §485.62(b)(4)) were measured on that file. The Part 482 and Appendix A counts are from the same run’s measurements of those documents. The point-in-time date of the eCFR file (2026-09-08) is recorded in the reference’s source manifest and in the file name; the XML itself carries no date. The documentation section is the reference’s judgment and is labeled as such.

Related Killed Claims

• “42 CFR Part 485 gives critical access hospitals an explicit pest control standard.” Disconfirmed. The explicit standard, §485.725(e), is in Subpart H (clinics, rehabilitation agencies, public health agencies). The CAH subpart’s physical plant condition, §485.623, contains no pest language; its closest text is “The premises are clean and orderly.”
• “§485.725(e) is the only explicit pest provision in the federal Conditions of Participation outside long-term care.” Not quite. It is the only freestanding “Standard: Pest control,” but §485.62(b)(4) (CORFs) also requires that “the facility’s premises are maintained free of rodent and insect infestation.” Both are in Part 485; neither reaches hospitals.