EPA Integrated Pest Management in Health Care Facilities: Implementing an IPM Program (2021)

Correction Notice (September 12, 2026)

Three passages previously presented on this page as verbatim quotations from this toolkit do not appear in the document. They have been removed. They were: a numbered “six basic steps” sentence; a recordkeeping passage enumerating required record fields and a three-year retention period; and a sentence placing chemical controls after non-chemical alternatives. None of the three is in EPA 907K21002 in that form. The page’s subtitle was also wrong — the document is subtitled Implementing an IPM Program, not “A Practical Guide for Implementation” — and the cited URL was a landing page that returns 404 and was never archived.

What replaced them: the document’s actual six numbered sections, taken from its table of contents, and the passages that were in fact read from the PDF. Where this page now states a point that is not quoted, it is stated in plain language without quotation marks. On this site a quotation mark is a factual claim; see Methodology.

Citation

U.S. Environmental Protection Agency, Region 7. Integrated Pest Management in Health Care Facilities: Implementing an IPM Program. Publication No. EPA 907K21002. July 2021. 29 pages.

Live PDF (HTTP 200 as of September 11, 2026): https://www.epa.gov/system/files/documents/2021-07/integrated-pest-management-toolkit-2021.pdf

Stable archival copy: Wayback Machine snapshot captured February 26, 2026, 05:33:02 UTC (HTTP 200) at http://web.archive.org/web/20260226053302/https://www.epa.gov/system/files/documents/2021-07/integrated-pest-management-toolkit-2021.pdf

The URL this page cited before September 12, 2026 — https://www.epa.gov/ipm/integrated-pest-management-health-care-facilities-toolkit — returns HTTP 404 and has no Wayback capture. Cite the PDF path above, not the landing page.

This page does not attribute co-authorship to any organization other than EPA Region 7. An attribution to the National Center for Healthy Housing appeared here previously; it could not be confirmed against the document’s acknowledgements and has been removed rather than carried forward unverified.

What the Document Contains

The toolkit’s own table of contents, in order: Preface · Acknowledgements · How to Use This Toolkit · Self Assessment · Glossary · Introduction · Establishing an IPM Program in Your Facility (1. Establish Your IPM Team; 2. Develop an Official IPM Policy and Procedures — with a one-page sub-topic, Working with a Pest Control Company; 3. Set Pest Management Roles for Everyone; 4. Inspect, Identify, Monitor, Evaluate; 5. Implement Pest Prevention Strategies; 6. Document and Communicate Pest Management Activities) · Evaluating the Costs · References and Resources · Appendix A: Sample IPM Policy · Appendix B: Sample IPM Procedure.

So the toolkit does carry six numbered steps, but they are not the six that were previously listed on this page. The real six are:

1. Establish Your IPM Team
2. Develop an Official IPM Policy and Procedures
3. Set Pest Management Roles for Everyone
4. Inspect, Identify, Monitor, Evaluate
5. Implement Pest Prevention Strategies
6. Document and Communicate Pest Management Activities

Note what that ordering does and does not say. Steps 1–2 are organizational: who is accountable, and what the written policy says. Working with a Pest Control Company is a one-page sub-topic within step 2 (p. 13), conditional on the facility having a contract — “Many facilities may contract out pest control services. If you have a pest control contract, you will also need to review the contract specifications to ensure it is consistent with your IPM policy.” — and steps 3–6 (pp. 14–22) address roles, inspection, prevention, and records for the facility itself. Two items commonly attributed to this document are not among the six: there is no numbered “set action thresholds” step, and there is no numbered “evaluate results” step separate from step 4’s Inspect, Identify, Monitor, Evaluate.

The document also contains a Self Assessment and two model documents, Appendix A: Sample IPM Policy and Appendix B: Sample IPM Procedure. For a facility building a program from nothing, those appendices are the most directly usable part of the toolkit, and they are the part least often cited.

What It Says (Verbatim)

The following passages were read from the PDF on September 11, 2026 and pinpointed to their pages on September 15, 2026 against the archived copy (the toolkit’s printed page numbers equal its PDF page numbers).

On the standard healthcare facilities are held to:

“Health care facilities, including but not limited to hospitals, ambulatory centers, long-term care facilities, rehabilitation centers, and other outpatient facilities, must meet the highest level of sanitation, while caring for sensitive populations.”

(Preface, p. 2.)

On the two-sided nature of the problem — this is the passage that carries the document’s actual position on chemicals:

“While it is important that health care facilities be free from pests that pose health risks, it is also critical that patients and employees be protected from chemicals that may also threaten their health.”

(Preface, p. 2.)

On the toolkit’s relationship to accreditation, and on its own authority:

“Additionally, The Joint Commission has recommendations for health care facilities. You should modify the suggestions here to tailor them to your specific needs.”

(Disclaimer, p. 2.)

That third sentence is worth reading closely, because it is the document describing its own force. The toolkit calls its own contents suggestions and instructs the reader to modify them. It is not written as a compliance floor.

On the place of pesticides in the program. The toolkit contains no numbered control hierarchy. Its position — that prevention and non-chemical means come first and pesticides are applied as needed, targeted, and least-risk — is stated in several places, verbatim:

“IPM focuses on pest prevention and least-toxic control methods … Preventive pesticide application is limited to minimize the risk of pesticide exposure, especially when non-chemical methods provide the same results.”

(Preface, p. 2.)

“3. Are pesticide treatments used in and around your facility only as a last resort?”

(Self Assessment, p. 6.)

“Note that IPM does not exclude the use of pesticides, but rather encourages the use of multiple mitigation approaches – and when deemed necessary, the application of pesticides that pose the least risk to people and the environment. IPM focuses on long-term solutions to pest issues rather than routine and repetitive use of pesticides.”

(Introduction, p. 9.)

“Often, routine pesticide applications are not necessary unless there is a constant infestation by a pest and non-chemical methods have failed to control the pest. Service contracts should include periodic inspections, but pesticides should not be applied unless the pests are actually present and cannot be controlled by other means.”

“Pesticide use should be targeted and applied on an as-needed basis only. In general, routine (e.g., monthly) applications of pesticides are not a component of an IPM program.”

(Working with a Pest Control Company, p. 13.)

“The most common and effective habitat modifications are exclusion, repair and sanitation. If preventive methods are no longer effective or available, IPM programs then select a proper control method, based on both effectiveness and risk.”

(Step 4, p. 15.)

“IPM is proactive rather than reactive, eliminating the need for routine and repetitive use of pesticides by focusing on a sequential decision-making process.”

(Appendix A, Sample IPM Policy, p. 26.)

On Recordkeeping — Stated, Not Quoted

The toolkit’s sixth section is Document and Communicate Pest Management Activities. Its treatment of recordkeeping states why records matter and lists seven contents of the facility’s pest management logbook (p. 22); it does not specify per-application record fields or any retention period. Records, the toolkit says, are what let a facility determine whether the program is working, verify that the written policy is actually being followed, identify trends over time, and justify the decisions the program has made (p. 22). The seven logbook contents, stated rather than quoted: a copy of the IPM policy and procedures; pesticide use and service schedules for each property or site; a copy of the current EPA-registered label and current Safety Data Sheet for each pesticide used on the property; pest surveillance data sheets; diagrams of pest-vulnerable areas noting historical activity and the locations of all traps, trapping devices, and bait stations; listings and diagrams of environmentally or culturally sensitive areas where pesticide use must be avoided or limited; and copies of all pest management contracts (p. 22). These are restatements, not quotations.

The specific record fields and the three-year retention period that this page formerly attributed to EPA are not in the document. If you need an enforceable list of required service-record contents, the toolkit is the wrong source. Two real ones:

• Utah Admin. Code R68-7-11(11) imposes nine required elements on every commercial pesticide application record, requires the record within 24 hours of application, and sets a two-year retention period. See Utah R68-7.
• VHA Directive 1850.02 requires a written Integrated Pest Management Operations Plan at every VA medical facility, reviewed annually, with recordkeeping as a mandatory plan element; its contract scope names the record categories — inspection reports, pest sightings, pesticide application and follow-up activities (¶3.d) — without prescribing record fields. See VHA Directive 1850.02.

What It Means in Plain Language

The toolkit is EPA’s guidance product for healthcare IPM. It is not regulation: there is no enforcement mechanism in it, no penalty attaches to departing from it, and, as quoted above, it describes its own contents as suggestions to be tailored. Treating it as a compliance standard — the facility’s or a surveyor’s — overstates it.

What it is good for is program design and the vocabulary of a defensible program. A facility that can show an IPM team, a written policy, assigned roles, a monitoring routine, prevention work, and documentation is describing its program in the same six terms EPA uses, which makes the program legible to an infection preventionist, an accreditation surveyor, and a state licensing surveyor alike.

Where a binding pest requirement exists, it comes from somewhere else. For a nursing home that is §483.90(i)(4) / F925. For a clinic, rehabilitation agency, or public health agency providing outpatient physical therapy or speech-language pathology it is §485.725(e). For a Utah hospital it is R432-100-38(1)(d). For a VA medical facility it is VHA Directive 1850.02. For a hospital under the Medicare Conditions of Participation there is no explicit pest tag at all — see Which Tag Is Pest Control?.

Who It Applies To

By its own terms the toolkit addresses health care facilities “including but not limited to hospitals, ambulatory centers, long-term care facilities, rehabilitation centers, and other outpatient facilities.” It is written for the people who own the program inside those buildings — administrators, infection preventionists, environmental services and plant operations managers — and for the pest management companies serving them; the toolkit devotes one page (p. 13) to contract specifications for facilities that contract out.

Because it is guidance and not regulation, it applies to no facility as a matter of law. It applies as a matter of practice wherever a facility, an accreditor, or a contract adopts it.

What This Page Does Not Say

• It does not say EPA requires anything of a healthcare facility through this document. EPA’s binding authority over pesticides runs through FIFRA and the product label, not through a Region 7 toolkit.
• It does not say the toolkit establishes a numbered control hierarchy. The toolkit contains no numbered control hierarchy and no sentence requiring non-chemical alternatives to be “evaluated and found inadequate.” Its stated position, in several places (pp. 2, 6, 9, 13, 15, 26, quoted above), is that prevention and non-chemical means come first and pesticides are applied as needed, targeted, and least-risk — e.g., p. 13: “pesticides should not be applied unless the pests are actually present and cannot be controlled by other means.”
• It does not say the toolkit requires anything: as guidance it describes action thresholds (pp. 7, 12, 26), an annual program review (pp. 10, 22), and seven logbook contents (p. 22); it states no retention period.

Confidence Notes

HIGH confidence as of September 15, 2026. Raised from MEDIUM. The document’s title, subtitle, publication number, date, issuing office, length (29 pages), table of contents, live URL, and the quoted passages above were read directly from the PDF on September 11, 2026, and the archival snapshot was confirmed at the Internet Archive for February 26, 2026. The two conditions that held confidence at MEDIUM are now met: the full PDF is held in this reference’s primary-source archive (EPA_IPM_HealthCareFacilities_Toolkit_907K21002_2021-07.pdf, placed September 12, 2026, byte-identical to the file EPA serves — 4,876,968 bytes, MD5 81d848e29decff054c4da908001472d0), and every quoted passage is pinpointed to its page (verified September 15, 2026; printed page numbers equal PDF page numbers). The EPA-archive item under OPEN_QUESTIONS.md R5-1 is closed by that placement.

Related Killed Claims

Three claims killed on September 12, 2026, all previously carried on this page inside quotation marks:

A fourth error, not a quotation: the subtitle “A Practical Guide for Implementation” was not the document’s subtitle. The document is Implementing an IPM Program.