Safety Standards for Therapy Pools


Published by the Aquatic Therapy & Rehab Institute














Author: Dr. Mary Wykle

Editor: Ruth Sova

Committee Chair: Dr. Mary Wykle






Copyright 2003













Aquatic therapy facilities accept responsibility to abide by a Standard of Care that adheres to the principles of risk management. The purpose of these Standards describes the safe operation of the facility used for aquatic therapy and rehabilitation. The National Spa and Pool Institute has facility standards for pool design and workmanship to insure product integrity. Public agencies regulate quality control. Aquatic therapy practitioners must often work in pools beyond their control, unless they are specifically involved in the building of the pool.


Standard I - Aquatic therapy pools will have an appropriate and comprehensive Emergency Action Plan insuring timely response to emergencies and situations that endanger the health and safety of the users.


A.     The Emergency Action Plan will be in writing and posted within the facility.


B.     The Emergency Action Plan will insure emergencies are handled in a safe, efficient, and effective manner.


C.    Personnel and staff will be trained to respond and execute the Emergency Action Plan in a timely manner.  All will know how to activate emergency code procedures.


D.    Personnel and staff will know their role in implementation of the Plan.


E.     A systematic line of communication will be available in the immediate pool area with emergency numbers, dialing instructions, and directions to the pool posted by the telephone. 


F.     Regular training and practice drills will be conducted and documented.


G.    Surveillance and monitoring plans are written and posted as part the Emergency Action Plan.


H.     Two evacuation routes are posted in diagram form and included in the Plan.


I.         A documentation file is part of the annual competency assessment and includes


  1. Emergency Action Plan
  2. Training and rehearsal schedule with personnel and staff participating in training.
  3. Incident report forms.
  4. Blood or body fluid exposure of personnel or staff members.
  5. Copy of current certifications and licenses with expiration dates of personnel and staff.
  6. List of rescue equipment on deck, first aid supply kit with current inventory, biohazards kit, and CPR pocket facemasks.  Kits are checked monthly and re-stocked after each use.
  7. Policy on pool closure for environmental conditions based on recommended guidelines of the National Weather Service and the National Lightning Safety Institute.


Standard II - Administrative standards will be identified and implemented by the person with supervisory responsibility to insure a safe environment for staff and clients.


A.      Daily safety checks of the facility will be conducted before opening and after closing by designated staff and documented.  This includes the pool area, dressing and shower areas, and facility entrances.


B.      Signage will be posted according to ANSI guidelines listing therapy pool use rules, warnings, and regulatory signs.  Pool rules will be posted away from congestion and easy to read.  Warning signs will be placed before the danger area.


C.      The pool supervisor should be a certified as a pool operator.


D.      All therapy pool personnel and staff will maintain and display a copy of current certifications and licenses with expiration dates in CPR, First Aid, Risk Management and Water Safety/Lifeguarding skills, and specialized training.  Personnel are encouraged to have Industry Certification, AED, and Supplemental Oxygen certificates.


E.      Certified lifeguards will provide supervision whenever the therapy pool is in use and follow the guidelines recommended by the National Aquatic Coalition.  State certifications and licenses are required or approved in some states.


F.       Appropriateness of water therapy will follow standard indications, precautions, and contraindications.  Individual therapy pools will make final decisions.


Standard III - Therapy pools will comply with applicable published national, state, and local government agency rules, regulations, health codes, and published standards.


A.     The supervisor in charge of the therapy pool will obtain a copy of and prudently review relevant state, county, and/or city pool health codes, regulations, and available checklists or information sheets.


B.     Precautions established by the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration's Blood-Borne Pathogen Rule and the Preventing Disease Transmission plan will be in writing and implemented in practice and regular training.  Equipment data and report forms will be completed and all incidents documented and handled according to guidelines.


C.    Compliance with the Hazard Communication Standard requires Material Safety Data Sheets on all chemicals stored at the facility, containers of hazardous chemical properly marked and stored, and all trained in execution of the written Exposure Control Plan.


D.    The supervisor of the therapy pool will retain a copy of state and local regulations that apply to therapy pools and insure minimum legal standards are enforced.


Standard IV - Therapy pools will maintain appropriate water chemistry, air quality, and ventilation.


A.     Therapy pools will have properly operating filtration and drainage systems to accommodate overflow of water from the pool.  Drains and skimmers will be cleaned on a regular schedule.


B.     Water circulation and filtration systems will be of appropriate size and operated 24 hours a day. 


C.    Water clarity will meet published guidelines.


D.    Water will be tested on a regular schedule to insure water quality and chemical levels are within acceptable ranges.  The analysis log will be posted.


E.     Water chemistry and air quality and ventilation will be based on and dependent upon desired water temperature of the therapy pool.


F.     Health codes regulating the quantity and quality of sanitizer used as disinfectants for preventing contamination and clean up after an incident will be followed.


G.    Therapy pools will coordinate with health departments and independent laboratories for water sampling to test for organisms and contaminants.


H.     The recirculation system of the therapy pool will be separate.  It will not interconnect to a non-therapeutic pool.