Healthcare Facility Manager Resources

AHU Maintenance

• Outdoor air-cooled chillers and condenser: gently clean condenser coils with foaming cleaner.
• Clear weeds and debris around air-cooled condensing units and check refrigeration lines for insulation decay.
• Visually inspect electrical components.
• AHU evaporator coil cleaning: clean condensate drain pan and condensate drain lines.
• Clean AHU airflow stations, especially those subjected to surgery area lint.
• AHU outdoor air economizers and building pressure control. When outdoor air temperatures are between 50 °F and 72 °F, air handlers utilize outdoor air for economy cooling. Proper operation of relief fans, exhaust fans, and building pressure controls are essential to prevent doors from standing open.

Terminal Unit Maintenance

• Air-side reheat coil cleaning: In summer cooling mode, VAV boxes typically deliver 55°F air to maintain a 72°F room temperature. That is only a 17°F air delta-T. Lower air delta-T requires a higher airflow. Summer cooling typically requires twice the airflow. When cleaning the coils, do not forget to clean the VAV box air-velocity sensors.

Hospital surveys and inspections can be a stressful activity for facility managers. Below is a list of tips and tricks that can help you be more prepared for a surveyor’s visit.

1. Be prepared with a life safety plan for the facility showing all rated partitions and smoke compartments.
2. Be prepared with a map for each medical gas zone valve box and which areas are controlled under each zone.
3. Be prepared to demonstrate proper pressurization of spaces that are required to be negative (soiled utilities, janitor’s closets, compounding pharmacy areas, isolation rooms, etc.) and positive (operating rooms, clean work areas, protective environment rooms, etc.). This can be through visual means such as room pressure monitors located at the space or through the building automation system. Some hospitals have built out a table showing all spaces that should be monitored for their own benefit and to easily show compliance during a survey.
4. Have a completed ARC flash study document for your building.
5. Do a visual inspection to make sure all electrical panels and gear are clear and do not have stored materials stacked around them.
6. Double check fire-rated walls and ensure all penetrations have been caulked (especially if there are areas of recently completed construction).
7. Be prepared with a record of completion of fire alarm and fire smoke damper testing. Testing and inspection of fire alarm and damper testing is required annually by NFPA90A. NFPA 25 and 72 require inspection and testing of fire sprinkler systems every five years.
8. In medical gas rooms, comingling of full and empty cylinders is not allowed. Empty cylinders must be marked and kept separate from full cylinders.
9. Be able to maintain required relative humidity levels for spaces that require it per the FGI Guidelines such as OR rooms and or storage rooms where any stored items have humidity requirements on their packaging or labels.
10. All circuits within a panel shall be clearly identified with a panel directory located on the face or inside of the panel door. NFPA 70 Article 408.4.

Fault studies are not done as a part of a typical construction document design, with the exception of a basic short circuit study. The information required for such a study is not available until the project is in construction, shop drawings have been reviewed, and actual feeder distances are known. Often, a specification is included in the project manual that requires the contractor to perform, or contract to perform, the study for a given project. However, this is usually just a small portion of the facility.

For a healthcare campus, it’s usually more typical that there is an overall campus fault study done, and then when projects add to or change the system, those changes are incorporated. In order for information to be accurate, it’s best to have all in one model. The Cushing Terrell team has done this for several healthcare clients such as Saint Vincent Healthcare, Billings Clinic Main Campus, Billings Clinic Bozeman Campus, Holy Rosary Hospital, and Prairie Hospital.

The question many people have is: What is a fault study and why would we need one? The main reasons are:

• To increase the life safety for building occupants, maintenance personnel, and other qualified individuals that may work on the system.
• To protect the electrical equipment. When equipment is damaged, there’s often a high cost to replace it and a higher liability for life safety at the time of failure, during downtime of the equipment, and during equipment replacement.
• To minimize power interruptions to the electrical system.
• To be compliant with the latest edition of National Electrical Code (NEC).

There are three major components to a fault study: a short circuit study, an overcurrent device coordination study, and an arc flash study.

The short circuit fault analysis evaluates the worst case of potential three-phase and single-line-to-ground faults that occur at electrical equipment. The 2020 NEC 110.9 requires all equipment intended to interrupt current to have an interrupting rating for the potential fault levels that can occur. If equipment is not rated for the potential fault and a high enough fault happens, it will be damaged. That damage could be a minor melt down or could be explosive, which is an obvious safety concern and would naturally cause electrical system downtime as well.

The overcurrent device coordination study evaluates overcurrent device types, sizes, and settings with the overall goal of isolating potential faults closest to fault source. Power interruptions can sometimes be life threatening and need to be minimized to the extent possible. It’s not uncommon for a fault on a small branch circuit to trip a switchboard main breaker due to the system not being coordinated. For healthcare facilities, the 2020 NEC articles 517, 700, and 701 require emergency systems to be selectively coordinated.

The arc flash study determines the incident energy levels at working distances from the equipment and the personal protective equipment (PPE) that must be worn when working within the flash protection boundary. The 2020 NEC has added requirements for electrical equipment to have arc flash warning labels. These labels indicate a warning about the arc flash hazard, the incident energy level from a fault potential shock hazard, and PPE required when working on the electrical equipment. The 2020 NEC 110.16 requires arc flash labels on electrical equipment such as switchboards, panelboards, meter socket enclosures, and motor control centers that are likely to require examination, adjustment, servicing, or maintenance while energized. The arc flash label will warn qualified individuals of the potential arc flash hazards. Healthcare facilities have critical systems that often need to be worked on live to minimize shutdowns so these labels are that much more important. With these labels, the electrician can see what the incident energy potentially could be at that panel and put on the appropriate PPE for protection.