CHFM cheat sheet

FGI Guidelines establish minimum design standards for healthcare facilities, including space requirements, safety risk assessments, infection control, and functional relationships; many states adopt them by reference.

A pre-construction risk assessment (PCRA) is completed before construction or demolition and addresses infection control, utility interruptions, noise, vibration, air quality, and life safety impacts.

The Infection Control Risk Assessment (ICRA) classifies construction activity from Class I through Class IV; Class IV is the highest risk and requires critical barriers, HEPA filtration, and negative pressure where indicated.

Interim Life Safety Measures (ILSM) are implemented when construction, damage, or system impairment reduces normal life safety features; examples include fire watch, temporary barriers, and additional exit signage.

Typical design sequence: programming, schematic design, design development, construction documents, bidding/negotiation, construction administration, and commissioning.

Commissioning verifies that building systems meet the owner's project requirements through documented functional performance testing and issue resolution.

NFPA 101 governs life safety by occupancy classification; new and existing occupancies have different requirements, and sprinkler protection can affect allowable construction and exit requirements.

Accessible design under ADA/ABAAS requires accessible routes, clear floor space, accessible fixtures, and accessible patient and public areas.

PM completion rate = completed preventive maintenance work orders ÷ scheduled preventive maintenance work orders × 100.

MTTR = total repair time ÷ number of repairs; MTBF = operating time ÷ number of failures during the period.

NFPA 25 covers inspection, testing, and maintenance of water-based fire protection systems, including sprinklers, standpipes, valves, alarm devices, and fire pumps on defined frequencies.

NFPA 72 covers fire alarm inspection, testing, and maintenance; initiating devices, notification appliances, and system functions are tested on defined schedules.

NFPA 110 requires emergency power supply systems to be maintained and periodically exercised; Level 1 systems include monthly loaded exercise requirements.

ASHRAE 170 specifies ventilation, pressure relationships, and air-change rates for healthcare spaces; airborne infection isolation rooms are negative pressure relative to adjacent areas.

NFPA 99 governs medical gas and electrical systems; medical gas outlets, alarms, and source equipment require verification and ongoing maintenance documentation.

A CMMS tracks assets, work orders, PM schedules, labor, parts, and performance metrics such as backlog, PM completion, and downtime.

Work order priority: immediate life safety or clinical threat first, then critical clinical systems, then routine and cosmetic work.

The capital budget covers long-lived assets above a defined cost threshold; the operating budget covers recurring expenses within the current fiscal year.

NPV = present value of cash inflows − present value of cash outflows; an independent project with NPV greater than zero creates value at the chosen discount rate.

IRR is the discount rate that makes NPV equal zero; accept a project when IRR exceeds the organization's cost of capital or hurdle rate.

Payback period = initial investment ÷ annual net cash inflow; it ignores the time value of money and cash flows after the payback point.

Straight-line depreciation = (asset cost − salvage value) ÷ useful life.

Variance = actual − budget; for expenses, actual greater than budget is unfavorable; for revenue, actual less than budget is unfavorable.

Life-cycle cost includes acquisition, installation, operation, maintenance, energy, and disposal costs over the asset's useful life.

Cost per adjusted patient day and cost per square foot are common healthcare facility benchmarking metrics.

CMS Conditions of Participation set federal Medicare and Medicaid requirements; compliance is necessary for reimbursement and survey success.

Joint Commission Environment of Care standards address safety, security, hazardous materials, fire safety, medical equipment, utilities, and staff education.

The Statement of Conditions documents life safety compliance and deficiencies; Plans for Improvement track corrective actions and completion dates.

OSHA requires programs such as hazard communication, bloodborne pathogens, lockout/tagout, confined space, and asbestos awareness when applicable.

EPA regulates refrigerants, hazardous waste, and stormwater; permits, manifests, and disposal records must be maintained.

NFPA 101 and NFPA 99 are commonly adopted through state licensure, CMS, and Joint Commission standards; local codes may be stricter than national codes.

Joint Commission tracer methodology follows patient care processes across departments to evaluate standards compliance and system integration.

A utility system risk assessment identifies critical utilities, failure modes, redundancy needs, maintenance requirements, and emergency procedures.

RACE = Rescue, Alarm, Contain, Extinguish/Evacuate; it is the fire response sequence used in healthcare occupancies.

PASS = Pull, Aim, Squeeze, Sweep; it is the technique for using a portable fire extinguisher.

ILSM are required when fire safety features are impaired; examples include fire watch, temporary barriers, added exit signage, and enhanced surveillance.

Hot work requires a permit, area preparation, a fire extinguisher, and a fire watch during and after the work.

Defend-in-place uses smoke compartments and horizontal evacuation to protect occupants rather than immediate building evacuation.

A hazard vulnerability analysis (HVA) ranks hazards by probability, impact, and preparedness to prioritize emergency management planning.

A risk register records identified risks, likelihood, impact, owner, mitigation actions, and status.

Root cause analysis is used after sentinel events or major failures to identify system causes and prevent recurrence.