As existing programs are expanded and new services added, facilities must upgrade their heating, ventilating and air conditioning systems (HVAC) to keep pace.

The location and configuration of such alterations to a large degree, dictates the type and configuration of the HVAC solution. One of the first decisions that needs to be made involves the existing HVAC systems that are in place. The efficiency of the existing equipment should be evaluated to determine if it is in need of replacement or can be upgraded and optimized. A balancing report should be commissioned to verify the quantity or air being delivered to the spaces being altered/expanded. This balancing report will reveal how much additional conditioning is needed to serve the new or expanded programs and spaces.

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In general terms, your facility's Essential Electrical System (EES) consists of a stand-by generator power source and the branch circuits which deliver emergency power where it is needed.  However, in real terms, an EES is much more than its technical definition.  It is the life line your residents and staff depend on to keep critical systems and equipment operating during an emergency.

Emergency power systems in health facilities are governed by the National Fire Protection Association (NFPA) Code 99 entitled "Health Facilities".  Per NFPA 99, facilities providing critical care are required to have a Type I EES.  This, of course, includes hospitals but also includes nursing facilities with respiratory units.  A Type I EES divides the emergency power system into a number of branches, each connected to an automatic transfer switch or ATS.  The function of each ATS is to "switch" a given branch from normal to emergency power.  The life safety branch, powers emergency & exit lighting, fire alarm & nurse call systems, emergency communication systems, etc.  The equipment branch serves a facility's boiler plant, walk-in refrigeration and similar systems.  The critical care branch powers vent units other high risk treatment areas.  By creating separate EES branches, the risk of failure of any one branch is reduced.  This multi-branch configuration also allows for load-shedding whereby the total load on the generator can be temporarily reduced if there is a danger of an overload.  Even older hospitals have a Type I EES.  However, most nursing homes that are more than ten years old do not.  Therefore, when vent units first appeared in nursing homes 20 years ago, it was customary to apply to Health Departments for a waiver regarding a Type I EES.  In most cases, these waivers were granted.

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