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eLibrary > ASHRAE/ASHE Guideline 43 - Operations Guideline for Ventilation of Health Care Facilities >

ASHRAE/ASHE Guideline 43 - Operations Guideline for Ventilation of Health Care Facilities, 2025

ASHRAE Online Bookstore
Addenda
Errata
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ASHRAE/ASHE Guideline 43-2025 [Go to Page]
Contents
Foreword
1. Purpose
2. Scope [Go to Page]
2.1 This guideline pertains to the operation, of health care facility HVAC systems and equipment, their normal and routine maintenance, major tasks of periodic maintenance, and energy conservation.
2.2 This guideline applies to all health care facilities. It contains guidance for operational parameters and preventative maintenance, based on the capabilities of the infrastructure, and the risks incurred in the systems and spaces, including the n...
2.3 This guideline lists the health care spaces that should be monitored for compliance, the parameters that should be monitored in each, and the means of monitoring and recording.
2.4 This guideline applies to emergency operations, continuity of service, and resiliency planning. It includes guidance on maintaining, modifying, or overriding space parameters monitoring during emergency operations and specifies what environmental...
2.5 This guideline does not cover the design of new facilities or equipment, including additions and renovations of HVAC systems, or the spaces served by HVAC systems.
3. Definitions
4. Operating Practices [Go to Page]
4.1 Reference and Planning Documents
4.2 Facility leaders and their teams are part of a larger hospital team. The ability and methodology to accurately convey capabilities and responsibilities in both normal and emergency conditions needs to be established and maintained. Construction o...
4.3 One aspect that makes health care facility operation unique is, for most hospitals, the occurrence of ongoing surveys to confirm that the facility HVAC and all other elements of care are appropriate. Accreditation surveyors such as the Accreditat...
5. Monitored Spaces [Go to Page]
5.1 General. Ventilated spaces are categorized based on risk of harm. This section defines critically ventilated spaces and generally ventilated spaces. Additionally, operational functionality of a space must be periodically monitored and verified. T...
5.2 The monitored space category of risk is dependent on space clinical function and the required delivery of environmental parameters such as temperature, relative humidity, pressure relationships, and ventilation rates as defined in the VMP.
5.3 Classification of Spaces
5.4 Verification of Space Conditions
Table 1 Recommended Monitoring Frequencies
6. Implementation [Go to Page]
6.1 Introduction. This guideline is intended for all health care building HVAC systems owners and applies to all health care facilities. Requirements are described in terms consistent with a minimal maintenance program. The responsible party can sele...
6.2 Responsible Party. The health care facility management organization will be responsible for implementing the recommendations of this guideline. The health care facility management organization may designate other parties that shall be authorized ...
6.3 Ventilation Management Program Plan (VMP). There should be a VMP that preserves the capability of the HVAC systems to provide the intended thermal comfort, energy efficiency, and indoor air quality required for the health care facility and that d...
6.4 VMP Authorization and Execution. The VMP should be approved by the responsible party. Approval will authorize performing the work included in the plan.
6.5 Revision of the VMP. The VMP should be capable of continuous improvement. Improvement in this context should be manifest when changes in equipment condition or status, changes to the facility, changes to space functions, or acquisition of new mai...
6.6 Operational Air Changes per Hour, Temperature, Relative Humidity and Pressure Relationships. The baseline recommendations of this guideline should be considered by the multidisciplinary committee for air changes per hour, temperature, pressure re...
6.7 Unoccupied Turndown. Where allowed in ANSI/ASHRAE/ASHE Standard 1706, and where a risk assessment allows, unoccupied turndown can be a significant energy savings and should be incorporated wherever feasible. Documentation in the VMP should includ...
6.8 Excursion Variations. Under certain conditions, the relative humidity and/or temperature in health care facilities will vary from the VMP condition indicators. This section suggests recommended protocols to follow in those situations, but alterna...
6.9 Unacceptable Condition Indicators. If unacceptable condition indicators or unacceptable performance are found on a system or component during two successive inspections, the VMP and condition history of the system or component should be reviewed ...
6.10 Acceptable Condition Indicators. If acceptable condition indicators or acceptable performance are observed during three successive inspections, the VMP should be reviewed for opportunities to reduce task frequencies or work procedures without co...
6.11 Climate Related or Facility Operational Requirements. Climate-related external environmental factors and/or facility operational requirements may impact execution of the VMP. These circumstances should be reviewed along with the VMP for necessar...
6.12 Equipment Warranty. The recommendations of this guideline should be evaluated so as not to supersede equipment manufacturers’ warranty terms and conditions and other guidance that may require different tasks and/or task frequencies.
6.13 Program Review. The responsible party and the implementing party should periodically review the VMP. Two formal review meetings between the responsible party and the implementing party, one at the beginning of the performance period and one at t...
Table 2 Thresholds for Response to Temporary Increase in Relative Humidity
Table 3 Thresholds for Response to Temporary Decrease in Relative Humidity
Informative Appendix A: Recommended System Condition Indicators
Informative Appendix B: Sources of Program Objectives
Informative Appendix C: Situations Requiring Review of the Maintenance Plan
Informative Appendix D: Reasons for Adjusting Maintenance Task Frequency
Informative Appendix E: Facility Observations that May Influence Baseline Inspection Frequencies
Informative Appendix F: Ventilation Management Program Plan
Informative Appendix G: Ventilation Management Program Plan Baseline Inspection and Maintenance Tasks [Go to Page]
Table G-1 Air Distribution Systems Includes ductwork, grilles, registers and diffusers, insulation, and duct lining
Table G-2 Air Handlers Includes coils in the air handlers
Table G-3 Boilers Includes condensing, boiler stack, superheaters, and heat-recovery boilers
Table G-4 Chillers—Absorption
Table G-5 Chillers—Air-Cooled
Table G-6 Chillers—Water-Cooled Includes provision for water-side economizers
Table G-7 Coils and Radiators Includes thermostats and local sensors
Table G-8 Condensing Units Split-system exterior component; indoor/evaporator section in “Delivery”
Table G-9 Control Systems Includes sensors and actuators not in spaces; does not include controls integral to equipment
Table G-10 Cooling Towers and Evaporative-Cooled Devices
Table G-11 Dehumidification and Humidification Devices “Utility,” as it may exist inside a unit. However, some are closer to the delivery point, so considering “Distribution” here.
Table G-12 Economizers—Air Side
Table G-13 Fan For example, exhaust, supply, transfer, return
Table G-14 Fan Coils—Hot-Water, and Steam Unit Heaters Limited to storage and warehousing; mostly associated with integrity verification
Table G-15 Furnaces—Combustion Unit Heaters Limited to storage and warehousing; mostly associated with integrity verification
Table G-16 HVAC Water Distribution Systems
Table G-17 Indoor Section Duct-Free Splits Includes condenser (outdoor unit), indoor section duct-free splits, thermostats, and local sensors
Table G-18 Outdoor-Air Heat-Exchanging Systems Includes enthalpy wheels and ERVs as well as outdoor-air heat-exchanging systems
Table G-19 Package Terminal Air Conditioners/Heat Pumps (PTACs/PTHPs) Includes thermostats and local sensors
Table G-20 Pumps
Table G-21 Rooftop Units
Table G-22 Steam Distribution Systems
Table G-23 Terminal and Control Boxes (e.g., VAV, Fan-Powered, Bypass) Includes thermostats and local sensors
Table G-24 Water-Source Heat Pumps Includes thermostats and local sensors
Informative Appendix H: Informative References and Bibliography [Go to Page]

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ASHRAE/ASHE Guideline 43 - Operations Guideline for Ventilation of Health Care Facilities, 2025

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