6 Considerations for Healthcare Facility Condition Assessments

Featured in FacilityCare, January 2015

Deciding you need a Facility Condition Assessment (FCA) can often be the easiest part of getting it done. There are multiple variables to consider once you have identified the need for an FCA of your healthcare facility. To assist you in the process, I will discuss the six issues I consider the most critical in setting the scope and cost of an FCA.

Facility Assessment Concept Array Architects

Purpose of the Assessment

Identifying and conveying purpose of the assessment to your assessment team is vitally important, as the purpose will affect every step of the process. Defining whether it is for identifying routine or deferred maintenance, facility re-purposing, functional longevity, planned capital improvements, or purchasing an existing facility informs the team of the view they should take when assessing the facility.

For example, assessing a building for possible purchase may include a general overview of the age and condition of the envelope, systems and site improvements, while also identifying major cost items that could aid in negotiating the purchase price. However, assessing to develop a deferred maintenance plan should be more thorough and seek to provide data on the scope, location and timing of needed repairs.

With a clearly defined purpose, you can more easily select an assessment team, create a list of items to be assessed, and better project the time and cost estimates of the study.

The Assessment Team

The purpose of your assessment will define the experience, expertise and disciplines needed for your team.  Assessing facilities for functional longevity or re-purposing requires knowledge distinctly different from that required for identifying deferred maintenance items or capital improvements.

Assessing for deferred maintenance or capital improvements typically requires architectural, structural, mechanical and electrical expertise, and possibly civil engineering knowledge. Re-purposing an existing facility, however, could require a team with more experience in facility planning and design.

Your purchased maintenance programs, as well as your own staff’s abilities, may influence the required disciplines. For example, if you have an exceptional in-house IT&S group, you may not need an outside assessment. If you have a 20-year roof maintenance contract, you may want to avoid paying for a roof review.

Additionally, the team must possess objectivity and good listening skills in order to conduct effective staff interviews that can provide information, which can only be learned over time, about the facility. An assessor’s ability to remain objective, and not regurgitate the staff’s opinion, is important to an assessment’s results.

Another consideration is who will use the report’s information. Will only the maintenance staff use the details of the report or will you need an executive-level presentation to obtain funding? The maintenance staff speaks a different language than the C-Suite, and a team that can effectively communicate with the intended audience is crucial.

Format and Content of the Report

Again, who will need the information found in the report? The maintenance staff will need the details and technical descriptions of items in a maintenance assessment to implement the repairs, but the funding comes from the Board of Directors, so will they need executive summaries or a PowerPoint presentation?

What format do you want to receive? A database or spreadsheet can be a living document used to track the costs and progress in addressing the issues, but it has to be a system your staff can actually use. Discuss this thoroughly with your staff and assessment team.

They say a picture is worth a thousand words. Showing pictures of critical conditions to leadership who have never seen them before can be worth thousands of dollars as well.

Once again, the purpose for having the assessment done will guide the decisions in this category.

Items to be assessed

This variable can have a great impact on the duration and cost of an FCA.

Consider the purpose of the study and the level of detail you need to set the list of assessment items. Are you looking for the general condition of your facility? Perhaps you want to review the envelope as well as the building and site systems.

Maybe you need an objective look at the conditions of the interior construction to obtain funding for refresh programs. Alternatively, you might have persistent problems with your HVAC system and need a deep dive into the conditions and reasons for these problems, including air-balance testing.

An upcoming article on this subject will give more insight into the items to consider for assessment and the level of detail to pursue.

Projected Time of the Study

How far into the future can you see? It depends.

Once again, the purpose of the study will inform this issue. Maintenance assessments typically would project cost and timing of repairs to a three to five-year period.

A review of conditions for planned capital improvements relate more directly to the planned lifespan of the improvements. Cost of money, return on investment, dynamics of the market and strategy for the capital improvements all influence the time span to be considered.

Functional longevity reviews to determine whether to keep an existing facility could have a much longer horizon and should tie into your long-term strategic vision.

Quality of the Cost Estimates

No assessment report is complete without cost estimates. How these estimates are prepared, and what they include, are important factors to consider.

Consider requiring contractors experienced in repair costs and knowledgeable of your local market perform the estimates.

You will want to know the whole picture, so be sure the estimates include the soft costs of design, bonding, insurance and other soft costs to define the total project cost, not just construction costs.

There can be a cost to doing nothing, so consider including a comparative cost analysis of maintaining the status quo versus the life-cycle cost of repairs and improvements. This is a specialized expertise, so if you need this, get it in the scope.

Watch for upcoming articles that will help increase the value of your next assessment.

Blog authored by Ray Corby, prior Engagement Manager with Array.