Ask an Attorney: Healthcare Facilities Require Specialized Construction Considerations

Kristi Pronovost Merit Shop Spokesman Blog

By: Ronald H. Pollock. Esq., Saxton & Stump, LLC

Are there any special considerations that must be taken into account when approaching a construction project located at a hospital, healthcare, or longterm/nursing care facility?

Yes, due to the unique nature of healthcare facilities, construction projects require specialized and careful handling. There are a number of regulatory and legal ramifications and liabilities to take into account. A detailed risk management plan should be undertaken before every project. Failing to do so can open an organization up to significant potential liability. A few specific areas that should be evaluated for risk include:

• Infection prevention
• Air quality
• Shut down and destruction of utilities
• Vibration
• Noise
• Facility egress and ingress
• Access to patient care areas
• Hazards to patients, visitors, and staff

Ideally, documentation of risk mitigation strategies during the pre-bid, bid, contracting, building, and punch list process should be undertaken. For example, it is well known that fire and life safety present unique challenges in the healthcare environment. Therefore, the principles of building compartmentalization, fire suppression, or rated materials must be used. An additional unique consideration when working in healthcare facilities is the handling of medical gas systems. These medical gases include oxygen, nitrous oxide, nitrogen, and carbon dioxide. Medical gases are subject to regulation and inspection.

Mechanical, electrical, and plumbing systems require special attention. An outage or malfunction in any of these areas can result in catastrophic patient impact. Further, a critical component for preventing the spread of infection is a properly designed, installed, and maintained HVAC system. Proper technique, regulation, and legal risk management requires that the movement of air borne spores, viruses, and bacteria be controlled through the use of “clean to dirty” air flow and proper pressurization. Again, proper pre-planning will go a long way towards legal compliance and reducing risk.

Finally, it must always be of paramount concern that the patients in a healthcare facility are, by definition, in a compromised state of health. Infections, mold, and fungus can become air borne and result in enhanced infection risk. As a result, containment barriers, monitoring of air flow, conducting an overall infection control risk assessment, and appointing an infection control team are vital components of protecting the health and life of those entrusted to the care of the healthcare facility undergoing the construction process.

The author, Ronald H. Pollock, Esq., Saxton & Stump, LLC, is a trial lawyer who actively litigates matters in state and federal court and concentrates his litigation practice in construction litigation and business disputes, catastrophic injury cases and personal injury law, as well as insurance coverage, bad faith cases and workers’ compensation.

In his construction litigation practice, Ron represents owners, contractors, subcontractors, architects and engineers, among others. He has specific expertise in contract interpretation and disputes, payment/collection actions, bid challenges, change order and liquidated damages claims, and construction insurance, indemnification and arbitration contract provisions.


ABC Keystone offers Healthcare Construction training and certification annually! Visit abckeystone.org to learn more and register for:
ASHE Healthcare Construction Certificate Program (HCC) / January 22, 2019 & Wednesday, January 23, 2019
Certified Healthcare Constructor (CHC) Exam Preparation / Thursday, January 24, 2019

If you are interested in writing for the “Ask an Attorney” or the “Ask an Accountant” feature, please contact: kristi@abckeystone.org.

January 2, 2019