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checkPractice preventive maintenance of major HVAC equipment.

All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.


Establish regular and specific preventive maintenance schedules for all HVAC equipment to optimize efficiency, maximize estimated useful life, and maintain a level of indoor air quality that supports the well-being of patients, staff, and visitors.

  • Project Talking Points

    • Preventive maintenance enhances energy efficiency, and optimal efficiency often results in energy savings, thus reducing costs (see Benefits Calculator page).
    • Preventive maintenance extends the life of equipment by keeping it operating as it was designed to do. Preventive maintenance is less expensive than early replacement of equipment.
    • A comprehensive preventive maintenance program increases compliance with Joint Commission Environment of Care (EC) standards.
    • Proactive scheduling of maintenance activities, rather than waiting until a disruption in service occurs, improves system reliability and can reduce labor resources required to maintain systems and equipment.
    • Preventive maintenance benefits infection control efforts by safeguarding indoor air quality.
    • Preventive maintenance supports planning and budgeting for major component upgrades.
  • Triple Bottom Line Benefits

    • Cost benefits: Preventive maintenance extends the life of equipment, enhances efficiency, and improves reliability. Some cost benefits are easier than others to quantify, but anticipated savings make the effort worthwhile.
    • Environmental benefits: Reducing energy use always has an environmental benefit through reduction of emissions associated with energy production and delivery.
    • Social benefits: Both controllability and thermal comfort may be improved as a result of improvements made to equipment during preventive maintenance, which can enhance patient, visitor, and staff experience.
    • Quality and outcomes: Metrics are in development.  If you have suggestions, please  contact us or participate in the discussion below.
  • Commissioning Connections

    The ASHE Health Facility Commissioning Guidelines and accompanying Health Facility Commissioning Handbook are good information sources for undertaking this performance improvement measure.

    • Chapter 4 Transition to Operational Sustainability – Dynamic operating and maintenance (O&M) dashboards created for the automatic  temperature control system are well-suited for detection of inefficient system operation and for providing guidance for optimizing operation.
      • 4.1.1 Development of Dashboards – The Healthcare Facility Commissioning Authority (HFCxA) should facility the development of dashboards base on the owner’s project requirements.
      • 4.2 Systems Requiring Dashboards
        • Building Energy demands and costs: The energy dashboard should indicate actual building electricity, heating fuel, and water demands and costs as well as the current cost of building operation in dollars per hour.
        • Air terminals: The air terminal dashboard should indicate the average terminal damper position, space temperature, discharge air temperature, heating valve position, and airflow as a percentage of maximum cooling airflow for each air-handling unit as well as other pertinent information about air terminals.
        • Air-handling units (AHU): Each air-handling unit should have its own dashboard and indicate supply airflow, supply fan speed,  return fan sped, static pressure, supply air temperature, percentage of outside, return and mixed air and pressure drop across filter banks, and many other real-time characteristics of the system.
        • Exhaust fan: The exhaust fan dashboard should indicate the operating status of each exhaust fan and provide separate lists of exhaust fans status (off/on) with associated AHU status (off/on).
        • Domestic hot water systems: Each domestic hot water systems should have its own dashboard indicating water heater flow, cold water flow, hot water supply/return temperature, and other real-time system characteristics.
        • Heating water systems: Each heating water system should have its own dashboard indicating heating water flow, primary pump status, recirculation pump status, supply temperature, return temperature, and other real-time system characteristics.
        • Chilled water systems: The chilled water dashboard should indicate which water chillers are operating, the chilled water flow rate, supply water temperature, return water temperature, temperature difference, total power requirement, average efficiency (kW/ton) and system operating parameters.
        • Water chillers and cooling towers: The dashboards for this equipment should indicate equipment operating status, flow, entering and leaving water temperatures, make-up water consumption, % load on chillers, and power consumption.
        • Steam system: The steam dashboards should indicate equipment operating status, temperature gain across economizer (if applicable), feedwater flow and temperature, as well as other real-time characteristics and system operating parameters.
        • Boilers: The boiler dashboards should indicate equipment operating status, stack temperature, feed water flow and temperature as well as other real-time characteristics and system operating parameters.
        • Fuel oil systems: The fuel oil dashboard should indicate the fuel oil pump operating status and fuel oil storage level.
        • Normal power system: The normal power system dashboard should indicate voltage, amps, apparent power, real power, power factor, and main breaker status.
        • Essential power system: The essential power system dashboard should indicate which generators are operating and the automatic transfer switch positions.
      • 4.6 Facilitate Fire and Smoke Damper Inspection and Testing
        • National codes require health care facilities to inspect and test their fire and smoke dampers within 12 months of installation and every six years thereafter. Provide a written report listing each damper number, damper location, date of inspection, damper inspection results, and associated corrective work if required.
      • 4.8 Facilitate Development and Implementation of the Building Maintenance Program (BMP) - the BMP should utilize a computerized maintenance management system (CMMS) software program.
  • Purchasing Considerations

    If you have suggestions for purchasing considerations, or suggested sample contract language for any product or contracted service, please participate in the discussion below.

  • How-To

      1. Determine who's on the team: commissioning agent, building engineer, HVAC maintenance personnel, BAS manager. 
      2. Consult with the safety officer to assure that HVAC equipment that may be considered “critical” by Joint Commission standards meets the required annual preventive maintenance standards and that maintenance is properly documented.
      3. Develop a “systems narrative” of the building HVAC system, including heating, cooling, ventilation, and building control systems. If available, use the facility’s operations and maintenance manual to document sequence of operations, efficiency goals, anticipated performance and system/equipment-specific training materials.
      4. Develop a preventive maintenance plan and schedule, including a scheduled annual review of the overall preventive maintenance program.
      5. Examples of preventive maintenance practices include:
        • Boilers: Cleaning, descaling, and water treatment.
        • Cooling towers: Cleaning to maximize condenser performance.
        • Chillers: Removing calcium carbonate from copper tubing.
        • Water-cooled systems: Inspecting and testing for leaks; calibrating sensors. Consider opening and closing all valves on a regular interval.  Validate that when commanded closed control valves are not leaking.
      6. Use a computerized maintenance management system (CMMS)—one that is integrated into the building automation system, if possible—to manage the preventive maintenance program. The CMMS should ideally track and document inspections, meeting minutes, and actions taken, and trigger maintenance alerts.
      7. Provide regular training for operations & maintenance personnel on how to calibrate and maintain HVAC equipment so that it operates at a level of efficiency in alignment with the design intent.
      8. Perform appropriate preventive maintenance activities prior to implementing performance improvement measure Retrocommission HVAC controls.
  • Tools

    If you have an ROI tool, calculator, or similar resources to share, please contact us or participate in the discussion below.


  • Case Studies

    Howard Hughes Medical Institute

    • Key Points
      • Goal of preventive maintenance program is to assure that equipment meets or exceeds its expected life cycle without any major failures. Use the CARE routine: "clean, adjust, repair, examine.”
      • Prioritize system maintenance based on how directly each piece of equipment supports critical facility functions. This hierarchy also informs calculations on the true cost of maintaining and replacing equipment.
      • Regular training is essential to the success of the preventive maintenance program.

    University of Alabama, Birmingham    

    • Key Points
      • The preventive maintenance program uses a computerized system to summarize weekly preventive maintenance tasks.
      • The preventive maintenance group is responsible for testing and fine-tuning HVAC equipment so that HVAC mechanics are available to respond to heating and cooling requests from building occupants.
  • Regulations, Codes and Standards, Policies

  • Cross References: LEED

    • LEED for Existing Buildings: Operations + Maintenance
      • Energy & Atmosphere Prerequisite 1: Energy Efficiency Best Management Practices—Planning, Documentation, & Opportunity Assessment
      • Energy & Atmosphere Prerequisite 2: Minimum Energy Performance
      • Energy & Atmosphere Credit 1: Optimize Energy Efficiency Performance
      • Energy & Atmosphere Credit 2.1: Existing Building Commissioning—Investigation & Analysis
      • Energy & Atmosphere Credit 2.1: Existing Building Commissioning—Implementation
      • Energy & Atmosphere Credit 3.1: Performance Measurement—Building Automation System
      • Energy & Atmosphere Credit 5: Measurement & Verification
    • LEED for Healthcare: New Construction and Major Renovations
      • Energy & Atmosphere Prerequisite 1: Fundamental Commissioning of Building Energy Systems
      • Energy & Atmosphere Prerequisite 2: Minimum Energy Efficiency Performance
      • Energy & Atmosphere Credit 1: Optimize Energy Efficiency Performance
      • Energy & Atmosphere Credit 3: Enhanced Commissioning
      • Energy & Atmosphere Credit 5: Measurement and Verification
  • Cross References: GGHC

    • Green Guide for Health Care Operations Section
      • Facilities Management Prerequisite 1: Energy Efficiency Best Management Practices—Planning, Documentation, & Opportunity Assessment
      • Facilities Management Prerequisite 2: Minimum Energy Efficiency Performance
      • Facilities Management Credit 1: Optimize Energy Efficiency Performance
      • Facilities Management Credit 3.1: Existing Building Commissioning—Investigation & Analysis
      • Facilities Management Credit 3.2: Existing Building Commissioning—Implementation
      • Facilities Management Credit 3.3: Existing Building Commissioning—Ongoing Commissioning
      • Facilities Management Credit 4.3: Building Operations & Maintenance: Building Systems Monitoring
  • PIM Synergies

  • Education Resources

    Pacific Northwest National Lab, Building Retuning Training

    Energy UniversityEnergy University Courses

    The American Society for Healthcare Engineering (ASHE) has approved the courses below for continuing education credits. ASHE issues credits in quarter-hour increments, and a total of 10 contact hours equals 1 continuing education credit.

    HVAC Thermodynamic States

    All refrigeration systems involve the movement or transport of heat from a cold region to a warm region. The subject of thermodynamics describes how these heat transports may occur. Thermodynamics is a branch of physical science that deals with the relations between heat and other forms of energy (such as mechanical, electrical, or chemical energy), and, by extension, of the relationships and interconvertibility of all forms of energy. “Thermo” means heat, and “dynamic” refers to energy and change. In cooling applications, we are interested in managing heat, energy, and change, and so a knowledge of basic thermodynamics helps us to grasp the processes that are taking place, for example, in an air-conditioner.

    ASHE has approved this course for .50 CEU (5 contact hours).

    Boiler Types and Opportunities for Energy Efficiency

    Steam and hot water provide a means of transporting controllable amounts of energy from a central boiler house, where it can be efficiently and economically generated, to the point of use. Steam and hot water are popular throughout industry for a broad range of tasks from mechanical power production to space heating and process applications. The boiler room is a place where there are many opportunities for energy efficiency, as described in this class. 

    ASHE has approved this course for .75 CEU (7.5 contact hours).

    Combustion Processes

    Combustion is an almost universal process in energy use, and it usually offers opportunities for modest but worthwhile energy savings through good management. Conversely, it carries a significant risk of avoidable energy waste. In this course, you will learn the basics of combustion chemistry, how avoidable losses arise, and how they are measured. Particular attention will be paid to burners fitted in heating boilers but the basic principles are applicable to any kind of combustion plant. 

    ASHE has approved this course for .75 CEU (7.5 contact hours).

    Fan Systems I: Introduction to Fan Performance

    Fans are machines for moving air and air-borne materials, and are widely used in industrial and commercial applications. Fans use billions of kilowatt-hours of energy each year. Fan reliability can be critical – for example, in material handling operations fan failure will often force a process stoppage. The importance of reliability may cause system designers to compensate for uncertainties by adding capacity to fans. Unfortunately, fans that are oversized for their service requirements do not operate at their best efficiency points. Paradoxically oversizing fan systems creates problems that can increase system operating costs while decreasing fan reliability. In this class we provide a basic introduction to fans to equip an energy manager to understand the principal characteristics of this equipment. 

    ASHE has approved this course for .75 CEU (7.5 contact hours).

    Fan Systems II: Fan Types

    Key impacts that determine which fan type is the most appropriate include technical and nontechnical attributes. Understanding the principles of fan selection can be helpful in correcting poor system performance, especially during retrofit or upgrade opportunities. In this course we will look at the different fan types and the appropriate applications for each fan type.

    ASHE has approved this course for .75 CEU (7.5 contact hours).

    Fan Systems III: Improving System Efficiency

    Fan systems are vital to the operation of many industries and buildings. Fans often serve over a wide range of operating conditions because of changes in ambient conditions, occupancy, and production demands. The importance of fans often causes system designers to be concerned about under-performing systems. Designers tend to compensate for uncertainties by adding capacity. However, peak requirements may only occur for a few days or weeks each year, and normal operating conditions could be well below the design conditions. Although your fan may be the right size some of the time, it may be the wrong size most of the time. An oversized fan operates below its most efficient point and creates problems such as high capital costs, high energy costs, decreased reliability, high system pressures and flow noise. In this course we will discuss the ways that airflow is controlled in fan systems and we will define the main opportunities to improve performance in fan systems. We will also explore common fan system problems. 

    ASHE has approved this course for .75 CEU (7.5 contact hours).

    Fan Systems IV: Improving System Efficiency

    Problems such as unusually high operating and maintenance costs, poor airflow delivery, surges or noise or wear on the electrical components can be caused by oversized fans, poor system design, poor balancing or leakage, or wasteful airflow control practices. Often, users are only concerned with initial cost, accepting the lowest bid for a component, while ignoring system efficiency. To achieve optimum fan system economics, users should select equipment based on life-cycle economics and operate and maintain the equipment for peak performance. This course helps define opportunities to improve fan system performance by identifying common fan problems. We'll also uncover why a highly efficient fan system is not merely a system with an energy-efficient motor.

    ASHE has approved this course for .75 CEU (7.5 contact hours).

  • More Resources

  • PIM Descriptors


    Level: Beginner

    Category List:

    • Building and Maintenance
    • Commissioning
    • HVAC
    • Operations

    PIM Attributes:

    • Optimize Operations
    • Repair or Optimize Existing Systems (fix what you have)

    Improvement Type:

    • Commission/Retro-Commission
    • Retrofit/Renovations
    • New Buildings
    • Operations and Maintenance


    • Engineering/Facilities Management
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