ansi/ashrae/ashe standard 170- 2017 - nafahq.org · 170 may re-format to 3 separate standards for...

Copyright 2018 ASHRAE

Presented by:Richard (Dick) Moeller, PE FASHE,

HFDP, CHC, LEED AP

Principal, GnGB [email protected]

September 26, 2018 NAFA Conf

ANSI/ASHRAE/ASHE Standard 170-2017


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1. The purpose of this standard is to define ventilation system design requirements that provide environmental control for comfort, asepsis, and odor in health care facilities.

Std. 170 - Purpose

(This standard is not intended be restrictive regarding design or building system.)


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2.1 The requirements in this standard apply to patient-care areas and related support areas within health care facilities, including hospitals, nursing facilities, and outpatient facilities.2.2 This standard applies to new buildings, additions to existing buildings, and those alterations to existing buildings that are identified within this standard.2.3 This standard considers chemical, physical, and biological contaminants that can affect the delivery of medical care to patients; the convalescence of patients; and the safety of patients, health care workers, and visitors.

Std. 170 - Scope


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History

• Roots in ASHRAE Standard 62 and the FGI Guidelines

• First SPC meeting: 2002• Standard issued in 2008 “Mission

Accomplished”• First ASHRAE Standard co-sponsored by

ASHE• Standard given Continuous Maintenance

status in 2008• Standard initially incorporated in 2010

Guidelines for Design and Construction of Health Care Facilities


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• Republished in 2013 (25 new addendums added)

• Incorporated into 2014 Guidelines for Design and Construction of Health Care Facilities (2 books)

History


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• Republished again in 2017 (12 new Addendums included)

• Incorporated into 2018 Guidelines for Design and Construction of Health Care Facilities (3 books)

History


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!! Be Careful with this Book !!


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To receive reimbursement, you must be accredited.Options for accreditation: •The Joint Commission, •Health Care Facilities Accreditation Program (HFAP)•Det Norske Veritas – Germanischer Lloyd (DNV-GL)•Other

Why?

$$$


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Accreditation programs use the 2012 edition of the “NFPA 101- Life Safety Code” - published by the National Fire Protection Association (NFPA). (CMS issued a rule requiring the use of the 2012 edition of NFPA 101 and all its reference documents.)

Considered to be effective as of July 5, 2016 with enforcement on November 1, 2016.

For many years, CMS and the Joint Commission used different editions of the code, which often led to confusion and difficulties in compliance.

Why?


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CMS Adoption Makes Std. 170 ComplicatedIssue: • If you design to current Standard 170 requirements, CMS may require you to comply with the 2008 edition, without amendments, anyway.

•This is a potential problem when requirements of the 2008 edition have been relaxed or reduced by amendments to either the 2008 or 2013 edition.

•This is also a potential issue with states that have not adopted the current edition or addenda.


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“It’s really difficult for any regulatory agency to adopt a moving target. General due process concerns prevent the agency from adopting any addenda that ASHRAE would come up with ‘after the fact’. Practically however, some will consider dealing with information in the addenda as potential alternative methods.”

WA State AHJ

ASHRAE Addendum Adoption Process


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2008 ASHRAE 170 Approved – 31 August 2011

2008 170 Addendum Adoption Datea 25 July 2009b 16 Nov 2009d 10 July 2010

e, f 3 Feb 2011g 3 March 2011h 27 July 2011

2012 NFPA 99 Approvedl, m 26 Jan 2012r, s 29 June 2012

j, p, q, t 27 Oct 2012k, n, v 30 Jan 2013u, w 4 July 2013

x, z, ab 24 July 2013ac 31 July 2013y 5 Dec 2013

2013 ASHRAE 170 Approved – 5 Dec 2013

2013 170 Addendum Adoption Date

3 July 2014

ae 6 Oct 2014

a, e 1 Dec 2014

d 1 June 2015

g 1 Oct 2015

c, f, h 1 June 2016

2012 NFPA 99 Adopted by CMS 5 July 2016k 16 July 2016

m 30 Nov 2016

CMS Adoption – it’s complicated


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Continuous Maintenance

Coordination Efforts with:

• ASHRAE Standards 55, 62.1, 90.1, 189.3, 188, etc.

• Association for the Advancement of Medical Instrumentation (AAMI)

• Association of periOperative Registered Nurses (AORN)

• Association for Professionals in Infection Control and Epidemiology (APIC)

???


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Other reasons• Technology• Energy• Knowledge• Corrections

Continuous Maintenance


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Clarifications/Definitions


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Asymptotic CurveMissing definitions/clarifications?• Volume - what constitutes ‘volume’ in space for air change calculation reg’s

In HVAC it’s not ‘change’ - -- Think ‘dilution’.What’s an ‘Air Change’?

Clarifications/Definitions


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ASHRAE Addendum Adoption Process

Suggestionsby Standard 170

committee members or the

public

Public Review

and Comments

Response to

CommentsPublication


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ASHRAE Addendum Adoption Process (con’t.)

• Approved Addenda are “Part of the Standard”• Most Informed Design Direction• Standard of Care for DesignersoCodeoStandardoGuidelineoStandard of Care


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•Status – Included in 2013 edition (Approved -10 July 2010)

•Topic – Critical Area Humidity Requirements• Reduces minimum relative space humidity from 30%

RH to 20% RH in these short stay spaces:• Class B and C Operating Rooms• Operating/ Surgical Cystoscopy Rooms• Delivery Rooms• Treatment Rooms• Trauma Rooms• Laser Eye Rooms• Class A Operating/Procedure Rooms• Gastrointestinal Endoscopy Procedure Rooms

Issues:• For any of these

spaces, where Owners want to take advantage of the lower (20% ) humidity requirement, CMS could require a minimum of 30%

Addendum d – 2008 (Example)


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Addendum h – 2008 (filter location)

• Status – Included in 2013 edition (Approved – 27 July 2011)• Topic – Recirculating Room HVAC Units

• All ventilation air must be filtered and conditioned • May only serve a single space• MERV6 filter required if any surface designed to condense moisture• Recirculated airflow counts towards Total Air Change Rates required by

Table 7.1

• Issues – None anticipated


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Addendum j – 2008 (Filters for PACU units)

• Status – Included in 2013 edition (Approved – 27 Oct 2012)• Topic – Nursing Facility Requirements

• Add definition of Nursing Facility• “A facility that provides resident care, treatment and services areas,

including skilled nursing, subacute care, and Alzheimer’s and other dementia facilities.”

• Restore requirement for higher level filtration in nursing facilities• Require MERV 13 as Filter Bank Number 1, no requirement for Filter Bank

Number 2



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Addendum u – 2008 (Recirculation w/HEPA)

• Status – Included in 2013 edition (Approved 4 July 2013)• Topic – ED and Radiology Waiting Room Exhaust

• Clarifies HEPA filtered air may be recirculated, in lieu of exhausted• The Radiology Waiting Room requirement only applies to those spaces

where patients with respiratory disease may be waiting• Drops changes to footnote q after 1st public review



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Addendum u – 2008 (Recirculation w/HEPA


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Addendum x – 2008 (Filtration req’s)

• Status – Approved (24 July 2013)

• Topic – Hospice and Assisted Living Filtration

• Adds filtration requirements for Hospice and Assisted Living Facilities



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Space Designation (According to Function)Filter BankNumber 1(MERV)a

Filter BankNumber 2(MERV) a

Resident care, treatment and support areas in Inpatient Hospice Facilities 13 N/R

Resident care, treatment and support areas in Assisted Living Facilities 7 N/R

Table 6-1 Minimum Filter Efficiencies

Addendum x – 2008 (Filtration req’s)


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ASHRAE Std. 170 - 2013 Edition

(Included in 2014 FGI Guidelines)


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Addendum g- 2013 (FGI/ASHRAE coordination)

• Status – Approved • Topic – Definitions of Operating and

Procedure Rooms Aligns ORs and Procedure Rooms with FGI

Guidelines. Deletes Class A, B, and C terminology and

replaces with • Operating Room, Procedure Room

Definition are included from 2014 FGI Guidelines for these spaces:• Operating Room, Procedure Room,

Invasive Procedure, Restricted Area


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Addendum n - 2013

Topic: FGI 2018 - Reorganization into 3 separate books – Hospitals, Outpatient and Residential Health, Care, and Support Facilities

Status: Approved, currently under appeal

170 is included in its entirety in each book.Work underway to identify and organize requirements for each occupancy

170 may re-format to 3 separate standards for 2022 addition?! (Similar to 90.1, 90.2, etc.)


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Addendum o – 2013 (Risk assessment approach)

Status: Approved for Public Review (2nd Review)

Topic: Risk based validation systems operations approach• Adds an appendix that describes an approach to allow operation of

ventilation systems at lower requirements than indicated in the Standard based upon Facility based risk assessment.

• (This approach is not applicable to design and construction)


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Risk-Based Approach in an Informative Appendix?


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Addendum p – 2013 (Carryover)

• Status – To be issued for Public Review soon

• Topic – Revisions to Table 7.1

• Relocates filtration requirements from Table 6.4 to Table 7.1, where they can be based on individual space requirements

• Adds Unoccupied Turndown column to Table 7.1

• Revises space names in Table 7.1 to coordinate with FGI Guidelines


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Proposed Addendum P (2013) - Filtration and Unoccupied Turndown


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Proposed Addendum A (In progress) - Further Filter Req Revisions

• Go to: https://www.ashrae.org/standards-research--technology/standards-addenda

May also address/reference proposed ISO Filtration Standard in conjunction w/ ASHRAE STD 52.2 (???)


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FINE TUNING SCOPE


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Current Issues

•Cooling Tower Placement Clarification•Alternate Air Change Rate Calculation Method•Natural Ventilation•ETO Sterilization•Clean Linen OA Air Change Rate•Clarification of “Recirculating Room HVAC Units”


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Future Issues

•Clarify ED terminology and space•Patient Room Air Distribution•OR Air Distribution•Air Change rate reductions•Outside air intake separation from exhaust•Pharmacy requirements (USP 797 & 800)


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What is the BIG Deal?

• How “Minimum” should a Minimum Standard be ? Different Definition of Minimum Reflected As In Political Spectrum

• How many Prescriptive Requirements should exist in the standard for the perceived safety of the all involved, included designers ?

• How can a Performance Approach be provided?

• 170 is under pressure to align or assign items to ASHRAE 62


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Benefits of Committee Membership: • Know Upcoming Changes

• Help Build a Better Standard• Become an Expert

• Support ASHRAE’s role as Technical Lead• Plus “See the World”

Committee Membership – aka: Sales Pitch


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Become a Committee Member and get a FREE copy!

Committee Membership


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Questions/Answers/Comments

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ansi/ashrae/ashe standard 170- 2017 - nafahq.org · 170 may re-format to 3 separate standards for...

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