July 5, 2028 - Deadline for high-rise health care to comply with CMS fully sprinklered requirement
Evelyn Dougherty • March 23, 2026
ASHE Core Competencies – Training Resources Available
ASHE has put together training programs for facility maintenance staff on core competencies of which many are available free to ASHE chapters.
The American Society for Healthcare Engineering (ASHE) has a Core Competency Framework defining eight key areas for healthcare facility managers:
Here are the eight core competencies defined by ASHE:
- Administration: Leading teams, communication, documentation, and policies.
- Compliance: Adhering to regulations and standards.
- Energy Management: Strategies for saving energy and reducing costs.
- Finance: Understanding financial language, budgeting, and long-term value.
- Maintenance & Operations: Keeping facilities safe, comfortable, and functional.
- Project Management: Overseeing projects, including construction and renovations.
- Managing Risk: Assessing and mitigating physical, safety, and infection-related risks (like waterborne pathogens).
- Sustainability: Developing green strategies, decarbonization, and climate resilience. ASHE provides training, such as e-learning courses and live workshops, for each area, helping managers improve skills from financial literacy to developing water management plans.
Why staying current with code updates is critical for health care facilities Here are seven reasons facilities professionals should get involved in the code development process By Chad E. Beebe reprinted from HFM Magazine Oct 13, 2025 In the complex world of health care facilities management, staying up to date with the latest codes and standards isn’t just a best practice, it’s essential. While the Centers for Medicare & Medicaid Services (CMS) often lags in updating its Conditions of Participation (CoPs) sometimes by a decade or more, there are compelling reasons why health care professionals should actively engage with and apply the most current codes available. 1. ASHE Advocacy: A voice for practical, patient-centered code development The American Society for Health Care Engineering (ASHE) plays a vital role in shaping the codes that govern health care facilities. ASHE’s Advocacy Team and members work tirelessly to address issues as they arise, whether it’s correcting misinterpretations, removing outdated requirements, or introducing new provisions that reflect real-world challenges. Our success stems from a deep understanding of the health care environment and a commitment to improving patient care through practical, feasible code changes. Over the past decade, ASHE has tracked more than 600 code changes that positively impact health care environments. These include clarifications, conflict resolutions and proactive updates that reflect the evolving needs of facility managers. Without ASHE’s involvement, code updates would be riddled with impractical requirements and costly surprises. 2. Embracing new technology with updated codes Technology in health care evolves rapidly, and outdated codes often fail to address new innovations. This leads to confusion among authorities having jurisdiction (AHJs), who may interpret the absence of guidance in varying ways. For hospital systems operating across multiple jurisdictions, this inconsistency can create significant operational burdens. Take, for example, flexible medical gas tubing, a technology not addressed in the 2012 editions of the National Fire Protection Association’s NFPA 101, Life Safety Code, and NFPA 99, Health Care Facilities Code. However, these are the codes referenced in CMS’s CoPs. Without updated codes, facilities would not be able to use this product. Fortunately, CMS granted a categorical waiver, allowing consistent use nationwide. This underscores the importance of updated codes in enabling safe, efficient adoption of new technologies. 3. New practices require clear guidance Some may assume that if a practice isn’t addressed in a code, it’s fair game. Unfortunately, that’s rarely the case. In reality, AHJs determine compliance, and without clear code language, interpretations vary widely. This sometimes leads to unsafe or overly burdensome requirements. A prime example is the introduction of hybrid operating rooms. In the absence of specific guidance, many AHJs combined requirements for operating and imaging rooms, resulting in unnecessary mandates like access to toilet facilities and increased risks from mixing staff roles. Updated codes help avoid these pitfalls by providing clear, tailored guidance. 4. Newer codes offer solutions when older ones fall short Even when CMS mandates older code editions, newer codes can offer valuable guidance in areas not previously addressed. For instance, microgrids, which are critical for energy resilience, aren’t covered in the 2012 codes. However, newer editions provide frameworks for their safe and effective implementation. Only those familiar with current codes can identify and leverage these opportunities. 5. ASHE serves a diverse membership beyond CMS requirements Not all ASHE members are bound by CMS’s outdated codes. Many operate under state or private regulatory bodies that adopt current editions. ASHE supports these members by offering educational resources and frequent updates, ensuring they remain informed and compliant with the latest standards. 6. Code update presentations: Informing and engaging the community ASHE’s conferences and code update presentations serve dual purposes: educating attendees and gathering feedback for future advocacy. As the gap between adopted and current codes widens, member engagement becomes even more critical. Without firsthand experience of new code impacts, feedback dwindles making it harder for ASHE to advocate effectively. 7. Preventing unwanted surprises through continuous involvement Code development involves many stakeholders, each with their own interests. ASHE ensures that proposed changes are practical, feasible and ultimately beneficial to patient care. Our advocacy emphasizes simplicity, clarity and consistency, which makes codes easier to interpret and apply. ASHE also considers financial implications. For example, we successfully opposed a proposal to the International Building Code requiring equivalent underground space in hurricane-prone areas. While well-intentioned, the proposal ignored the logistical and safety challenges of relocating patients underground, as well as the prohibitive costs.
ASHE Core Competencies – Training Resources Available ASHE has put together training programs for facility maintenance staff on core competencies of which many are available free to ASHE chapters. The American Society for Healthcare Engineering (ASHE) has a Core Competency Framework defining eight key areas for healthcare facility managers: Here are the eight core competencies defined by ASHE: Administration: Leading teams, communication, documentation, and policies. Compliance: Adhering to regulations and standards. Energy Management: Strategies for saving energy and reducing costs. Finance: Understanding financial language, budgeting, and long-term value. Maintenance & Operations: Keeping facilities safe, comfortable, and functional. Project Management: Overseeing projects, including construction and renovations. Managing Risk: Assessing and mitigating physical, safety, and infection-related risks (like waterborne pathogens). Sustainability: Developing green strategies, decarbonization, and climate resilience. ASHE provides training, such as e-learning courses and live workshops, for each area, helping managers improve skills from financial literacy to developing water management plans.
My ASHE Oct 2025 - Portable Space Heater Use (The following excerpt from MyASHE has been edited to conserve space) STEPHEN YORK10-07-2025 15:43 With the cold weather approaching I'm trying to find the requirements for space heater use in a hospital... I found NFPA 101 - 18/19.7.8 Portable Space-Heating Devices. Portable space-heating devices shall be prohibited in all health care occupancies, unless both of the following criteria are met: (1)Such devices are used only in nonsleeping staff and employee areas. (2)The heating elements of such devices do not exceed 212°F (100°C). Does this requirement eliminate the use in a patient care area since it only refers to nonsleeping staff and employee areas? Are there any other restrictions on the use of space heaters? Especially for use in a patient care area? I thought I remembered something about that they could not be used in a patient care smoke compartment or in a patient care area. Thanks for any help with this. Responses: 1. Laura Cooke, CHFM, CHFSP, CHSP; Director of Safety VCU Health System - Elon, NC If you are Joint Commission accredited, the current standard actually states the following: "Portable space heaters are prohibited in smoke compartments containing sleeping rooms and patient treatment areas. Non-sleeping rooms that are occupied by staff and separated from the corridor are permitted to have portable space heaters, but must contain heating elements not exceeding 212°F. (For full text and exceptions please refer to NFPA 101-2012: 18/19.7.8) Note: For this EP nurse's stations are considered patient treatment areas." This would mean the entire smoke compartment where patient treatment or staff sleeping areas are located. 2. Brad Gammons; Manager, Plant Operations, Northern Regional Hospital, Mount Airy NC We don't allow them in our patient care areas. Right now, I am struggling to find any heater that the element doesn't go over 212 degrees. We used to use oil filled heaters, now they are running temperatures way over 212 degrees. Does anyone have any recommendations for a heater that doesn't go over 212 degrees? 3. Chris Sibell; CHFM, Facility Manager, Abbott Northwestern Hospital; Minneapolis MN Posted 10-10-2025 10:08 Grainger sells a QMARK model 202SLB that will not get to over 212 degrees. This is the model that we allow. We’re up in Minnesota where it gets a little bit chilly and if we do not identify one, they will show up organically and will most likely not meet those specifications. 4. Stevie Kennedy; Environmental Safety Officer/Emergency Management Coordinator Memorial Hospital of Sweetwater County; Rock Springs WY We were looking at ordering these, I reached out to the manufacturer. They replied back they have no documentation supporting that it does not exceed 212, because when they tested it, it was higher than 212 so they no longer make that claim. I can forward you the response. We are stuck trying to find something, at this point my staff is bringing in illegal ones and I am finding them everywhere and removing them. 5. Melissa Graves; Service Coordinator, Hendrick Medical Center Brownwood; Abilene TX; (601)918-4217 Brad, we use a flat panel QMARK model 202SLB radiant heater from Grainger. It is safe for under desk. We have tested it multiple times and the temp has never been higher than 200 F. 6. Eddie Gomez; Vice President, Facilities; Bowen Health, eddie.gomez@bowenhealth.org I second Melissa's response. This is exactly what I have used in the past and they work well. and of course, we only allow them in non-patient care areas. 7. William Pate; DrPH, MBA, CHP, CIH, CSP, CPP, CHFM, CHMM, Assoc VP, EHS; Radiation Safety Officer, Envir Health & Safety, University of Texas Medical Branch; Galveston TX Exactly. Building systems are not designed to have every individual achieve their personal level of comfort. People who are too cold but the space is within design specs should bring a jacket or sweater to work. Our policy does not prohibit the use of heated blankets by staff, so that is another option we provide to them. 8. Ted Baker; Facilities Coordinator, OSS Health, York PA You may want to look at Joint Commissions interpretation under LS 02.01.70 EP 8. In my past experience, it is also very difficult to ascertain the exact temperature of heating elements not to exceed 212 degrees as per NFPA 101 19.7.8 (2). A few years ago, I infrared tested appx. 6-8 various type portable heater elements, and all gave temperature readings from 350-500 degrees. This subject comes up every heating season in our colder climates, but our organization has adopted a policy of No Portable Heaters permitted whatsoever. The policy doesn't always make staff happy, but re-education and emphasis on patient and fire safety assists with understanding. 9. Elaine LaRochelle; Dir of Facilities, Grande Ronde Hospital La Grande OR The only device we allow in our corporation buildings is a heated footrest. 10. Don Page; CHFM, MBA; Director of Facilities, Good Samaritan Hospital, Vincennes IN We do not allow space heaters within our facility, period. Very difficult to police when you allow some but not others. The other issue I had was a citation from the fire marshal several years ago because the heaters had to be 3 feet from combustible material and as you would expect most of them were under someone's desk. 11. Chad Rock; Facilities Manager, UC Health, Fort Collins, CO We only allow space heaters in compliant spaces and for temporary use. Space heaters are an indication that there is a building issue that needs to be fixed. Generally, space heater use is hiding a bigger problem that the Facilities team, with proper resources, can correct. We try to ask why a space heater is wanted in a hospital, then we dig into the root issue of what is needed. 12. Danny Holmstedt; Mgr, Accreditation LS,EC, & EM Providence, Portland OR May I also suggest that you check what edition of NFPA 101 has been adopted in your jurisdiction. TJC & CMS use the 2012 edition but if you have a local AHJ that has adopted the 2021 edition (or the 2024 edition) then NFPA 101 (2021) 19.7.8 requires the freestanding movable heaters in healthcare occupancies to be UL listed in accordance with UL 1278 13.Mary Wiersma; Facility Manager, Pine Rest Christian Mental Health Services, Grand Rapids MI You may want to check with the insurance carrier for guidance. Ours had specific requirements for portable space heaters. If you follow their requirements, there are very few areas where space heaters can be safely used. Here are a few requirements that I found: Keep at least 36 inches of clearance around every space heater and only use them in areas free of flammable liquids and easily ignited or combustible materials. Space heaters must be plugged directly into the wall receptacle. Turn off the space heater when you leave the room and unplug it at the end of the day. Our policy does not allow space heaters in 24-hour care areas or in locations near IT equipment rooms. Also we require the site manager approve the use and take the responsibility for regular inspection. 14. Jeff Bales: Cody, Wy I recommend prohibiting portable space heaters (such as oil filled) everywhere. Because: 1. They can migrate. 2. Some employees might not understand prohibited areas vs allowed. And might not understand sanction heaters vs non. 3. Possible tripping of circuits. 4. I have seen staff park them under a t-stat and cause cooling. However, when I worked at a critical access hospital that would not fund upgrades to the ailing HVAC system, we did mount the plastic radiant heaters under the leg space of certain desks. Stephen York: Plant Operations Dir, Wabash General Hospital Mount Carmel IL Thank you to everyone for all your comments. Lots of great information shared.
