CHFM Certified Health Care Facility Manager (CHFM) Questions and Answers

A medical equipment management plan must include:

Problem/failure/user error data collection for trending and corrective action.

Performance standards to ensure safe and reliable operation.

Annual review of the plan to maintain compliance and effectiveness.

A computerized inventory system is a useful tool but not mandated by The Joint Commission or CMS; paper-based systems may still be acceptable if compliant.

NFPA 13 (Standard for the Installation of Sprinkler Systems) specifies that quick-response and standard-response sprinklers shall not be mixed within the same compartment. This is to ensure uniformity in activation and discharge characteristics.

A (Compartment): Correct, all heads in a compartment must match type.

B, C, D: NFPA does not require wholesale replacement across zones, buildings, or corridors beyond the compartment.

A low-water cut-off is a safety device that shuts down the burner when water level falls below a safe operating point. This prevents catastrophic overheating and potential boiler explosion. It does not stop steam flow, air supply, or water feed; instead, it directly interrupts burner operation.

NFPA 101 (Life Safety Code) requires that on-call sleep rooms provided in healthcare facilities must be protected by single-station smoke alarms or an automatic smoke detection system. This requirement ensures early warning for occupants who may be sleeping and unable to respond as quickly in an emergency.

B: Rated doors may be required in certain hazardous areas but are not the mandated feature for on-call sleep rooms.

C: Emergency call buttons are part of patient care areas, not sleep rooms.

D: Bathrooms are not required by Life Safety Code in on-call rooms.

The Centers for Disease Control and Prevention (CDC) published the document “Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Healthcare Facilities”. These guidelines provide infection control practices for healthcare facilities, including engineering controls, ventilation requirements, and personal protective equipment (PPE) to minimize the risk of TB transmission.

Correct: CDC (B) – Responsible for publishing this guideline.

Incorrect:

A. FDA – Regulates drugs and medical devices.

C. EPA – Oversees environmental protection and pollutants, not healthcare infection prevention.

D. OSHA – Issues workplace safety standards, but this TB guideline is from CDC.

The primary cause of change orders is incomplete or unclear plans and specifications. Ensuring that drawings and specs are fully developed before bidding reduces ambiguity, scope gaps, and the likelihood of modifications during construction.

A (Correct): Complete plans/specs = fewer change orders.

B: Bonds/policies protect financially but do not reduce change orders.

C: Prequalification ensures capable bidders but doesn’t eliminate scope issues.

D: Competent managers/subcontractors help but cannot offset incomplete design docs.

NFPA 80 (Standard for Fire Doors and Other Opening Protectives) sets requirements for fire door construction and installation. It specifies that the maximum undercut clearance is 3/4 inch unless otherwise tested and listed. Greater clearances compromise the integrity of the fire barrier.

The Safety and Security Management Plan under TJC’s Environment of Care standards requires healthcare facilities to regularly inspect buildings, facilities, and grounds to identify unsafe conditions and security risks.

C. Safety and Security Management (Correct): Includes hazard surveillance rounds.

A. Utilities Management: Focuses on utility systems operation and maintenance.

B. Hazardous Materials Management: Covers handling/storage/disposal of hazardous substances.

D. Fire Safety Management: Addresses fire protection systems and procedures, not general hazard inspection.

Design–Bid–Build (DBB) is the traditional project delivery method where the architect/engineer completes design before contractors bid. The contractor has no input in the design phase.

IDP, DB, and CMAR all include contractor involvement earlier.

According to NFPA 251 (Standard Methods of Tests of Fire Resistance of Building Construction and Materials), once a material or assembly is tested and a measure of time is obtained, that result is defined as the fire resistance rating. This rating expresses the duration that a building element can withstand a standardized fire exposure while maintaining structural integrity.

Correct Answer (B. fire resistance rating): NFPA 251 specifically defines this as the time result from fire exposure testing. It applies to walls, floors, and structural assemblies.

Incorrect Options:

A. flame spread rating: This measures only the surface burning characteristics of materials, determined using ASTM E84 or UL 723, not the endurance of an entire assembly.

C. fire assembly rating: This is not an officially recognized NFPA term; the proper terminology is fire resistance rating.

D. fire protection rating: This applies to opening protectives such as doors, windows, or shutters, which are tested using NFPA 252 or NFPA 257, not NFPA 251. Fire protection ratings are distinct from fire resistance ratings, since they do not measure full structural endurance.

Relevance to CHFM Compliance Domain:

The Certified Health Care Facility Manager (CHFM) exam includes compliance with fire and life safety codes under its “Compliance” content area. The CHFM Candidate Handbook emphasizes the requirement to understand and apply NFPA standards in healthcare facilities, ensuring compliance with regulatory fire safety measures such as those defined in NFPA 251.

The Facility Guidelines Institute (FGI) Guidelines are the authoritative source that specifies requirements for the design and construction of healthcare facilities. Within these guidelines, the number and type of medical gas outlets required in patient care areas such as intensive care units, operating rooms, and patient rooms are detailed. NFPA 99 governs installation and performance standards for medical gas systems, but the quantities of outlets are determined by the FGI Guidelines, which CHFM candidates are expected to know.

Incorrect Options:

A. NFPA 101 Life Safety Code – Addresses fire and life safety, not medical gas outlet quantities.

C. ADA Guidelines – Focus on accessibility, not medical gas systems.

D. The Joint Commission EOC Standards – Require safe use of systems but do not prescribe outlet numbers.

Builder’s risk insurance is first-party property insurance that covers physical loss to the work under construction, including the replacement or repair value of a structure and materials during the construction period. It does not provide workers’ compensation (A), payment bond protection for subcontractors (B), or performance/contractor default liability (D). Those are separate coverages (workers’ comp, payment bond, performance bond).

Benchmarking is the structured process of setting a reference standard (internal or external) and comparing an organization’s processes, outputs, or outcomes against that standard to identify performance gaps and opportunities for improvement. In CHFM practice, benchmarking supports administrative decision-making for staffing, service levels, utility performance, and cost metrics by aligning results to recognized peer or industry standards.

“WAGD” stands for Waste Anesthetic Gas Disposal. These outlets are installed in operating rooms to remove excess anesthetic gases exhaled by patients or escaping from anesthesia equipment. The purpose is to maintain staff safety and compliance with NFPA 99 (Health Care Facilities Code), which requires WAGD systems in anesthetizing locations.

Correct (D): Operating rooms require WAGD outlets as part of medical gas and vacuum systems.

Incorrect:

A. boiler room: No patient care; WAGD outlets are not relevant.

B. electrical closet: For electrical equipment only, no medical gases.

C. laundry room: Handles linens, not anesthetic gas removal.

Scale forms where water is in direct contact with heated surfaces. In steam boilers, that location is below the water line, where dissolved minerals (calcium, magnesium, silica) precipitate and adhere to heat-transfer surfaces as scale. This reduces efficiency and can cause overheating of boiler tubes.

B. below the water line (Correct): Primary area where water meets heat-transfer surfaces; mineral deposits form here.

A. huddling chamber: This is part of a safety relief valve, not a surface for scale buildup.

C. weld above the water line: There is no continuous water exposure above the water line, so scale does not accumulate there.

D. blowdown valve: This is used to remove sludge/sediment, not a typical location for scale accumulation.

The Joint Commission (TJC) requires hospitals to conduct environmental tours (also called Environment of Care rounds) with the primary purpose of identifying hazards to patients, staff, and visitors. While compliance, risk categorization, and system failures may be evaluated, the main focus is proactive hazard identification to reduce safety risks.

Salary ranges are determined by job requirements and market benchmarks, not individual candidate qualifications. Key factors are:

Market salary analysis (1).

Internal equity review (3).

Job description (4).

Candidate qualifications (2) affect where within the salary range an individual may be placed, but not the establishment of the range itself.

The Safe Medical Device Act (SMDA) of 1990 requires healthcare facilities to report to the FDA and the manufacturer when a device is suspected of causing or contributing to death or serious injury.

C. death or injury (Correct): Specifically mandated under SMDA.

A. inappropriate application: A usage issue, not a reporting trigger.

B. recall: Issued by the FDA/manufacturer, not the facility’s reporting obligation.

D. major breakdown: Requires service but not mandatory reporting.

For electrical systems, real power (kW) is obtained by multiplying apparent power (kVA) by the power factor (PF):

kW = kVA × PF

This formula gives the average power consumed by a single-phase motor.

C. KVA × PF (Correct): Standard power equation for real power.

A. KVA / PF: Incorrect; dividing by PF would increase kVA, not convert to kW.

B. kW × PF / 1,000: Incorrect; kW already accounts for PF, and the division by 1,000 is irrelevant here.

D. amps / PF: Incomplete and not dimensionally correct.

Budget forecasting based on partial-year actuals uses the annualization formula:

Annual Forecast

=

Actual Costs for Months

Number of Months

×

12

Annual Forecast=

Number of Months

Actual Costs for Months

​

×12

For 5 months of data, the multiplier is 12/5.

Correct (D): current 5-month actual × 12/5.

Incorrect:

(A) × 5/12 would shrink the budget, not project it.

(B) Uses only one month, not representative.

(C) Uses only 2 months, less reliable.

Written fire procedures must include the method for promptly notifying the fire department or emergency response agency, ensuring immediate response to protect life and property. Evacuation routes and equipment locations are important operational elements, but the mandatory code requirement is a defined notification procedure.

According to federal and state healthcare waste management standards, regulated medical waste must always be separated from general waste streams at the point of generation. Proper segregation ensures compliance with OSHA’s Bloodborne Pathogens Standard, EPA’s Resource Conservation and Recovery Act (RCRA), and The Joint Commission’s Environment of Care standards. Containers for regulated waste must be red, leak-resistant, and labeled with the universal biohazard symbol.

Correct Answer (D. separated from other types of waste): CHFM compliance and Environment of Care standards require that infectious or hazardous medical waste be physically separated to prevent cross-contamination and maintain compliance with infection control protocols.

A (labeled with specific content): While containers must be labeled, they do not list specific contents; only the biohazard designation is required.

B (refrigerated at 40°F): Refrigeration applies only in specific storage conditions, not universally required for all regulated medical waste.

C (incinerated within 10 days): Time requirements vary by jurisdiction; incineration within 10 days is not a universal federal mandate.

Under the ADA Accessibility Guidelines (ADAAG), room identification signs must include raised tactile characters and Braille. These apply to permanent spaces such as patient rooms, restrooms, and offices.

C. room identification (Correct): Required by ADA to have tactile and Braille.

A. directional: May use visual characters only; Braille is not required.

B. informational: Same as directional, not required to have Braille.

D. mechanical spaces: These areas are typically staff-only; signs do not require tactile or Braille by ADA standards.

22% excess oxygen is far higher than normal (typical excess O₂ is 3–6%). This means there is too much air compared to fuel, causing inefficiency.

The corrective action is to increase fuel pressure, which reduces excess oxygen by balancing the air-fuel ratio.

D. Increase the fuel pressure (Correct): Restores optimal combustion balance.

A. Steam atomization: Not relevant unless using certain oil burners.

B. Increase nozzle air pressure: Would worsen the excess O₂ condition.

C. No adjustment necessary: Incorrect because efficiency is compromised.

According to NFPA 72: National Fire Alarm and Signaling Code, the following frequencies apply:

Waterflow devices (D): Must be tested quarterly.

Supervisory signal devices: Semiannual testing.

Duct detectors and door holders: Tested annually.

Thus, only water flow devices require quarterly testing.

Before performing any work on electrical or mechanical equipment, OSHA and NFPA 70E require lockout/tagout (LOTO) procedures to isolate energy sources. This ensures the safety of workers and prevents accidental energization. Only after lockout/tagout can guards be removed, wiring disconnected, or diagnostic tests performed.

According to standard accounting practices, when an overhaul or replacement extends the useful life of an asset, it is considered a capital expenditure. Operating costs are day-to-day expenses; contingency is reserved budget for unforeseen costs; non-depreciable refers to land, not equipment.

The Joint Commission (TJC) aligns with NFPA 101: Life Safety Code. For business occupancies (such as outpatient clinics), the requirement is that fire drills be conducted annually (every 12 months).

Quarterly (every 3 months) drills are required for healthcare occupancies (hospitals, nursing care).

Outpatient business occupancies are less stringent.

In a standard patient room in a healthcare facility, the typical medical gas outlets include:

Oxygen (1) – for patient respiratory therapy.

Medical Air (2) – used for respiratory support.

Vacuum (4) – for suction applications.

Nitrogen (3) is not normally supplied in a patient room; it is typically used in surgical suites for powering tools.