By Scott Czubkowski

Summer storms are here, which means lightning strikes, floodwaters, high winds and downed trees and power lines are more likely to create power disruptions. Backup power is essential for healthcare facilities to continue to provide life-saving care despite a storm’s severity. 

Backup power loads fall into three essential categories: life safety, critical and equipment branches. Life safety and critical branches switch over via automatic transfer switches (ATS) immediately. Equipment branches typically have delayed switchovers to generator power. Life safety and critical branches support loads associated with safety and direct patient care. The equipment branches support ancillary loads required to keep a facility functioning for critical-support needs, such as operating room HVAC and medical gas system. 

All other loads should be considered non-essential and evaluated for their necessity. Adding too many non-essential loads increases the required backup power in terms of the size of the generator and its fuel requirements. 

Healthcare facilities must have two independent power sources, according to the National Electrical Code (NEC) 517.30. The first source is normal commercial power. For this source, healthcare facilities managers should consider having power from two different utility feeds. 

The second source is independent of the utility, such as a diesel generator, natural gas generator, fuel cell or other energy-producing device that is not the utility, and each has regulations managers must keep in mind. Generators are the most common backup power sources for healthcare facilities. This equipment can run on diesel — No. 2 fuel oil — or natural gas. Under certain applications, a fuel cell may be permitted. If a fuel cell is the primary means of power, external utility service can be considered the alternate source of backup power. 

Standard issues 

Given the high stakes associated with healthcare facilities’ power supplies, all facilities must comply with the applicable standards. The National Fire Protection Association (NFPA) provides standards, information and knowledge resources on fire, electrical and related hazards to help save lives, keep patients safe and reduce loss. These resources include backup power requirements and many standards associated with generators in particular. 

NFPA 99 and NFPA 110 are two primary standards that regulate generator use in healthcare facilities. In NFPA 99, generators are a part of the essential electrical system (EES). As referenced in NFPA 110, generators are part of the emergency power supply system (EPSS). An EPSS encompasses the entire electrical system, including protective devices, conductors, power monitoring, transfer switches and remote annunciators. 

Generator applications are designed to specific standards: Level 1, in which loss of power could lead to the loss of human life, and Level 2, where electrical failure is less critical to human life. Backup generators for healthcare are highly regulated, so the codes and application of equipment are very prescriptive. 

In addition to the requirement of a backup generator, the generator must perform above commercial standards. This means it must start within 10 seconds of a power outage to support life safety operations for emergency lighting and egress, and it must have sufficient fuel onsite to run essential branch circuits for at least 96 hours or incorporate a refueling plan as part of the facility emergency response plan. 

New-generation options 

Despite generators’ prevalence as backup power for healthcare, they are costly to procure, maintain and operate. In addition, managers must maintain 96 hours of fuel annually, which requires storing thousands of gallons of diesel that hopefully are barely used. 

Natural gas generators, fuel cells and microgrid applications are viable backup power options. As ATS options increase, facility power management controls are applied, and facilities can adapt to an emergency through management and delayed loading. Managers also can minimize backup power requirements by active load shedding of equipment and non-essential loads. 

Managers should evaluate backup power generation based on multiple generators’ ability to connect to one another and produce twice the power, known as paralleling. They also should evaluate the quantity of fuel required for extended run operations, natural gas supply accessibility and if fuel cells or microgrids support sustainability goals. 

Patient considerations 

The customer experience during backup power might not be high on many managers’ priority lists, but it is a critical consideration in patient-centered healthcare facilities. Managers should keep in mind the following factors when implementing new or switching to backup power: 

• proximity of generator to patient care relative to noise, fuel and exhaust smell and line of sight 
• location of fuel tanks — above grade or below ground 
• safety and security of equipment 
• facility evaluation and response requirements if loads need to be shed 
• load shed plan if fuel must be conserved for extended outages and run times. 

Managers also should consider load testing or switching equipment to backup power during a planned event — for example, on the same day or at same time every month — when facility use is at a minimum, causing minimal disruption to operations. This step will also help facilities evaluate how they need to communicate backup power to physicians, staff, patients and visitors in an emergency. 

Managers can find typical NFPA requirements specific to healthcare standby power systems through these links to help determine their facilities' needs: 

• NFPA 37, Standard for the Installation and Use of Stationary Combustion Engines and Gas Turbines 
• NFPA 70, National Electrical Code 
• NFPA 99, Healthcare Facilities Code 
• NFPA 10, Life Safety Code 
• NFPA 110, Standard for Emergency and Standby Power 
• NFPA 111, Standard on Stored Electrical Energy Emergency and Standby Power Systems 

Hospitals and other healthcare facilities do not get to take a break just because the power goes out. They offer life-saving care to members of the community, and ensuring facilities have reliable backup power options should be of the utmost importance for managers to provide care for patients when they need it the most. 

Scott Czubkowski, P.E., is national director of energy and facility performance with Medxcel.