By Dan Hounsell, Senior Editor

Facility managers in the nation’s public institutional facilities, from K-12 schools to federal office buildings, are no strangers to deferred maintenance. For decades, news reports have documented the billions of dollars — taxpayer dollars — required to erase the ever-growing backlog of repairs it would take to make these buildings safe, compliant and reliable.  

Often overlooked in such conversations are healthcare organizations, which also face continuous pressure to effectively manage expenses and improve profits while meeting evolving demands in their communities. Healthcare facilities face a perfect storm of conflicting priorities — an aging infrastructure, deferred maintenance increasing annually, and demands to improve energy efficiency and cut carbon emissions.    

As revealed by the 2022 Hospital Construction Survey from the American Society for Healthcare Engineering (ASHE), healthcare facilities find themselves in a truly challenging position. Thirty-five percent of hospitals surveyed say they have performed an emergency repair on a piece of equipment after deferring maintenance on it, and 86 percent say the cost for emergency projects was higher by an average of nearly 18 percent. 

The topic of deferred maintenance took center stage earlier this month at the ASHE Health Care Facilities Innovation conference in Anaheim. A roundtable discussion among managers and consultants spotlighted the front-line challenges managers face in tackling deferred maintenance in their facilities. 

Two topics emerged as the most challenging for managers: 

Data domination. Many healthcare facilities are losing the battle to deferred maintenance, and turning the tide will require managers to rethink their approach to securing funding for upgrade projects. Instead of just telling the financial people in an organization about the problems, managers need to take a more analytical and strategic approach. 

“We have to get past the anecdotes” one attendee said. “We have to get smarter on the data side of the equation.”  

Another attendee advised managers to dig deeper into the data than just the age of equipment. 

“We tend to focus on age, but it shouldn't be on age or miles on the odometer,” he said. “It’s not just the investment. It’s the maintenance of the investment.” 

Speaking up. Compiling data and project lists are critical elements of addressing deferred maintenance in healthcare facilities. But managers also must learn to package that information effectively and communicate facility needs to the organization’s C-suite in ways that resonate. 

“What services are we not able to provide because deferred maintenance took down an area?” asked one attendee, adding that managers should focus on the revenue impact of failing facilities. “The C-suite understands lost revenue.” 

Because the executives in healthcare organizations are businesspeople first, managers need to make the case for repair funds using relevant strategies. 

“Make sure when you tell them what you don’t need, as well as what you need,” one attendee advised, adding that managers should point out which projects can be delayed rather than demanding full funding. “It shows the money folks you know how to run your business. That said, showing them the whole list keeps the total dollar amount on the CFO’s mind.” 

Another strategy for building support in the C-suite for renovations and upgrades is to align with the strategies of the organization. 

“It builds trust capital in the C-suite,” one attendee said. “If the organization is prioritizing pediatrics, FMs need to align their projects and activities with that target.” 

While ASHE’s 2022 survey spells out the challenges managers face in addressing deferred maintenance in healthcare facilities, it does offer a bright spot for managers who can successfully make the case for funding upgrade projects: While very few hospitals got their entire maintenance requests approved, nearly one-third of respondents had more than 70 percent of their budget approved. 

Dan Hounsell is senior editor for the facilities market. He has more than 30 years of experience writing about facilities maintenance, engineering and management.