ANSI/ASHRAE/ASHE Standard 170-2017

Presented by:
Richard (Dick) Moeller, PE FASHE,
HFDP, CHC, LEED AP

Principal, GnGB
dmoeller@gngb.us

September 26, 2018 NAFA Conf

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 Std. 170 - Purpose

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.

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

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Std. 170 - Scope

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
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workers, and visitors.

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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 Courtesy:

Health Care Facilities

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 History
• Republished in 2013 (25 new addendums added)
• Incorporated into 2014 Guidelines for Design and
Construction of Health Care Facilities (2 books)

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 History
• Republished again in 2017 (12 new Addendums included)
• Incorporated into 2018 Guidelines for Design and
Construction of Health Care Facilities (3 books)

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 !! Be Careful with this Book !!

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 Why?

$$$
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 Courtesy:

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 Why?
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.
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CMS Adoption Makes Std. 170 Complicated
Issue:
• 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
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have not adopted the current edition or addenda.

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 ASHRAE Addendum Adoption Process

“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.” Courtesy:

WA State AHJ

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 CMS Adoption – it’s complicated

2008 ASHRAE 170 Approved – 31 August 2011 2013 ASHRAE 170 Approved – 5 Dec 2013
2008 170 Addendum Adoption Date 2013 170 Addendum Adoption Date
a 25 July 2009 3 July 2014
b 16 Nov 2009
ae 6 Oct 2014
d 10 July 2010
e, f 3 Feb 2011 a, e 1 Dec 2014
g 3 March 2011 d 1 June 2015
h 27 July 2011
g 1 Oct 2015
2012 NFPA 99 Approved
c, f, h 1 June 2016
l, m 26 Jan 2012
r, s 29 June 2012 2012 NFPA 99 Adopted by CMS 5 July 2016
j, p, q, t 27 Oct 2012 k 16 July 2016
k, n, v 30 Jan 2013
m 30 Nov 2016
u, w 4 July 2013
x, z, ab 24 July 2013
ac 31 July 2013 Courtesy:

y 5 Dec 2013

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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) Courtesy:

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Continuous Maintenance

Other reasons
• Technology
• Energy
• Knowledge
• Corrections

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 Clarifications/Definitions

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

Asymptotic Curve
Missing definitions/clarifications? Courtesy:

• Volume - what constitutes ‘volume’ in space for air change calculation reg’s

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ASHRAE Addendum Adoption Process

Suggestions Public
by Standard 170 Review Response
committee
and to Publication
members or the Comments
public Comments

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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 Designers
oCode
oStandard
oGuideline
oStandard of Care Courtesy:

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 Addendum d – 2008 (Example)
• Status – Included in 2013 edition (Approved -
10 July 2010) Issues:
• Topic – Critical Area Humidity Requirements • For any of these
• Reduces minimum relative space humidity from 30% spaces, where Owners
RH to 20% RH in these short stay spaces: want to take advantage
• Class B and C Operating Rooms of the lower (20% )
• Operating/ Surgical Cystoscopy Rooms humidity requirement,
• Delivery Rooms CMS could require a
• Treatment Rooms minimum of 30%
• Trauma Rooms
• Laser Eye Rooms Courtesy:

• Class A Operating/Procedure Rooms

• Gastrointestinal Endoscopy Procedure Rooms

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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

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• 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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• Issues – None anticipated

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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

• Issues – None anticipated

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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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• Issues – None anticipated

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 Addendum x – 2008 (Filtration req’s)

Table 6-1 Minimum Filter Efficiencies

Filter Bank Filter Bank

Space Designation (According to Function) Number 1 Number 2
(MERV)a (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

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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
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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Status: Approved, currently under appeal

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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

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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?

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

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 Committee Membership – aka: Sales Pitch

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”
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 Committee Membership

Become a Committee Member and get a FREE copy!

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 Questions/Answers/Comments

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