CHFM Questions and Answers

The Hazard Vulnerability Analysis (HVA) is the primary tool recommended by The Joint Commission (TJC) for planning emergency response exercises. It allows facilities to identify, assess, and prioritize potential hazards and then plan drills and exercises accordingly.

C. HVA (Correct): Standard TJC requirement for developing emergency exercises.

A. ILSM (Interim Life Safety Measures): Used during construction or when life safety features are impaired, not for emergency planning.

B. PCRA (Pre-Construction Risk Assessment): Focuses on infection control and safety risks during construction.

D. ICRMR: Not a recognized TJC tool.

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.

When Alternate B is chosen, total price = Base Bid + price for Alternate B (or zero if “Included”).

A: Not available → cannot be selected.

B: $20,000 + Included ($0) = $20,000.

C: $19,000 + $500 = $19,500.

D: $19,000 + $1,000 = $20,000.

Lowest total = $19,500 (Company C).

Construction projects in healthcare facilities must have secured funding before starting. While approvals, staffing, and security considerations are important, the project cannot begin without the capital budget authorization. This aligns with AIA project delivery requirements and AHA/ASHE guidance for healthcare construction projects.

Acceptable indoor CO₂ concentrations in healthcare facilities are generally expected to remain below 1,000 ppm, as recommended by ASHRAE Standard 62.1 (Ventilation for Acceptable Indoor Air Quality). A reading of 1,500 ppm typically signals inadequate ventilation and insufficient outside air being introduced into the space. This is a direct indicator of poor dilution of indoor contaminants.

Correct: Lack of outside air (C) – High CO₂ concentrations are directly linked to reduced outside air supply.

Incorrect:

A. Within design – Not correct, since 1,500 ppm exceeds design thresholds.

B. Vehicular exhaust – Would raise CO and NOx levels, not primarily CO₂.

D. Humidity/dewpoint – Unrelated to CO₂ measurement.

Overage = 140 cu. ft.

Each small cylinder = 25 cu. ft.

140 ÷ 25 = 5.6 → minimum 6 needed if rounding up. However, since the question asks for the minimum number to remove to get below the limit, removing 5 cylinders = 125 cu. ft. would still leave 15 cu. ft. over the limit. Therefore, 6 cylinders must be removed.

Correct answer = C (6), not B.

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.

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.

To stay within the $5,000,000 annual budget, the facilities department must reduce monthly spending to $337,500 for the remaining 8 months.

NFPA 101 (Life Safety Code, Chapter 18/19.7.1.4) requires healthcare fire drills to include transmission of the fire alarm signal and a simulation of emergency fire conditions, ensuring staff are trained to carry out emergency duties. Full evacuation of patients is not required during drills.

The correct sequence aligns with the Plan–Do–Check–Act (PDCA) cycle of continuous improvement:

Identify and prioritize opportunities (3).

Take action on those priorities (4).

Evaluate to confirm results (1).

Take further action if goals are not sustained (2).

This matches performance improvement processes emphasized in the CHFM Administration domain.

NFPA opening-protective tables specify that doors protecting openings in 2-hour fire-resistance-rated fire barriers are required to have a 1-1/2-hour (90-minute) fire protection rating. This distinction between the wall’s fire-resistance rating and the door’s fire-protection rating is standard in NFPA 101 and NFPA 80.

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.

OSHA’s Control of Hazardous Energy (Lockout/Tagout) standard, 29 CFR 1910.147, requires that each authorized employee shall affix a personal lockout device to the energy-isolating device when they are working on equipment. This ensures that energy cannot be restored until every individual has removed their own lock, thereby directly protecting each worker.

Correct (D): The standard explicitly describes the use of a multiple lockout device (commonly called a hasp), where each employee applies their own personal lock. No lock may be removed until the individual’s work is complete.

Incorrect Options:

A: Listing multiple names on a single lock/tag does not meet OSHA’s requirement for individual control.

B: Providing multiple keys to a single lock defeats the purpose of individual energy control and is not compliant.

C: Commonly keyed locks are prohibited because one employee could remove another’s lock.

Relevance to CHFM Exam (Compliance Domain):

The CHFM exam tests knowledge of OSHA workplace safety standards because healthcare facility managers must ensure compliance in utility and maintenance operations. Proper lockout/tagout procedures are critical for worker safety and regulatory adherence.

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.

Comprehensive and Detailed Explanation From Exact Extract:

Per NFPA 101: Life Safety Code, the maximum allowable capacity for soiled linen or trash receptacles located outside of hazardous storage rooms (such as within patient rooms or nurse stations) is 32 gallons (121 liters). If containers are larger than this, they must be stored in a room meeting hazardous area protection requirements.

Correct Answer (C. 32 gal.): Matches NFPA 101, 18/19.7.5.5.7 (Health Care Occupancies), which restricts container size to 32 gallons maximum unless in a protected hazardous storage room.

Incorrect Options:

A. 8 gal. and B. 16 gal. – These are not the standard NFPA thresholds.

D. 64 gal. – Exceeds NFPA’s maximum; would require special hazardous storage protections.

Relevance to CHFM: This falls under the Compliance domain, as CHFM professionals must ensure healthcare facilities follow NFPA 101 and Joint Commission standards regarding fire and life safety.

To evaluate overall building condition, the Facility Condition Index (FCI) is commonly used. FCI = Deferred Maintenance ÷ Current Replacement Value. A lower FCI indicates better building condition (less deferred maintenance relative to value).

Building 1: 1,200,000 ÷ 25,000,000 = 0.048

Building 2: 200,000 ÷ 2,500,000 = 0.080

Building 3: 25,000 ÷ 600,000 = 0.0417

Building 4: 900,000 ÷ 10,000,000 = 0.090

Building 3 has the lowest FCI (0.0417), which means it has the least deferred maintenance compared to its value and therefore is in the best overall condition.

Incorrect Options:

Building 1 (0.048) – Good, but not the lowest.

Building 2 (0.080) – Higher FCI means poorer condition.

Building 4 (0.090) – Highest FCI of the group.

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.

A demand spike (kW) can occur when multiple large motors or systems restart simultaneously after a power interruption. Although energy consumption (kWh) over the interval may be less, the instantaneous demand registers higher because of inrush currents during restart. This aligns with CHFM exam energy management principles.

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.

When fire protection systems (sprinklers, alarms) are impaired during construction, Interim Life Safety Measures (ILSM) must be implemented to maintain safety. These include fire watch, additional training, and temporary compensating measures.

B. ILSM (Correct): Required under TJC and NFPA 101 during impairments.

A. ICRA (Infection Control Risk Assessment): Applies to infection risk during construction, not fire protection.

C. PASS (Pull, Aim, Squeeze, Sweep): Fire extinguisher operation technique.

D. RACE (Rescue, Alarm, Contain, Extinguish): Emergency fire response procedure.

NFPA 110 (Standard for Emergency and Standby Power Systems) requires that emergency generators be tested monthly under load. If the available load is less than 30% of the generator’s nameplate rating, the test may be conducted until operating parameters (water temperature, oil pressure) stabilize. For longer durations, supplemental loading or load bank testing applies, but the minimum standard is monthly operation until systems stabilize.

NFPA 10: Standard for Portable Fire Extinguishers requires that extinguishers be visually inspected at least monthly. This inspection confirms accessibility, proper charge, and readiness.

Weekly, quarterly, semi-annual are not correct; only monthly inspections are mandated.

Hospital-grade receptacles, as defined in UL 498 and required under NFPA 99 Health Care Facilities Code, must be marked with a green dot. This identifies receptacles tested for durability, grounding reliability, and retention force.

Red outlets are often tied to emergency power, but that is separate from the “hospital grade” designation.

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.

Leadership requires a business case to justify capital expenditures. The Return on Investment (ROI) demonstrates cost savings, efficiency, and risk reduction benefits of replacing the boiler, making it the most critical piece of information. Size, maintenance cost, or timeline support the request, but ROI is decisive for approval.

“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.