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Sent by a restoration contractor, under their own name and logo. Who it is for: Facilities directors, plant operations, infection prevention and safety officers. When to send it: Send it to hospitals, clinics and medical office buildings before asking to pre-credential.

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Before you send this. Most hospitals will not let an outside crew in until it clears their vendor credentialing: badges, background checks and vaccination records, for every person on the job. Expect them to ask for proof that your supervisors and technicians are trained to work under an infection control risk assessment (ICRA) and its precaution classes. If the crew finds suspect asbestos above the ceiling, the work falls under OSHA's construction asbestos standard (29 CFR 1926.1101) and your state's asbestos licensing, so line up a licensed abatement crew before you promise a start time.

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EMERGENCY GUIDE

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Healthcare Facility Emergency Guide

Water, sewage or mold in a patient care area is an infection control event first. This guide covers the first hour, the containment the job requires, and the records that show it was met.

Where your loss lands

• For a water, sewage or mold loss in a care environment, negative pressure containment and HEPA filtration are the starting point, not an upgrade. When sewage, gray or black water, mold or asbestos is present, the ICRA matrix calls for Class IV in Low and Medium risk areas and Class V in High and Highest risk areas. Class I and Class II precautions do not reach this work. Expect IV or V from the first phone call and staff it that way.
• Know your risk group before you dial. Low is non-patient areas off the clinical units. Medium is waiting areas, clinical engineering, materials management, the dirty side of sterile processing, and food service. High is patient care rooms, acute care units, the emergency department, the general pharmacy work zone, medication rooms, diagnostic imaging and laboratories. Highest is transplant, intensive care and oncology units, operating theaters, procedural suites, pharmacy compounding, the clean side of sterile processing and invasive imaging. Tell us the group for the affected space and for every space next to it.
• Every Class IV and Class V job needs a signed infection control permit, and so does Class III work that comes from a Type C activity. Name who signs the permit after hours.
• Look past the wet room to everything around it: the floors above and below and the spaces on each side, front and back. Water runs down. Dust moves sideways through the plenum.
• Keep a printed copy of your precautions matrix at the plant operations desk and a blank infection control permit in the after-hours binder.

What makes healthcare different

• The infection control risk assessment governs the work. Your compliance officer and the authority having jurisdiction decide what applies in your building. We work to the class your ICRA assigns. We do not set it, and we do not argue it down.
• Interim life safety measures (ILSM) apply whenever egress, alarm, or compartmentation is affected.
• Patient care continuity drives the schedule. The department decides when the work can happen.
• Wet building materials near immunocompromised patients are an infection control question your infection prevention team owns. We bring the containment, the equipment and the documentation to whatever class that team writes down.
• Access is a schedule item, not paperwork. Badging, background checks and vaccination records for an outside crew take longer to clear at two in the morning than the water takes to reach the next corridor.

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