Why this matters for a public hospital
Nashville General Hospital operates on the Meharry Medical College campus in a facility built in the 1970s, with major renovations completed in the 1990s. It is one of the oldest hospitals in the region, and much of its infrastructure is at or past the age engineers would normally expect it to last.
That is exactly the situation where guessing gets expensive. Jerry Galu, CHFM, the hospital's director of facilities management, put it plainly in the article: "You can't make informed capital decisions without understanding what you're working with."
The assessment gives the hospital a documented, prioritized list instead of a wish list. Findings tied to health and life safety rise to the top. Everything else gets sequenced behind them. Those results, along with equipment condition data and remaining useful life projections, feed directly into Nashville General's five-year capital plan.
Three examples of assessment findings becoming projects
Electrical panels. The assessment flagged a significant number of electrical panels that the industry now considers obsolete, with known reliability concerns. Replacing them was ranked among the hospital's highest priorities. Galu told the magazine the team is working with a vendor on a replacement approach that fits new equipment into the existing panel backboxes, which is expected to cut both cost and installation time by reducing how much rewiring is needed.
Elevators. The assessment confirmed that key elevator components had passed their expected service life and that replacement parts are getting harder to find. Capital funding has been secured, and a phased elevator modernization program is in planning.
Humidification systems. The hospital runs a mix of original and newer equipment. The assessment reinforced the case for modernizing the older systems to support occupant comfort and infection control. Projects are being developed for future capital budgets.
None of these are the kind of thing a patient or visitor notices on a good day. All of them are the kind of thing everyone notices on a bad one.
It only works as a team effort
One of the points Galu made to Building Operating Management is that an assessment cannot be run by the facilities department alone.
"The facilities team knows the equipment, the clinical staff know the impact and leadership knows the financial constraints. You need all these perspectives and sometimes even more in the room, or you're not really prioritizing. You're just guessing."
In a hospital, one infrastructure decision touches every department. An air handler is not an air handler. It is whether a surgical suite runs on schedule next winter. Getting the clinical teams and hospital leadership in the room during the assessment means less argument later about what deserves funding first.
The value of an outside look
Galu also pointed to something simpler: a fresh set of eyes finds things a familiar one stops seeing.
"My guys go past a compressor at minimum three times a day doing their shift checks. But when somebody else walks by it for two minutes, they can find something new."
An assessment does not make deferred maintenance disappear. What it does is replace surprise with a plan, and replace opinion with data. For a hospital that answers to the community it serves, that is the difference between reacting to a failure and preventing one.
Read the full article
"FCAs in Action" by Elaina Myers appears in the September 2026 issue of Building Operating Management (Volume 73, Issue 9). Read the full feature in the September 2026 digital edition.
Source: Elaina Myers, "FCAs in Action," Building Operating Management, September 2026. Published by Trade Press Media Group, Inc.
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