25 Facts About Hospital Maintenance & Infrastructure

Hospitals rely on a combination of buildings, skilled staff and technological infrastructure to deliver care. To provide quality patient care, they must find the balance — and the budget — to manage their workforce, IT systems and physical infrastructure.

As buildings age, they require significant capital to meet modern standards for technology and safety. Facilities managers are tasked with keeping these systems running smoothly without disrupting patient care, which requires specialized skills. Advancements in medical technology have revolutionized the concept of care, but aging infrastructure often limits the ability to implement these innovations. 

With chronic diseases like diabetes, cancer and dementia on the rise, global treatment costs for these conditions is expected to reach $47 trillion by 2030. Investing in hospital maintenance and infrastructure is essential for the future of healthcare, improving both patient outcomes and economic stability. Here are 25 hospital maintenance facts that highlight why.

Hospital Maintenance Overview

There are more than 6,000 hospitals in the U.S. that require maintenance.

Hospitals, health systems and care providers maintain over 6,000 hospitals, 920,000 beds and thousands of clinics to deliver safe, effective care. This infrastructure relies on complex and costly systems, including mechanical, IT and medical equipment.

Healthcare has been valued at $4.3 trillion, making up 18.3 percent of the GDP.

In 2021, the U.S. healthcare industry was valued at $4.3 trillion, making up 18.3 percent of the GDP. As such a significant industry, healthcare faces challenges in delivering quality care, managing data, ensuring equity and supporting its workforce.

50 percent of health system facilities managers are overseeing at least one facility that is more than 50 years old.

More than half of the health system facilities managers and executives surveyed for the 2024 American Society for Health Care Engineering (ASHE) Hospital Operations Survey oversee at least one facility that is more than 50 years old, confirming aging infrastructure as a top concern.

As of 2021, there was $390 billion in deferred maintenance across U.S. healthcare facilities.

Facilities managers know how easily deferred maintenance turns minor issues into major system failures. According to Jonathan Flannery, senior associate director for ASHE Regulatory Affairs, “A roof leak can be an annoyance, but it’s not a big deal to repair. The issue is that recurring roof leaks are a sign of the beginning of the end of the life of the roof. If that’s not addressed in a timely manner, the entire system can fail.”

There are 33 percent fewer hospital beds in the U.S. than there were in 1980.

Changes to the healthcare payment system have pressured hospitals to reduce inpatient bed capacity, with total hospital beds in the U.S. dropping 33 percent since 1980. The U.S. has fewer beds per person and lower hospital density than similar countries. 

Working in Hospital Maintenance

Hospitals employ more than 6 million people in full-time or part-time positions.

Hospitals and health systems are key economic drivers, creating jobs and supporting local businesses. In 2019, hospitals employed over 6 million people, spent more than $1 trillion on goods and services, supported nearly 18 million jobs and generated $2.30 in business activity for every dollar spent.

The average annual pay for a hospital facilities manager is $74,526.

That works out to approximately $35.83 an hour, $1,433 a week or $6,210 a month.

Teaching hospitals provide more than 7.1 million jobs nationwide.

Teaching hospitals play a key role in education, research and clinical services, supporting more than 7.1 million jobs nationwide.

33 percent of health systems’ facilities maintenance activities are contracted out.

As healthcare organizations struggle to offer competitive wages for in-demand specialists, outsourcing can help to fill some of these gaps. For instance, 73 percent of healthcare facilities managers report a shortage of HVAC and controls technicians, with 62 percent outsourcing their facility maintenance work.

37 percent of facilities managers focus on career growth and fund continuing education to retain staff.

Once staff is recruited, 37 percent of facilities managers prioritize career growth pathways and paying for employees’ continuing education opportunities as a way to retain that staff and maintain proper care of the physical environment.

Industry Pain Points

In 2020, hospitals in the United States experienced a total loss of over $200 billion. 

COVID-19 care prompted higher operating expenses for necessary supplies and rapidly escalating labor costs. Overall, hospitals in the United States experienced a total loss of over $200 billion, largely due to an estimated 45 percent decrease in operating revenue between March 1 and June 30, 2020.

33 percent of hospitals are facing negative operating margins.

For the last few decades, around a third of hospitals throughout the U.S. have had negative operating margins. Among the largest hospitals, profitability tends to be positive only when considering non-operating revenue contributions. During COVID-19, the severity of the disease and lack of outpatient volumes created worsening performance.

Four dozen hospitals closed or declared bankruptcy due to COVID-19.

COVID-19 revealed the gaps in healthcare infrastructure. Many hospitals, already financially strained, faced unprecedented losses, 50 closing or declaring bankruptcy in 2020 alone. 

80 percent of health system facilities managers say aging facilities and infrastructure is their biggest concern.

As infrastructure ages, maintenance costs rise and the risk of equipment failure or safety hazards increases, making this a primary concern for facilities managers working in healthcare. This strain not only impacts day-to-day operations but also makes it difficult to adapt to new technologies or healthcare standards. 

58 percent of health system facilities managers cite lack of funding and staffing challenges as their second biggest concern.

Limited financial resources and hiring and retaining staff is an ongoing struggle, so much so that 58 percent of health system facilities managers believe it is their biggest challenge. These obstacles often compound one another, undermining operational effectiveness.

Techʼs Influence on Hospital Maintenance

Automating workflows helps to take the burden off workers and to prevent burnout.

Inefficient workflows for both healthcare workers and facility managers are a common issue in hospitals. But hospital maintenance software can help automate the process — by tracking maintenance requests, assigning tasks and keeping everything running smoothly and on schedule. This work order software provides a centralized location for you to create, assign and track work orders, moving them through the work order process using a single dashboard and keeping all necessary communications and updates in one place.

64 percent of facilities managers say that explaining to executive leadership how infrastructure impacts patient care is the most effective strategy for securing maintenance funds.

And 59 percent report that tying upgrades to regulatory compliance also makes a compelling case. This approach often depends upon having data to build a case. “Tracking equipment failures and downtime has led to better root-cause analysis and aided in acquiring additional capital funds,” says one facilities manager. 

72 percent of facilities managers report that they are tracking and benchmarking their maintenance activities. 

To demonstrate the financial benefits, 72 percent of facilities managers say it’s essential to analyze historical equipment spending, assess demand flow on outdated equipment, calculate full-time equivalent (FTE) employee costs, renegotiate vendor contracts and secure repair and replacement proposals from original equipment manufacturers. Tracking maintenance activities makes it easier to pull historic maintenance data that can support future funding requests.

80 percent of facilities managers have turned to maintenance software to provide the data for effective storytelling.

“Work order and preventive maintenance counts, completion rates, time to close and forecasted preventive maintenance all help with scheduling staff and following up on teams that need additional support or resources,” says one facilities manager. 

Tracking equipment failure rates, unplanned downtime of critical infrastructure, patient room closures for maintenance and daily work order completion can also be helpful.

21 percent of facilities managers use reliability-centered maintenance (RCM).

Reliability-centered maintenance (RCM) is gaining traction in health systems, with 21 percent of facilities managers finding it useful to tailor maintenance methods and schedules to specific assets. A computerized maintenance management system (CMMS) like Coast enhances reliability-centered maintenance by streamlining processes and improving asset management. It offers a centralized platform for tracking asset location, condition and history, while real-time data helps facilities managers make informed maintenance decisions.

Future of Hospital Maintenance

Two-thirds of healthcare facilities are designing workplaces to meet diversity, equity and inclusion standards while addressing the needs of a multi-generational workforce.

Healthcare facility teams are increasingly focused on creating social value, and 84 percent of corporate real estate leaders around the world report having a well-defined program to drive greater community impact. To strengthen this impact, facilities departments can explore using workplaces for nonprofit and community events while continuing to innovate in hiring local talent and serving the community.

The trend towards predictive maintenance is growing, with 35 percent of all magnetic resonance imaging maintenance cases now solved predictively.

Advances in AI and data-driven technologies are driving the transition from reactive to proactive and eventually, predictive maintenance. Garry Jepp, head of services operations at Philips, underscores the importance of proactive and predictive maintenance. “We are developing these capabilities fast to constantly improve the customer experience. If you can predict it, you can prevent it.”

Remote monitoring and resolution in Latin America now stands at 42 percent.

The shift to remote monitoring of medical equipment accelerated in early 2020 when hospitals limited personnel access during the pandemic. Field service engineers could quickly diagnose issues, have parts ready and perform maintenance through proactive assessments and scheduling. This trend is continuing to grow as U.S. health systems recognize the benefits of remote monitoring and resolution.

The global hospital market is expected to grow 21 percent from 2023 to 2030.

With the global hospital market expected to surpass $153 billion by 2030, adopting technology to support the growth and maintenance of new healthcare facilities is more important than ever. Internet of Things (IoT) devices, software and systems, like vibration sensors and smart meters, collect data on equipment performance. This helps detect potential failures, urgent maintenance needs and sources of energy or water waste.

The smart buildings market is expected to reach $121.6 billion by 2026.

The smart buildings market is expected to reach $121.6 billion by 2026, growing at a 10.9 percent CAGR. Smart building technologies are automating tasks like lighting and temperature control, while data from these systems is used to optimize building operations and maintenance. 

Enhancing Hospital Infrastructure for Improved Patient Care

Outdated facilities make it increasingly difficult to provide optimal patient care, improve workflow and meet regulatory standards. As these issues persist, attracting patients, retaining staff and maintaining financial viability become greater challenges. Using a CMMS simplifies the process of data collection so facilities managers can demonstrate the value of investing in hospital infrastructure and advocate for the funding they need.