NABH 6th Edition FMS Chapter: Facility Management and Safety Explained

What the FMS chapter is about

NABH's intent for FMS is a safe and secure environment for patients, families, staff and visitors. The hospital keeps its building, equipment and internal environment safe through proactive risk analysis, regular inspection rounds, staff training and emergency planning. It provides safe water, electricity, medical gases and vacuum, manages medical and utility equipment, plans for fire and non-fire emergencies and handles hazardous materials safely. The intent also says the hospital is a no-smoking area and works towards energy efficiency.

Every Core element must score at least 4 out of 5 at every assessment. Our 6th Edition overview explains the scoring. NABH marks 14 FMS elements with an asterisk, meaning they must be documented: FMS.3.a, 3.d, 3.e, 3.f, 4.c, 4.h, 5.c, 5.f, 5.g, 6.a, 6.c, 7.a, 7.b and 7.e.

The 7 standards at a glance

Safety rounds and security (FMS.1 and FMS.3)

Two Core elements open the chapter: patient safety devices and infrastructure are installed and inspected periodically (FMS.1.a), and facility inspection rounds happen at least once a month (FMS.1.c). Round reports are documented with corrective and preventive action, the hospital has facilities for the differently-abled, and a risk assessment is done before any construction, renovation or expansion.

FMS.3 covers security and hazards. Operational planning identifies areas that need extra security and defines who can enter where. Hazardous materials are identified and used safely (FMS.3.e, Core), there is a spill management plan that is actually implemented and a procedure for identifying and disposing of material no longer in use. Electrical safety audits (FMS.3.c) moved from Achievement to Commitment in this edition, so every hospital now needs them. Considering structural safety, especially of critical areas, when building new hospitals or retrofitting old ones is the chapter's only Excellence element.

Evidence that works: a monthly round checklist with findings and closure dates; a list of safety devices (grab bars, bed rails, call bells, anti-skid flooring) with inspection records; a pre-construction risk assessment; a security zoning plan; a hazardous materials inventory with safety data sheets and spill kits; the latest electrical safety audit.

Facilities, signage and utilities (FMS.2)

Space and facilities must match the scope of services, and as-built drawings are kept up to date as the law requires. NABH's change notes say the interpretation now includes extra-low-voltage (ELV) and IT network drawings. Internal and external signage that patients, families and the community understand (FMS.2.c) and potable water and electricity round the clock (FMS.2.d) are both Core. Backup sources for water and electricity are provided and tested at a frequency the hospital defines.

Evidence that works: current as-built drawings, including electrical, plumbing, ELV and network layouts; bilingual signage on every floor; water quality reports; DG set and UPS test logs; a backup water arrangement with test records.

Engineering and utility equipment (FMS.4)

The hospital plans its utility and engineering equipment around its services, keeps an inventory and logs, and implements a documented preventive and breakdown maintenance plan (FMS.4.c, Core). Equipment is inspected and calibrated where applicable, competent people operate and maintain it, maintenance staff can be reached round the clock, and written guidance covers replacement and disposal. Monitoring downtime of critical equipment from report to corrective action is an Achievement element.

Medical equipment (FMS.5)

The same discipline applies to medical equipment: planning, an inventory with logs, and a documented preventive and breakdown maintenance plan that is implemented (FMS.5.c, Core). Equipment is periodically inspected and calibrated, qualified and trained staff operate and maintain it, and written guidance covers replacement and disposal. The hospital also monitors adverse events involving medical equipment and devices and acts on recall and hazard notices (FMS.5.g), for example by reporting to the Materiovigilance Programme of India. Monitoring downtime is again an Achievement element.

Evidence that works: an equipment inventory with unique IDs; preventive maintenance and calibration schedules with stickers on the equipment; breakdown logs; AMC and CMC contracts; operator training records; a recall and hazard notice register.

Medical gases, vacuum and compressed air (FMS.6)

Written guidance covers the procurement, handling, storage, distribution, use and replenishment of medical gases. Gases are handled, stored, distributed and used safely (FMS.6.b, Core), piped gases, compressed air and vacuum have an operation, inspection, testing and maintenance plan, and alternate sources are provided in case of failure (FMS.6.d, Core) and tested regularly.

Evidence that works: a manifold room with secured, labelled cylinders and an alarm panel; a reserve supply with changeover tests; pipeline testing and maintenance records; staff who know what to do if the oxygen supply fails; the PESO licence your cylinder or liquid oxygen storage needs, if it crosses the licensing threshold.

Fire and non-fire emergencies (FMS.7)

This standard holds two Core elements: plans and provisions for early detection, containment and abatement of fire and for evacuation (FMS.7.a), and plans for identifying and managing non-fire emergencies (FMS.7.b), which is new in the 6th Edition. The exit plan is documented and displayed, mock drills are held at least twice a year, and fire equipment and infrastructure have a maintenance plan.

Two related requirements sit in other chapters. Training staff in the disaster management plan and in handling fire and non-fire emergencies are both Core elements in HRM (HRM.6.e and HRM.6.f). Planning for community emergencies, epidemics and disasters is in COP (COP.4).

Evidence that works: a valid fire NOC; fire detection and suppression systems with maintenance records; displayed evacuation maps; drill reports with timings, observations and corrective actions; emergency codes for non-fire events such as violence, a bomb threat, a power failure or a gas leak; staff who can explain what they do in each code.

What changed from the 5th Edition

• New Core element: plans for non-fire emergencies (FMS.7.b).
• Electrical safety audits moved from Achievement to Commitment (FMS.3.c).
• The interpretation for as-built drawings now covers ELV and IT networks, and the infrastructure upgrading requirement moved into FMS.2.a from COP.
• The security and structural safety elements swapped places (now FMS.3.a and FMS.3.b).
• Medical gas elements were merged, and interpretations for the fire plan and equipment downtime now stress implementation.

How assessors test FMS

FMS is assessed on foot. Assessors walk the building with your facility team, check that exits are clear and signed, look at extinguisher tags and hydrant pressure, open the manifold room and the hazardous materials store, read maintenance stickers on equipment and compare them with the logbook, and ask the DG set operator when the backup was last tested. They will ask a nurse what to do if a fire breaks out on her ward and what the code for a non-fire emergency is. A recent drill with an honest list of what went wrong usually impresses more than a perfect report.

Getting FMS ready

1. Check statutory approvals first: fire NOC, electrical and lift approvals and any licence your gas storage needs.
2. Start monthly facility rounds and close every finding.
3. Build the utility and medical equipment inventories with maintenance and calibration plans.
4. Write the fire and non-fire emergency plans, display exit maps and train every shift.
5. Hold your first two mock drills and fix what they reveal.

Our NABH documents checklist lists the FMS policies, and we run 6th Edition gap analyses scored the way assessors score. Hospitals up to 50 beds follow the equivalent chapter in the SHCO standards.

All ten NABH 6th Edition chapter guides: AAC · COP · MOM · PRE · IPC · PSQ · ROM · FMS · HRM · IMS