AHA CHFM Certified Health Care Facility Manager (CHFM) Exam Practice Test

NFPA 101 (Life Safety Code) is structured around occupancy classifications (healthcare, business, assembly, residential, etc.). Determining the correct occupancy type is the first step because all subsequent requirements—such as egress, fire protection features, and construction criteria—are based on occupancy classification. Construction type, deficiencies, and location are important, but they are addressed only after occupancy is defined.

Replacement of major building systems (e.g., chillers, boilers, roofs) falls under capital expenditures because these items are large, non-recurring, and add to or extend the life of facility assets. The capital budget accounts for these costs, which are not part of the day-to-day operations budget.

Correct: Capital budget (A) – Covers replacement of major equipment and infrastructure.

Incorrect:

B. Project fund – May finance special projects but not part of standard budgeting categories.

C. Depreciation fund – An accounting mechanism, not typically a direct budget line for replacement.

D. Operating budget – Covers recurring expenses like utilities, maintenance, and repairs, not full replacements.

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.

Salary ranges are determined by job requirements and market benchmarks, not individual candidate qualifications. Key factors are:

Market salary analysis (1).

Internal equity review (3).

Job description (4).

Candidate qualifications (2) affect where within the salary range an individual may be placed, but not the establishment of the range itself.

According to standard accounting practices, when an overhaul or replacement extends the useful life of an asset, it is considered a capital expenditure. Operating costs are day-to-day expenses; contingency is reserved budget for unforeseen costs; non-depreciable refers to land, not equipment.

Simple payback is calculated as project cost divided by periodic savings; conversely, project cost = periodic savings × payback period. Monthly savings = $400 (utilities) + $25 (labor) = $425/month. A 2.5-year payback is 30 months. Estimated cost = $425 × 30 = $12,750 → D.

Prior to occupancy of newly constructed healthcare space, the local fire department (or fire marshal) must perform a survey/inspection to ensure compliance with life safety requirements, fire alarm functionality, sprinkler coverage, and egress standards. This is part of code compliance and occupancy approval.

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.

The CHFM exam Financial Management domain requires knowledge of cost savings and revenue generation calculations from operational changes such as recycling initiatives. In this example, gross revenue is calculated by summing the total recycling income streams (cardboard and aluminum).

Correct Answer (C. $7,200): Derived from combining $6,000 (cardboard) and $1,200 (aluminum) revenue.

Other options are incorrect because:

A ($6,000): Considers cardboard only.

B ($6,600): Misapplies aluminum tonnage conversion.

D ($18,000): Exaggerates revenue beyond calculated amounts.

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).

Submittals and shop drawings are specifically reviewed to ensure compliance with the design intent, plans, and specifications prepared by the architect/engineer. Code compliance is established during design and permitting, while minimizing change orders or ensuring contractor understanding are indirect benefits.

Any renovation project in a healthcare environment—even in non-clinical spaces like a dietitian’s office—requires evaluation of infection control and safety hazards. The Infection Control Risk Assessment (ICRA) process, supported by The Joint Commission and Facility Guidelines Institute (FGI) standards, mandates involvement of infection prevention and safety personnel in planning.

Correct (D): Ensures compliance with infection prevention standards and staff/patient safety during renovation.

Incorrect:

A. housekeeping and security: Important for support but not primary coordinators.

B. interior designer and supply chain: Handle design and material procurement, but not regulatory compliance.

C. information technologies and finance: Important in certain projects, but not relevant for infection/safety planning.

All construction and renovation projects in healthcare must include Infection Control Risk Assessment (ICRA). Infection Control professionals assess potential risks such as dust, ventilation disruptions, and waterborne hazards during construction. They ensure patient safety through control measures (barriers, negative pressure, monitoring).

D. Infection Control (Correct): Mandatory involvement in construction planning.

A. IT / B. Biomed / C. Patient Services: May participate but are not mandated by TJC and CDC requirements for ICRA.

In a fire tube boiler, hot gases of combustion pass through tubes, and water surrounds those tubes, absorbing the heat to create steam or hot water.

Correct: Fire tube (B) – Gases inside tubes, water outside.

Incorrect:

A. Water tube – The reverse: water flows inside the tubes, combustion gases surround them.

C. Vertical tube – Refers to orientation but still a water-tube or fire-tube design.

D. Cast iron sectional – Built from joined cast iron sections, not tubular gas-through-water design.

Building automation system (BAS) costs are based largely on the number of control points (sensors, outputs, and monitored parameters) that must be integrated. The cost is driven by how many signals must be tracked, rather than just the square footage or vendor.

A: Gross square footage can influence scope, but cost scales with monitored points.

B: Vendor may affect pricing, but primary cost driver is point count.

C: Technology choice matters, but the quantity of control points is more significant.

The Centers for Disease Control and Prevention (CDC) published the document “Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Healthcare Facilities”. These guidelines provide infection control practices for healthcare facilities, including engineering controls, ventilation requirements, and personal protective equipment (PPE) to minimize the risk of TB transmission.

Correct: CDC (B) – Responsible for publishing this guideline.

Incorrect:

A. FDA – Regulates drugs and medical devices.

C. EPA – Oversees environmental protection and pollutants, not healthcare infection prevention.

D. OSHA – Issues workplace safety standards, but this TB guideline is from CDC.

CMS Condition of Participation 482.41(c)(2) requires hospitals to ensure that elevator equipment is routinely inspected, tested, and maintained. Appendix A to this regulation clarifies that documentation of these three elements demonstrates compliance.

Correct (C): Maintenance – Inspections and testing alone are insufficient; ongoing maintenance must be documented.

Incorrect:

A. recalls: Not part of CMS 482.41(c)(2).

B. cleaning: While important, cleaning is not listed as a compliance requirement.

D. repairs: Only performed when problems are found; maintenance is the proactive required element.

Budget forecasting based on partial-year actuals uses the annualization formula:

Annual Forecast

=

Actual Costs for Months

Number of Months

×

12

Annual Forecast=

Number of Months

Actual Costs for Months

​

×12

For 5 months of data, the multiplier is 12/5.

Correct (D): current 5-month actual × 12/5.

Incorrect:

(A) × 5/12 would shrink the budget, not project it.

(B) Uses only one month, not representative.

(C) Uses only 2 months, less reliable.

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.

Fuel requirements for emergency systems are determined by calculating total consumption per hour multiplied by the required operating duration.

Generator: 25 gallons/hour

Boiler: 35 gallons/hour

Total consumption per hour = 25 + 35 = 60 gallons/hour

For 72 hours: 60 × 72 = 4,320 gallons

Therefore, the fuel tank must have at least 4,320 gallons capacity to meet the 72-hour requirement.

Correct Answer (D. 4,320 gallons).

Other options are underestimations of total combined consumption and would not meet compliance with CMS and NFPA 110 standards, which require hospitals to maintain a 72-hour supply of fuel for emergency power and critical operations.

Per the AIA General Conditions of the Contract for Construction (AIA Document A201), the architect reviews and approves shop drawings, product data, and samples for compliance with design intent and contract documents. The contractor ensures submission and coordination, but final approval authority rests with the architect.

Builder’s risk insurance is first-party property insurance that covers physical loss to the work under construction, including the replacement or repair value of a structure and materials during the construction period. It does not provide workers’ compensation (A), payment bond protection for subcontractors (B), or performance/contractor default liability (D). Those are separate coverages (workers’ comp, payment bond, performance bond).

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.

In healthcare facility maintenance, institutional standards are established to improve consistency, reliability, and efficiency in operations. Ball valves are often chosen over gate valves because they are available in standardized sizes, have fewer variations, and simplify inventory management. This allows facility departments to reduce the number of spare parts stocked and streamline repairs. The CHFM exam reference materials, including ASHE/AHA guidelines, highlight that “ease of inventory control and standardization” is a common justification for selecting one type of valve as a facility standard.

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.

Hospitals must have a Type 1 Essential Electrical System (EES) as required by NFPA 99. Type 1 systems provide at least two separate branches: the Life Safety branch and the Critical branch, ensuring continuous power to essential life support, patient care, and safety functions during utility outages.

Type 2 systems (for smaller facilities) have fewer requirements.

Type A and B are not classifications under NFPA 99.

Best practice in safety and risk management is to have a final inspection performed by individuals with “fresh eyes” and go/no-go authority. Those directly involved may overlook issues due to task familiarity. Independent inspection reduces risk before re-energization.

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.

NFPA 72, National Fire Alarm and Signaling Code, is the controlling standard for inspection, testing, and maintenance (ITM) of fire alarm and signaling systems (see the ITM chapter—commonly Chapter 14). It details testing frequencies, procedures, and documentation requirements for initiating devices, notification appliances, control equipment, and interfaces.

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 Safety and Security Management Plan under TJC’s Environment of Care standards requires healthcare facilities to regularly inspect buildings, facilities, and grounds to identify unsafe conditions and security risks.

C. Safety and Security Management (Correct): Includes hazard surveillance rounds.

A. Utilities Management: Focuses on utility systems operation and maintenance.

B. Hazardous Materials Management: Covers handling/storage/disposal of hazardous substances.

D. Fire Safety Management: Addresses fire protection systems and procedures, not general hazard inspection.

MRI does not use ionizing radiation, so radiation-related injuries are not possible. The greatest risk is the “missile effect” where ferromagnetic objects (scissors, oxygen tanks, tools) are violently pulled into the MRI bore by its powerful magnetic field.

D. Missile projection (Correct): Most likely injury hazard.

A. Visual impairment: Not a typical MRI injury.

B. Radiation overexposure: MRI uses magnetic fields, not radiation.

C. Hearing loss: Possible from loud noise but mitigated with ear protection; less common than missile hazard.