How Often Should You Test PCREE Equipment? A Risk-Based Approach
NFPA 99 sets baseline requirements for Patient Care-Related Electrical Equipment (PCREE) testing, but facilities benefit from a risk-based approach that considers equipment type, usage frequency, and criticality. High-risk devices like ventilators should be tested more frequently than low-risk equipment, and thorough documentation ensures compliance with CMS surveys.
Why Testing Frequency Matters
Surveyors often cite facilities not for failing to test equipment, but for testing too infrequently or without a clear schedule. Since electrical safety directly impacts resident care, regulators expect a structured program that ensures every device is tested on time.
NFPA 99 outlines minimum requirements, but facilities that adopt a risk-based schedule not only stay compliant but also reduce downtime, improve safety, and pass CMS inspections more smoothly.
NFPA 99 Testing Requirements
NFPA 99 (Health Care Facilities Code) requires:
Initial testing of all PCREE before first use in patient care areas.
Periodic testing at defined intervals.
Receptacle testing in patient care areas, usually annually.
Leakage current and ground resistance testing on all equipment.
While NFPA 99 sets the floor, it allows facilities flexibility in setting risk-based schedules.
Risk-Based Testing Explained
A risk-based approach tailors inspection frequency to each device’s:
Criticality: Does the device support life (ventilator) or comfort (low-risk bed)?
Usage: High-use equipment wears down faster than rarely used devices.
Environment: Equipment in heavy-use wings or older facilities may need more frequent checks.
Failure history: Devices with repeated issues should be tested more often.
This approach prevents wasted effort on low-risk devices and ensures focus on what matters most.
Recommended Testing Frequencies
Here’s a sample framework that many facilities follow (based on NFPA 99 and industry practice):
Equipment TypeRecommended FrequencyRationaleLife-support devices (ventilators, monitors, defibrillators)Every 6–12 monthsCritical to survival; even small failures pose major risks.High-use PCREE (infusion pumps, beds, lifts)AnnuallyRegular wear-and-tear requires ongoing checks.Low-use PCREE (rarely used diagnostic devices)Every 2 years (or per NFPA 99)Lower usage = reduced risk, but still requires testing.Receptacles in patient care areasAnnuallyNFPA 99 requires polarity, grounding, and retention checks.After repair or serviceImmediately before return to serviceConfirms safety before patient exposure.
Common Survey Deficiencies on Testing Frequency
No documented schedule: Surveyors want a written plan, not ad hoc testing.
Expired testing intervals: Devices tested 18–24 months ago without risk justification.
One-size-fits-all approach: Testing all devices annually, regardless of risk, can still draw deficiencies if critical devices are under-tested.
Missed receptacle testing: Often overlooked but cited frequently.
Best Practices for Setting Testing Schedules
Start with NFPA 99 as the baseline.
Prioritize by risk: life-support > high-use > low-use.
Use your inventory: tie each device to a schedule in your log or CMMS.
Document the rationale: if you test less frequently, note why (e.g., low-use, low-risk).
Audit quarterly: check for overdue devices before CMS does.
Example: Risk-Based Testing in Action
A 150-bed facility adopted risk-based testing:
Ventilators tested every 6 months.
Infusion pumps tested annually.
Portable diagnostic devices tested every 2 years.
Receptacles tested annually.
During their CMS survey, inspectors asked about testing frequency. The facility provided logs with clear rationales tied to NFPA 99. Result: Zero deficiencies and faster survey approval.
Key Takeaways
NFPA 99 sets minimum PCREE testing requirements, but risk-based schedules are best practice.
High-risk, high-use devices require more frequent testing.
Documentation of rationale is as important as the testing itself.
A structured schedule protects residents, reduces risk, and satisfies CMS surveyors.
Resources
NFPA 99 Health Care Facilities Code
CMS State Operations Manual
OSHA Healthcare Electrical Safety
FDA Medical Device Guidance
Reviewed by the PCREE Test Compliance Team
Last Updated: September 2025