The Role of Preventive Maintenance vs. Reactive Repairs in PCREE

Preventive maintenance for Patient Care-Related Electrical Equipment (PCREE) reduces costs, minimizes downtime, and prevents survey deficiencies. Reactive repairs, while sometimes unavoidable, often cost more, create safety risks, and increase the likelihood of CMS citations. Facilities that prioritize proactive programs not only protect residents but also avoid unexpected expenses and regulatory trouble.

Preventive vs. Reactive: What’s the Difference?

• Preventive Maintenance: Regular, scheduled testing and servicing of PCREE equipment to identify issues before they become failures. This includes leakage current testing, receptacle checks, and inspections per NFPA 99 standards.

• Reactive Repairs: Fixing or replacing equipment only after it breaks, fails inspection, or causes an incident.

Both approaches exist in healthcare facilities, but relying too heavily on reactive repairs creates safety and compliance risks.

Why Preventive Maintenance Matters for PCREE

Skilled nursing facilities depend on PCREE daily — from beds and infusion pumps to ventilators and patient lifts. Preventive maintenance:

• Protects Residents: Ensures devices meet NFPA 99 safety thresholds and don’t expose patients to electrical hazards.

• Avoids Survey Deficiencies: CMS surveyors expect documented, routine testing. Missing preventive maintenance logs often leads to citations.

• Reduces Downtime: A scheduled inspection can catch a frayed cord before it causes a device outage.

• Lowers Long-Term Costs: Planned maintenance is almost always cheaper than emergency repairs or equipment replacement.

The Hidden Costs of Reactive Repairs

Relying on a “fix it when it breaks” strategy leads to:

1. Higher Repair Bills

   • Emergency vendor calls often cost 2–3x more than scheduled service.

2. Resident Risk

   • A failed device can harm a patient before staff realize there’s a problem.

3. Survey Deficiencies

   • CMS will cite a facility for failing to proactively test, even if the repair was done later.

4. Unplanned Downtime

   • A broken bed or ventilator can’t always be replaced immediately, disrupting care.

Example: One facility delayed preventive testing on resident beds. When surveyors arrived, three beds failed leakage current testing. Not only did residents have to be relocated, but the facility received a CMS deficiency for failing to identify the issue sooner.

Cost/Benefit Analysis: Preventive vs. Reactive

FactorPreventive MaintenanceReactive RepairsCost per DeviceLow, predictable (annual service fee)High, unpredictable (emergency call-outs, part replacement)Survey ComplianceStrong (logs available)Weak (documentation often missing)Resident SafetyProtected, risks minimizedHigher risk of shock/failureDowntimeMinimal (planned scheduling)High (unexpected outages)BudgetingEasy to forecastHard to control

Best Practices for a Preventive PCREE Program

1. Create a Complete Equipment Inventory

   • Track every PCREE device with make, model, serial, and location.

2. Set a Risk-Based Testing Schedule

   • Life-support and high-use devices: test every 6–12 months.

   • General PCREE: test annually.

   • Receptacles: test per NFPA 99.

3. Document All Preventive Actions

   • Logs should include test date, results, technician, and corrective actions.

4. Train or Partner with Experts

   • Use qualified biomedical engineers or trained staff.

5. Review Trends Quarterly

   • Identify devices that repeatedly fail and consider replacement.

When Reactive Repairs Are Still Necessary

Reactive repairs can’t be avoided entirely — devices will still fail unexpectedly. The key is to:

• Remove faulty devices from service immediately.

• Document the failure, repair, and return-to-service testing.

• Use root cause analysis to prevent repeat issues.

Key Takeaways

• Preventive maintenance reduces costs, protects residents, and ensures CMS/NFPA 99 compliance.

• Reactive repairs are costly, risky, and often cited during surveys.

• The strongest PCREE programs rely on preventive maintenance as the foundation, with reactive repairs as the exception — not the rule.

Resources

• NFPA 99 Health Care Facilities Code

• CMS State Operations Manual

• OSHA Healthcare Safety

• FDA Medical Device Guidance

Reviewed by the PCREE Test Compliance Team
Last Updated: September 2025