CHC Authority Having Jurisdiction (AHJ) & Healthcare Plan Review — Questions and Answers
Question 1: In healthcare construction, 'Authority Having Jurisdiction' (AHJ) is best defined as:
- The general contractor who holds legal responsibility for the construction site
- The organization, office, or individual responsible for enforcing the requirements of a code or standard (Correct answer)
- The hospital board of directors that approves the capital construction budget
- The design architect of record who has final decision-making authority on construction details
Correct answer: The organization, office, or individual responsible for enforcing the requirements of a code or standard
The AHJ is any organization, office, or individual empowered to enforce applicable codes and standards. In healthcare construction, multiple AHJs apply simultaneously — local building departments, state health departments, state fire marshals, and CMS or accreditation bodies each enforce their own jurisdictional requirements.
Question 2: When multiple AHJs impose conflicting requirements on the same healthcare construction project, the general governing principle is:
- Federal requirements automatically supersede all state and local requirements
- The local building department has final authority over all other AHJs
- The most stringent requirement governs, and the design team must satisfy all applicable AHJs (Correct answer)
- The owner may select which AHJ's requirements to follow based on project economics
Correct answer: The most stringent requirement governs, and the design team must satisfy all applicable AHJs
When AHJ requirements conflict, the project must satisfy all applicable authorities. Where specific requirements differ, the most stringent governs to ensure full multi-jurisdiction compliance. The design and construction team cannot satisfy one AHJ at the expense of another — all must be addressed.
Question 3: Certificate of Need (CON), in states where it exists, is best described as:
- A certificate issued by the contractor upon satisfactory project completion
- A state-level regulatory approval required before adding certain healthcare facilities or major services (Correct answer)
- The Joint Commission accreditation certificate for a newly opened facility
- An OSHA permit required before construction begins near occupied patient areas
Correct answer: A state-level regulatory approval required before adding certain healthcare facilities or major services
Certificate of Need (CON) laws require healthcare providers in applicable states to obtain state approval before undertaking major capital expenditures, building new facilities, or adding specific services. The CON review assesses community need, financial feasibility, and impact on existing providers — all before construction can begin.
Question 4: State health department plan review for a new hospital is primarily focused on:
- Verifying the financial viability and return on investment of the capital project
- Ensuring the facility design meets state healthcare licensure requirements, including FGI Guidelines compliance (Correct answer)
- Approving the selection of the general contractor through competitive bid review
- Reviewing construction contracts for adequate insurance and bonding levels
Correct answer: Ensuring the facility design meets state healthcare licensure requirements, including FGI Guidelines compliance
State health departments review healthcare construction documents to ensure compliance with state licensure requirements, which typically incorporate the FGI Guidelines and other healthcare-specific codes. This is a separate review from the local building department and specifically evaluates the facility's fitness to be licensed and operated as a healthcare facility.
Question 5: Who has the authority to grant a variance or waiver from a specific code requirement on a healthcare construction project?
- The general contractor, after consulting with the project architect and owner
- The hospital's infection control practitioner, for infection-related requirements
- The applicable AHJ that enforces the requirement in question (Correct answer)
- The construction manager at risk (CMAR) on behalf of the project team
Correct answer: The applicable AHJ that enforces the requirement in question
Only the AHJ responsible for enforcing a given requirement has the authority to grant a variance or waiver from it. The applicant — typically the owner or design team — must formally submit the request demonstrating that the alternative approach meets the intent of the code, or that strict compliance creates undue hardship.
Question 6: Which documents are most commonly required in an AHJ plan review submission for a major healthcare facility project?
- The contractor's bid bond, performance bond, and payment bond
- Construction documents (drawings and specifications) stamped by licensed design professionals (Correct answer)
- The master project schedule and itemized construction budget
- The contractor's site-specific safety plan and OSHA compliance logs
Correct answer: Construction documents (drawings and specifications) stamped by licensed design professionals
AHJ plan review requires construction documents — architectural, structural, mechanical, electrical, and plumbing drawings plus specifications — prepared and stamped by appropriately licensed design professionals. These documents demonstrate code compliance and form the basis for permits and certificates of occupancy. Bonds, schedules, and safety plans are contractual or operational documents, not plan review submittals.
CHC Authority Having Jurisdiction (AHJ) & Healthcare Plan Review
In healthcare construction, 'Authority Having Jurisdiction' (AHJ) is best defined as: