Future of HVAC and industry supply issues.

[Sigarms]

Would there be malpractice implications if the HVAC failed during some very long extended medical procedure?

That IMO is a philosophical discussion that would include politics (along with health care and who whould pay what) and what is required to live a healthy life.

I could be wrong, but the impression I get is the medical facility in question that was originally started by the physicians who originally worked there has no inclination to invest more money into the building for a long term investment because supplying medical services is no longer profitable?

 

[ultrarunner]

Would there be malpractice implications if the HVAC failed during some very long extended medical procedure?

This is why temp air brought in through existing HEPA filtration, air exchanges, etc. because out of range conditions means surgery cancellations.

I think the difficulty management has is comprehending the reality of some very long lead times and a changing regulatory environment.

 

[ultrarunner]

In my line of work, IMO the issue is on the business knwoing that they will need to replace the equipment due to age, not the vendor supplying product.

For several years it was touch and go as medical continued to function under pandemic lockdown with many suppliers unable to ship if even open... at least here in California.

Plus the unresolved issue if this location will be shuttered in June of 2024....

 

[ultrarunner]

That IMO is a philosophical discussion that would include politics (along with health care and who whould pay what) and what is required to live a healthy life.

I could be wrong, but the impression I get is the medical facility in question that was originally started by the physicians who originally worked there has no inclination to invest more money into the building for a long term investment because supplying medical services is no longer profitable?

The physician group founded the hospital in 1967 so all the original players are long gone and through acquisitions and mergers the facility continues to serve the community but the demographics have drastically changed... crime and transients were non issues and now are...

The main hospital with trauma center left the community for nearby greener pastures... the thinking is we should too...

 

[Sigarms]

Plus the unresolved issue if this location will be shuttered in June of 2024....

I think that is the bigger issue.

Even Carrier (as well as every other manufacturere) has a list given to vendors of excess equipment in stock in 3 phase sitting at their facility ready for shipment. The bigger issue is what factory installed options are required or if they can be field installed.

A guy needs a 15 ton straight AC unit with a 5 month lead time, buy a gas electric package unit for about the same price that is in stock. The question becomes what options available will actually work vs the price difference and lead time.

Need a 20 ton heat pump, but strips and economizer aren't available for another 6 months? Install the heat pump and install the strips and economizer when they come in. It will get you what you need ASAP.

 

[Sigarms]

The physician group founded the hospital in 1967 so all the original players are long gone and through acquisitions and mergers the facility continues to serve the community but the demographics have drastically changed... crime and transients were non issues and now are...

The main hospital with trauma center left the community for nearby greener pastures... the thinking is we should too...

And it becomes nothing more than a business decision.

I know nothing about health care in our country other than a dentist who we use to go to church with was a GOOD man, and donated his profession to the needy.

At his home getting onto health care in a side discussion, he told me he hates dealing with insurance companies, and he lets "his people" handle it.

If it were any other man, I'd just assume rich dentist bitching about not getting about how much he wants to charge, but I know he's a good man, and it told me something about his honest opinion about healthcare in our country.

As a family in the US without a healthcare plan, you could easily go bankrupt and become a pauper.

Honestly, and I'm guilty of this, I've always had health insurance since I started working so I don't really think about it.

 

[ultrarunner]

Like for like would be 50 ton DX built up system including air handler and hot water boiler and new compressor with dryer for Pneumatic Controls and replacing the Johnson Windows 2000nt energy management system.

Basically what we have but not new and not circa 1995.

If I had a clean slate I'm leaning towards 8 package units replacing the Built Up unit capable of 20 air exchanges of which 5 are outside...

The benefit is much simpler and no more all or nothing in terms of future problems... if one package unit has a problem it would only affect one specifics area...

Downside is power requirements, engineering for roof loading, rework existing ducts and lots of HEPA filter banks...

 

[ultrarunner]

And it becomes nothing more than a business decision.

I know nothing about health care in our country other than a dentist who we use to go to church with was a GOOD man, and donated his profession to the needy.

At his home getting onto health care in a side discussion, he told me he hates dealing with insurance companies, and he lets "his people" handle it.

If it were any other man, I'd just assume rich dentist bitching about not getting about how much he wants to charge, but I know he's a good man, and it told me something about his honest opinion about healthcare in our country.

As a family in the US without a healthcare plan, you could easily go bankrupt and become a pauper.

Honestly, and I'm guilty of this, I've always had health insurance since I started working so I don't really think about it.

Many here have very good coverage through county low income programs ..

We have some excellent older Docs that see anyone and don't even want to know capacity to pay so as not to influence best for patient medical treatment.

The reality is the days of sole practitioner or small partner group are fading away...

The burden/overhead of running a business and being compliant is simply to great for one Doc to carry and that's not even the medical side.

Viable practices and small groups get acquired or close if the Doc retires...

It's odd that almost no Docs encourage their kids to go into medicine... and majority of Docs and many RN's are foreign born...

 

[Sigarms]

The reality is the days of sole practitioner or small partner group are fading away...

You're right and I didn't even really think about it. Even in my area, most if not all doctors are generally either with Baptist or Novant healtcare.

 

[dstig1]

R410A came out around 2002-2003 (and even then, existing R22 equipment could still be sold), and as early as 2009, I heard possible gossip that R410 was on it's way out. I thought there was NO WAY the federal government could be that stupid.

Really? Have you MET our government?