1 Scope
NOTE This standard covers the design, specification, and installation of the Essential Electrical System (EES) that supplies power to patient care and life-safety loads in a healthcare facility during loss of normal utility power. (1.1)
NOTE The EES is the set of branches, alternate power sources, transfer switches, feeders, and panelboards required by NEC Article 517 and NFPA 99 to keep designated loads energized when the normal source fails. (1.2)
NOTE This standard applies to new construction and to renovation of any facility containing patient care spaces classified as Category 1 or Category 2 under the NFPA 99 risk-category framework. (1.3)
1.4The EES shall be designed and installed in accordance with NEC Article 517, NFPA 99, and NFPA 110 for the facility occupancy classification established in the project Building Code analysis.
1.5The applicable NEC 517 sub-article (517.30 hospitals, 517.42 nursing homes, 517.45 limited care facilities, 517.80 ambulatory health care) shall be confirmed against the occupancy classification before branch loads are assigned.
NOTE Transfer switch hardware ratings and construction are specified in
Automatic Transfer Switches; this standard states only the topology, branch assignment, and bypass requirements for switches serving the EES.
(1.7) 2 Referenced Standards
2.1Equipment, materials, and installation shall comply with the latest adopted edition of each of the following unless a specific edition is cited or a more recent edition is adopted by the Authority Having Jurisdiction.
2.2Where referenced standards conflict, the more stringent requirement shall govern unless the Engineer of Record directs otherwise in writing.
2.3The adopted NEC edition shall be verified with the Authority Having Jurisdiction before branch loads are assigned.
NOTE Many states enforce the 2020 NEC, and Article 517 requirements differ between editions. (2.4)
| Standard |
Title |
| NFPA 70 (NEC) Article 517 |
Health Care Facilities — Essential Electrical Systems |
| NFPA 99 |
Health Care Facilities Code |
| NFPA 110 |
Standard for Emergency and Standby Power Systems |
| NFPA 101 |
Life Safety Code |
| UL 1008 |
Transfer Switch Equipment |
| IEEE Std 602 |
Recommended Practice for Electric Systems in Health Care Facilities (White Book) |
| IEEE Std 446 |
Recommended Practice for Emergency and Standby Power Systems (Orange Book) |
| ANSI/ASHRAE/ASHE Standard 170 |
Ventilation of Health Care Facilities |
| IBC Chapter 27 |
International Building Code — Electrical (adopts NEC by reference) |
| 42 CFR 482.41 |
CMS Conditions of Participation — Physical Environment |
3 System Classification
3.1Type 1 EES is required whenever the facility contains any Category 1 patient care space — critical care areas, intensive care units, and operating rooms — per NFPA 99.
NOTE Type 2 EES is permitted for facilities whose patient care spaces are limited to Category 2 — general care — such as some medical office buildings, nursing homes, and limited-care facilities. (3.2)
3.3The EES type shall be selected from the facility's highest patient-care-space risk category as established by the NFPA 99 risk assessment.
3.4A Type 1 EES shall provide three branches: a Life Safety Branch, a Critical Branch, and an Equipment Branch.
3.5A Type 2 EES shall provide a Life Safety Branch and a Critical Branch; a separate Equipment Branch is not required.
NOTE A facility containing a single Category 1 space cannot be downgraded to Type 2 by load count; the presence of the space, not its size, governs the classification. (3.6)
● Type 1 (Category 1 spaces present — three branches)
○ Type 2 (Category 2 only — two branches)
Hospital (NEC 517.30)
Nursing home (NEC 517.42)
Limited care facility (NEC 517.45)
Ambulatory health care (NEC 517.80)
● Category 1 (critical care — ICU, OR, cath lab)
○ Category 2 (general care — inpatient bed)
○ Category 3 (basic care)
○ Category 4 (support)
4 Branch Definitions and Load Assignment
NOTE The EES is divided into branches so that the most life-critical loads are physically and electrically isolated from less critical loads, preventing a fault on one branch from de-energizing another. (4.1)
4.2Each branch shall be served by its own transfer switch and its own feeder, and shall not share a panelboard with another branch except where NEC 517 permits separately identified sections.
5 Life Safety Branch
NOTE The Life Safety Branch (LSB) supplies only the loads required for safe egress and life safety during a power outage and is the most tightly restricted branch in the EES. (5.1)
5.2The Life Safety Branch shall supply only the loads permitted by NEC 517.32; this is an exclusive list, and no other loads shall be connected.
NOTE Loads permitted on the Life Safety Branch include the following: (5.3)
- Illumination of means of egress
- Exit signs and exit directional signs
- Alarm and alerting systems, including fire alarm
- Communication systems used for issuing instructions during an emergency
- Generator set and transfer switch accessories required for operation
- Elevator cab lighting, control, communication, and signal systems
- Automatic doors used for egress
5.4Convenience receptacles, nurses' stations, IT loads, and general lighting shall not be connected to the Life Safety Branch.
NOTE Adding non-qualifying loads to the Life Safety Branch is a frequent design error that overloads the branch and fails inspection; the LSB serves egress and alarm functions only. (5.5)
5.6The Life Safety Branch shall be supplied by a dedicated transfer switch serving no other branch.
6 Critical Branch
NOTE The Critical Branch supplies power to patient care task illumination, selected receptacles, and equipment essential to patient care and life support that must remain energized within the 10-second restoration window. (6.1)
6.2The Critical Branch shall supply the patient care load classes listed in NEC 517.33, including critical care area task lighting and receptacles, isolated power systems for wet procedure locations, and nurse call and patient monitoring systems.
6.3Patient bed receptacle quantities on the Critical Branch shall meet the minimums of NEC 517.18 for general care and 517.19 for critical care.
6.4All receptacles connected to the Critical and Life Safety branches in patient care spaces shall be hospital-grade and identified by the listing mark and a distinctive color.
6.5Only hospital-grade devices shall be used for receptacles in patient care spaces on Critical and Life Safety branch circuits.
NOTE Specifying standard commercial-grade receptacles on Critical or Life Safety branch circuits is a common coordination miss between the electrical and medical-equipment specifications. (6.6)
820
Default: 8 duplex receptacles
1436
Default: 14 hospital-grade duplex receptacles
6.7The Critical Branch shall be supplied by a dedicated transfer switch serving no other branch.
7 Isolated Power Systems for Wet Procedure Locations
NOTE Wet procedure locations — operating rooms, cardiac catheterization labs, cystoscopy suites, and hydrotherapy rooms — require either an isolated power system (IPS) or ground-fault circuit-interruption protection per NFPA 99; an IPS is specified where interruption of a circuit on a single ground fault is unacceptable. (7.1)
7.2All wet procedure locations — including cath labs, cystoscopy suites, and hydrotherapy rooms — shall be evaluated for isolated power system requirements; IPS is not limited to operating rooms.
NOTE Designers frequently apply IPS only to operating rooms and miss cath labs, cystoscopy suites, and hydrotherapy rooms. (7.3)
7.4Each isolated power system panel shall be supplied from the Critical Branch.
7.5Each isolated power system shall include a line isolation monitor (LIM) providing continuous audible and visual indication of the hazard current.
7.6The line isolation monitor alarm shall be set to operate at a hazard current not exceeding 5 mA per NFPA 99.
7.7The line-to-ground impedance of a new isolated power system shall be at least 50 kΩ per NFPA 99.
● Isolated power system with line isolation monitor
○ GFCI protection (where momentary interruption is acceptable)
8 Equipment Branch
NOTE The Equipment Branch supplies major electrical equipment necessary for patient care and basic hospital operation that can tolerate a short, sequenced interruption — and is required only in a Type 1 EES. (8.1)
NOTE The Equipment Branch shall supply the loads listed in NEC 517.34, organized into delayed-automatic and manually-connected load classes to manage generator step loading. (8.2)
8.3Loads connected to the Equipment Branch shall be assigned to a connection class so that the generator does not see the full equipment load as a single step at restoration.
8.4Equipment Branch Class 1 loads shall be connected automatically within 10 seconds of restoration of the alternate power source.
8.5Equipment Branch Class 2 loads shall be connected by automatic delayed connection within 10 seconds of restoration of the alternate power source.
8.6Equipment Branch Class 3 loads shall be connected as needed, with no maximum connection time.
8.7The Equipment Branch load-shedding and reconnection logic shall be coordinated with the generator controls specified in Generators. NOTE Omitting the delayed-automatic and sequenced reconnection scheme causes voltage dips and generator overload at restoration. (8.8)
8.9HVAC loads serving infection-control and other ventilation-critical areas shall be assigned to the Equipment Branch per ANSI/ASHRAE/ASHE Standard 170 and NEC 517.34.
● Yes (Type 1 EES)
○ No (Type 2 EES — branch not required)
Sequenced delayed-automatic (Class 1 / Class 2 / Class 3)
Single delayed-automatic step
9 Alternate Power Source Interface
9.2The alternate power source shall restore power to the Life Safety and Critical branches within 10 seconds of loss of normal power, measured across the complete transfer path including generator start, transfer switch operation, and breaker closure, per NEC 517.31 and NFPA 99.
9.3Where generator start, ATS transfer, and breaker closure are specified independently, their combined elapsed time shall be verified against the 10-second restoration limit; no single step may be treated as compliant in isolation.
NOTE The 10-second restoration time is a system-level requirement, not a per-component budget. (9.4)
9.5The on-site fuel supply for a Medicare- or Medicaid-certified hospital shall provide a minimum of 96 hours of operation at the EES full-load demand, per the CMS Conditions of Participation, regardless of the NFPA 110 baseline.
NOTE CMS Conditions of Participation operate in parallel with NFPA 99 and NFPA 110 and impose the 96-hour fuel requirement independently of the adopted code edition; designs meeting only the NFPA 110 72-hour default fail the CMS requirement. (9.6)
9.7Generator neutral grounding (solid vs. high-resistance) shall be reconciled with the EES ground-fault protection scheme between this standard and Generators before the design is finalized. 96 hours (CMS-certified hospital)
72 hours (other healthcare facility)
Single generator
Two paralleled generators
Three or more paralleled generators
10 Transfer Switches
NOTE Each EES branch is served by its own listed automatic transfer switch so that a fault or maintenance action on one branch does not affect the others; hardware ratings and construction are specified in
Automatic Transfer Switches.
(10.1) 10.2Each branch transfer switch shall be listed to UL 1008 for emergency system use and rated for the available short-circuit current at its location.
10.3Each EES branch shall be served by a dedicated transfer switch; a common transfer switch with downstream branch distribution shall not be used where NEC 517 requires separate branch transfer equipment.
10.4Branch transfer switches in a Type 1 EES shall be provided with bypass-isolation construction so the switch can be maintained or replaced without de-energizing the branch.
NOTE Specifying a non-bypass transfer switch for a hospital branch means the branch must be de-energized for switch maintenance, which can require patient relocation; bypass-isolation is the default for Type 1 EES branches. (10.5)
10.6A closed-transition (make-before-break) transfer switch should be specified for the Equipment Branch where momentary interruption of motor-driven loads such as sterilizers or large air handlers is unacceptable.
● Bypass-isolation
○ Standard (non-bypass)
100
150
200
260
400
600
800
1000
1200
1600
2000
3000
4000
● Open transition
○ Closed transition (make-before-break)
11 Wiring Methods and Branch Separation
NOTE The Life Safety and Critical branch wiring is required to be mechanically protected and electrically separated from other wiring so that physical damage or a fault elsewhere cannot disable the branch. (11.1)
11.2Life Safety and Critical branch conductors shall be installed in a metallic raceway — EMT, RMC, IMC, or listed metal wireway — or as Type MI cable, per NEC 517.30(C)(3).
11.3Non-metallic conduit (PVC, ENT) shall not be used for Life Safety or Critical branch wiring except within listed prefabricated wiring assemblies or where a specific NEC 517 exception applies.
11.4The NEC 517.30(C)(3) metallic-raceway restriction shall be explicitly stated on the branch circuit specifications.
NOTE Specifying standard EMT-permitted wiring without noting the healthcare metallic-raceway requirement generates field RFIs and rework. (11.5)
11.6EMT is acceptable for concealed Life Safety and Critical branch runs; RMC or IMC shall be used where the raceway is exposed and subject to physical damage.
11.7Life Safety and Critical branch wiring shall be kept independent of all other wiring and equipment, and shall not occupy the same raceway, box, or cabinet as normal-service wiring except as permitted by NEC 517.30(C).
11.8EES branch feeders shall be physically separated from each other and from normal-service feeders along their routing so that a single event cannot disable more than one branch.
NOTE Sharing a feeder or combined panelboard between two EES branches without separately identified sections is a code violation often missed on design-build projects; each branch requires separate transfer equipment, feeder, and panelboard identification. (11.9)
12 Panelboards and Feeders
12.1Each EES branch shall be served by a separate panelboard, or by a separately identified section of a panelboard, per NEC 517.30(E).
12.2Each branch panelboard and feeder shall be permanently marked to identify the branch it serves and that it is part of the Essential Electrical System.
12.3Life Safety and Critical branch feeders shall be sized for 100% of the connected load; no demand-factor reduction is permitted on these feeders per NEC 517.30(D).
NOTE The EES feeder demand-factor prohibition is unique to the Life Safety and Critical branches; applying normal-service demand factors to these feeders undersizes them and is a frequent calculation error. (12.4)
● Separate panelboard per branch
○ Separately identified sections within a common enclosure
● None (100% of connected load — NEC 517.30(D))
13 Ground-Fault Protection
NOTE Healthcare facilities require a second level of ground-fault protection of equipment (GFPE) on the EES service or feeder, coordinated with the main service GFPE, so that a ground fault is cleared at the lowest level without tripping the entire service — a requirement unique to NEC 517.17. (13.1)
13.2A second level of ground-fault protection shall be provided on the EES service disconnect or feeder, coordinated to operate before the main service GFPE per NEC 517.17.
13.3The two levels of GFPE shall be selectively coordinated such that the feeder-level device operates faster than the service-level device, with a time separation of at least one full pickup band per NEC 517.17.
13.4A second level of GFPE coordinated with the service-level device is required on the EES; omitting it is a code violation that results in failed inspection.
NOTE Many engineers apply only the standard NEC 230.95 service GFPE rules and omit the second-level coordination required for healthcare facilities. (13.5)
13.6The GFPE pickup and time-delay settings shall be specified as selectable values and verified against the Protective Coordination Study for the project. 14 Submittals
14.1 Action Submittals
14.1.1The Contractor shall submit the following action submittals for review before fabrication or installation:
- Single-line diagram of the complete EES showing all branches, transfer switches, panelboards, and feeders
- Branch load assignment schedule keyed to NEC 517.32 / 517.33 / 517.34
- Transfer switch shop drawings, ratings, and UL 1008 listing
- Panelboard shop drawings with branch identification
- Feeder and conductor schedule showing 100% sizing for Life Safety and Critical branches
- Ground-fault protection coordination settings for the two GFPE levels
- Isolated power system panel and line isolation monitor data for wet procedure locations
☑ EES single-line diagram
☑ Branch load assignment schedule
☑ Transfer switch shop drawings and UL 1008 listing
☑ Panelboard shop drawings with branch identification
☑ Feeder and conductor schedule (100% sizing)
☑ GFPE coordination settings
☐ Isolated power system and LIM data
14.2.1The Contractor shall submit the following informational submittals:
- Manufacturer installation instructions for transfer switches and panelboards
- Generator-to-EES interface coordination memo confirming neutral grounding and restoration timing
- Load-step study confirming Equipment Branch sequenced reconnection
☑ Manufacturer installation instructions
☑ Generator-to-EES interface coordination memo
☑ Load-step study for Equipment Branch sequencing
14.3 Closeout Submittals
14.3.1The Contractor shall submit the following closeout submittals before final acceptance:
- As-built single-line diagram of the installed EES
- Acceptance test reports for the alternate power source and each branch transfer switch
- Line isolation monitor calibration records for each wet procedure location
- Operation and maintenance manuals including required testing schedule
☑ As-built single-line diagram
☑ Acceptance test reports
☑ Line isolation monitor calibration records
☑ Operation and maintenance manuals
15 Quality Assurance
15.1EES design and installation shall be performed by personnel qualified in healthcare electrical work.
15.2The completed EES installation shall be verified against NEC 517 and NFPA 99 before energization.
NOTE The EES is a life-safety system whose failure modes endanger patients. (15.3)
15.4The EES design shall be prepared under the responsible charge of a licensed professional engineer experienced in healthcare facility electrical systems.
15.5Branch load assignments shall be reviewed against the exclusive NEC 517.32 Life Safety Branch list and the NEC 517.33 Critical Branch list before installation to confirm no non-qualifying loads are connected.
15.7EES panelboards shall be explicitly listed in the arc-flash study scope so that incident-energy labels are produced for all branch distribution equipment.
NOTE EES panelboards are commonly omitted from the arc-flash study scope. (15.8)
16 Testing
16.1The EES shall be tested at installation and on a continuing periodic basis per NFPA 110 and NFPA 99.
NOTE Acceptance and periodic testing demonstrate that the EES actually transfers and restores within the required time and carries its designated loads. (16.2)
16.3The alternate power source shall pass a full-load bank test at rated kW for a minimum of 2 hours at installation, per NFPA 110.
16.4At acceptance, a complete transfer test shall verify branch-by-branch restoration of the Life Safety, Critical, and Equipment branches within the 10-second requirement.
16.5The installed EES shall be exercised by a no-load transfer test monthly and a full-load transfer test annually, with branch-by-branch restoration verified and documented.
16.6Each line isolation monitor shall be tested at acceptance and periodically to confirm it alarms at the specified hazard-current set point.
☑ Monthly no-load transfer exercise
☑ Annual full-load transfer test with branch restoration verification
17 Installation
NOTE EES branch routing, panelboard locations, and equipment arrangement are project-specific and shall be coordinated on the drawings; the requirements below apply regardless of layout. (17.1)
17.2EES feeders and branch conductors shall be installed to maintain the physical separation between branches shown on the drawings EES riser diagram. 17.4Branch panelboards and transfer switches shall be permanently labeled to identify the branch served before the system is placed in service.
17.5Isolated power system panels and line isolation monitors shall be installed at the wet procedure locations indicated procedure room power plan. 17.6Where exposed Life Safety or Critical branch raceway passes through areas subject to physical damage, it shall be RMC or IMC as established in the wiring-method section.
18 Delivery, Storage, and Handling
18.1Transfer switches and panelboards shall be delivered in the manufacturer's packaging and stored indoors in a clean, dry, protected location until installation.
18.2EES equipment shall be protected from moisture, dust, and construction debris; energizing equipment that has been exposed to construction contamination shall not be permitted until the equipment is inspected and cleaned.
19 Warranty
19.1The Contractor shall warrant the EES installation against defects in materials and workmanship for a minimum of one year from the date of substantial completion.
19.2Transfer switches and panelboards shall carry the manufacturer's standard warranty, and warranty documentation shall be included in the closeout submittals.
20 Spare Parts
20.1The Contractor shall furnish spare parts as recommended by the equipment manufacturer for the transfer switches and panelboards, including control fuses and indicating lamps.
☑ Transfer switch control fuses
☑ Indicating lamps / LED modules
☐ Spare hospital-grade receptacles
☐ Line isolation monitor spare module