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Bidding and Estimating Health Care Cleaning

There is opportunity and potential profit in the cleaning of health and medical related facilities. This includes such locations as Dr., dentist and other professional medical offices and buildings. Other locations that require similar levels of service include labs, pharmacies, research and dialysis centers and medical and pharmaceutical manufacturers. Larger facilities include nursing homes, assisted living, medical centers and hospices. Closely related locations include daycare and child development centers and health clubs.

These facilities are more difficult to clean than basic office buildings, because of issues related to medical treatment, contamination and infection control. Other concerns include hazardous chemicals, sharps (needles and glass), and the collection and disposal of bio-medical waste. These issues should not be taken lightly due to the possibly of illness, death, and liability.

What You Want to Know
– Production rates will depend on what you are doing; office areas can be bid pretty much at the same rate as other office areas, 2500 to 3500 or more sq. ft. per hour. Exam and procedure rooms are slower, exam tables need to be cleaned, disinfected and new paper (if used) put in place. There will be a sharps box and bio-waste container which you may or may not have to deal with. Disposal of this type of waste is regulated and must be handled in a specific manner, which may include red bagging, weighing, tagging and storage in special container. This waste must be picked up by a certified disposal firm and cannot be placed in the normal trash dumpster. There is a cost per pound for this disposal, so don’t include the cost in you bid without doing the proper research to see how it must be handled in your area and actual disposal cost. Exam rooms are normally bid in the 1100 to 1800 sq. ft. per hour range depending on services provided, equipment and processes used and the complexity of room.
– Operating suites and similar areas where blood and body fluids are commonly present are cleaned at much slower rates, from 400 to 1000 sq. ft. per hour. In medical centers that have several operating rooms and are busy, OR’s are normally cleaned by a team of two or three people to reduce down time and keep the cases on schedule. The more sophisticated and complex the operating suite, the longer the cleaning takes.
– OR cleaning is categorized as a turnover or a terminal clean. Turnover cleaning is faster and require less detail, terminal cleaning require more time as everything in the room needs to be cleaned and disinfected (including walls, floor and ceiling). In the average operating suite, if there is such a thing, a normal turnover clean will take from 20 to 45 minutes. A terminal clean will take twice as long. If there is a dirty case, (one where the patient is highly infectious or the room becomes extremely soiled) the cleanup will take even longer (possibly up to 2 hours or more), how long cleaning takes depending on what has to be done.
– The more specialized the room and operation being performed, the longer the cleaning will take. To attract and retain qualified staff, add an extra 20% to 35% to your labor costs.
– The risks and costs are greater in health care cleaning due to the nature of the work, which includes potential exposure to infectious materials, bio-medical waste disposal, and increased risk of slip, trip and fall injuries to cleaners, the public and facility staff. Additional costs that you will incur include background checks, badging, uniforms, and hepatitis shots which may cost $300 to $500 per employee. It is important to discuss insurance coverage (health, liability and other forms) with your agent before beginning this type of work to assure that you have adequate protection and how this may impact your overhead costs.
– The health care field leads the way in the use of modern equipment, chemicals and processes. What you purchase and use must be green, sustainable, productive, profitable and acceptable to facility management and the infection control committee.

What’s Different About Cleaning Health Care Facilities?
– Due to the risks involved and the technical nature of the work, there is no room for error. Strict supervision and management, along with intensive orientation and ongoing training is required. Building security and patient confidentiality are major concerns in medical facilities.
– Documentation such as Standard Operating Procedures (SOP’s) must be written, up to date and followed. Checklists and sign off sheets are often used to track and validate that the work is completed as scheduled and specified.
– Inspections and scientific testing maybe done to validate that the desired results of the cleaning processes are achieved. This can include the use of an ATP meter, tribometer, gloss meter, particle counter and other scientific instruments.
– Multiple private and governmental agencies monitor, audit, inspect and approve the operation and funding of most medical facilities.
– Patients are sick in these locations, some are simply uncomfortable and not feeling well, others are dealing with life threatening illnesses. Guests and family members may be distracted, uneasy and under stress. Workers must be aware of the need to take this into consideration when working in medical facilities.
– A high level of professionalism is expected and required. You are dealing with Doctors, nurses and other highly educated professionals who take their work, responsibilities, and time seriously.

If you are unfamiliar with this market, do adequate research before bidding. Other recommendations include getting adequate training/certification and start small by servicing independent doctor’s offices or a small medical office building and overtime as your knowledge and skills grow, work your way up to larger and more complex facilities and services.

Side Bar # 1

Resources For Health Care Cleaning
– International Executive Housekeeper Association (IEHA)
– Association for the Healthcare Environment (AHE) (formerly ASHES)
Training materials and programs, publications, seminars, convention and certification for health care cleaning professionals.

– International Sanitary Supply Association,
Training materials, Convention and Trade Shows, Sponsor of the Cleaning Industry Management Standard-Green Buildings (CIMS- GB)

– Cleaning Management Institute,
Training materials, certification and publication for cleaning professionals.

– Center for Disease Control and Prevention (CDC)
– Environmental Protection Agency (EPA)
Search health care and infection control topics

– State and County Health Departments (Local and state regulations, waste disposal, etc.)
– Green and Sustainable issue related to health care facilities, cleaning and maintenance