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Key Facts: CHC Exam

115

Total Questions

100 scored + 15 pretest

2 hrs

Exam Time

AHA CHC handbook

$400+

Exam Fee

ASHE member price

50%

Construction Domain

Content outline (heaviest)

5 yrs

Required Experience

Constr. total (5 yrs healthcare)

3 yrs

Certification Period

45 CEs for renewal

The AHA/ASHE CHC exam uses 115 questions (100 scored + 15 pretest) with a 2-hour time limit and $400-$570 fee. Content: Planning/Design/Construction (50%), Facility Safety (30%), Healthcare Fundamentals (10%), Financial Stewardship (10%). Administered via PSI test centers or remote. Requires bachelor's + 5 yrs construction (or associate + 7 yrs, or HS + 10 yrs), with 5 of those years on healthcare projects, plus 3 yrs management/supervisory experience. 3-year certification.

Sample CHC Practice Questions

Try these sample questions to review concepts for the CHC exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 105+ question experience with AI tutoring.

1Which of the following best describes the primary revenue source for most acute care hospitals in the United States?

A.Medicare and Medicaid reimbursements

B.Outpatient elective procedures

C.Philanthropic donations

D.Private pay patients

Explanation: Medicare and Medicaid represent the largest share of revenue for most U.S. acute care hospitals, often accounting for over 60% of patient revenue. Private pay and elective procedures contribute but are not the dominant source. Philanthropic donations supplement capital campaigns but are not operational revenue drivers.

2What is the primary function of a hospital's Central Sterile Processing Department (CSPD)?

A.Managing pharmaceutical inventory

B.Controlling HVAC systems for operating rooms

C.Sterilizing and distributing surgical instruments

D.Disposing of biohazardous waste

Explanation: The Central Sterile Processing Department (CSPD) is responsible for decontaminating, sterilizing, assembling, and distributing surgical instruments and medical devices. This department is critical to infection prevention and must maintain strict environmental controls including temperature, humidity, and air pressure differentials.

3Which federal agency administers the Conditions of Participation (CoPs) that hospitals must meet to receive Medicare reimbursement?

A.Centers for Medicare & Medicaid Services (CMS)

B.Occupational Safety and Health Administration (OSHA)

C.Food and Drug Administration (FDA)

D.Environmental Protection Agency (EPA)

Explanation: The Centers for Medicare & Medicaid Services (CMS) administers the Conditions of Participation, which are the minimum health and safety standards hospitals must meet to participate in the Medicare and Medicaid programs. Noncompliance with CoPs can result in loss of Medicare certification and revenue.

4In a hospital organizational structure, which department typically has primary authority over construction project approval and capital budget allocation?

A.The infection preventionist

B.Facilities management

C.Nursing administration

D.Senior leadership and the board of directors

Explanation: Senior leadership and the board of directors hold primary authority over capital budget allocation and construction project approval. While facilities management typically manages projects and nursing provides operational input, strategic capital decisions are made at the executive and board level through capital planning committees.

5Which healthcare industry trend is most directly driving the increase in ambulatory surgery center (ASC) construction?

A.Growing need for long-term care beds

B.Increased demand for emergency department capacity

C.Declining Medicare reimbursement rates

D.Shift from inpatient to outpatient care delivery

Explanation: The shift from inpatient to outpatient care delivery is the primary trend driving ambulatory surgery center construction. Advances in surgical techniques, payer pressure to reduce costs, and patient preference for convenient settings have moved many procedures from hospital inpatient settings to outpatient ASCs.

6The term 'DRG' in hospital finance refers to which of the following?

A.Department Regulatory Guideline for compliance

B.Direct Revenue Generation from patient services

C.Diagnosis Related Group for payment classification

D.Design Review Group for facility projects

Explanation: DRG stands for Diagnosis Related Group, a patient classification system used by Medicare to determine hospital reimbursement. Each DRG groups patients with similar clinical characteristics and expected resource consumption. Understanding DRGs helps construction professionals appreciate how hospital revenue is tied to patient volume and case mix.

7Which type of healthcare facility typically requires the most stringent HVAC and air quality controls during construction?

A.Acute care hospital with operating rooms

B.Urgent care clinic

C.Medical office building

D.Outpatient rehabilitation center

Explanation: Acute care hospitals with operating rooms require the most stringent HVAC and air quality controls. Operating rooms demand positive pressure, high air change rates (minimum 20 ACH per FGI Guidelines), HEPA filtration, and precise temperature and humidity control. Construction activities near these spaces require extensive containment measures.

8What does the acronym 'AHJ' stand for in the context of healthcare construction code compliance?

A.American Healthcare Joint Commission

B.Authority Having Jurisdiction

C.Accredited Hospital Justification

D.Administrative Health Judgment

Explanation: AHJ stands for Authority Having Jurisdiction, which refers to the governmental body or official responsible for enforcing codes, standards, and regulations within a specific jurisdiction. In healthcare construction, the AHJ may include state health departments, local building officials, and fire marshals.

9Which organization publishes the Guidelines for Design and Construction of Hospitals that most states adopt for healthcare facility construction?

A.Centers for Medicare & Medicaid Services (CMS)

B.Facility Guidelines Institute (FGI)

C.National Fire Protection Association (NFPA)

D.American Hospital Association (AHA)

Explanation: The Facility Guidelines Institute (FGI) publishes the Guidelines for Design and Construction of Hospitals, which is adopted in whole or in part by the majority of U.S. states as a regulatory standard for healthcare facility design and construction.

10In healthcare terminology, what does 'CON' stand for when a hospital is planning a major expansion project?

A.Certificate of Need

B.Construction Operations Notification

C.Capital Obligation Narrative

D.Compliance Oversight Notice

Explanation: CON stands for Certificate of Need, a regulatory program in many states that requires healthcare facilities to obtain state approval before undertaking major capital expenditures, adding services, or expanding bed capacity. The CON process can significantly impact project timelines.

About the CHC Exam

The CHC credential certifies healthcare construction professionals. The exam covers planning, design and construction processes including codes, special systems, and project logistics (50%), healthcare facility safety including ICRA and interim life safety (30%), healthcare industry fundamentals (10%), and financial stewardship (10%). Requires a degree plus construction experience, including 5 years on healthcare construction projects.

Exam sponsor: AHA-CC/ASHE. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

115 questions

Time Limit

2 hours

Passing Score

Criterion-referenced (Angoff, not disclosed)

Exam / Certification Fees

$400–$570

Exam sponsor website

Reported exam pass rate: Not publicly reported. AHA does not publish CHC pass rates Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

AHA-CC/ASHE: official exam information

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

50%

Planning, Design and Construction

NFPA/CMS/FGI codes, medical gas, essential electrical, fire protection, HVAC, plumbing, sustainability, project closeout

30%

Healthcare Facility Safety

ICRA, interim life safety, barrier management, defend-in-place, utility interruption, emergency planning, workplace safety

10%

Healthcare Industry Fundamentals

Healthcare organization, departments, revenue sources, Medicare/Medicaid, terminology

10%

Financial Stewardship

Constructability, value analysis, life-cycle costing, procurement methods

Preparing for the CHC Exam

What You Need to Know

Passing score: Criterion-referenced (Angoff, not disclosed)
Exam length: 115 questions
Time limit: 2 hours
Exam / certification fees: $400–$570 Official sources

Using Our Practice Resources

Work through all 105 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

CHC: Suggested Study Strategy

1Planning/Design/Construction is 50% — master NFPA 101 (Life Safety Code), NFPA 99 (Health Care Facilities), FGI Guidelines, and medical gas systems

2Facility Safety (30%): know the ASHE ICRA 2.0 matrix (activity types A-D, risk groups Low-Highest, precaution classes I-V), interim life safety measures, and defend-in-place concepts

3Understand essential electrical system branches: life safety, critical, and equipment per NEC/NFPA 110

4Study special systems: medical gas zone valves, fire alarm notification, HVAC pressure relationships in healthcare

Frequently Asked Questions

How many questions are scored?

100 of 115 questions are scored. The other 15 are unscored pretest items.

What are the prerequisites?

Bachelor's + 5 years construction experience, OR associate + 7 years, OR HS diploma + 10 years. Under every pathway, 5 of those years must be on healthcare construction projects, plus 3 years of management/supervisory/administrative experience and healthcare construction work within the last 3 years.

What is ICRA?

Infection Control Risk Assessment — required before any construction/renovation near patient care areas. A major exam topic in the Safety domain.