Hospitals and Nursing Homes

In designing a hot water system for a hospital or nursing home, the requirements for hot water include tubs and showers, wash basins, service sinks, kitchen equipment used for food service to the patients and laundry service.

Some designers use a rule of thumb of 125 gallons of 140ºF water per bed per day for estimating the hot water requirement. This estimating practice is quite general and should only be used for estimating purposes.

An account and record of all fixtures requiring hot water should be completed when sizing the required system. It should be noted that this may lead to a system that is oversized if there is a high percentage of bedridden patients. Since bedridden patients do not use the volume of water for cleaning purposes such as ambulatory patients, it is recommended that the sizing be reduced as much as 25% of the normal fixture volume.

Special Design Considerations:

• Therapeutic baths typically require approximately 75 gallons of warm water at about 110ºF.
  
• Many hospitals have bed pan sanitizers on every floor requiring 180ºF domestic water.
  
• Special care must be taken when sizing the needs of a hospital or nursing home. Ensure all fixtures requiring hot water are recorded and note any special needs for hot water and how it's usage affects the peak demand.
  
• For kitchen and laundry requirements, see the appropriate sections regarding those sizing needs.
  
• The U.S Department of Health and Human Services established 1983/1984 guidelines for hot water provided for hospitals and medical facilities as follows:

	Clinical	Dietary	Laundry
Gallons per hour per bed	3.0	2.0	2.0
Water temperature ºF	110	120	160
Liters per hour per bed	0.0033	0.0021	0.0021
Water temperature ºC	43	49	71

General "Rules of Thumb" For Sizing

	Max. Hour	Max. Day	Avg. Day
Nursing Homes	4.5 gal/bed	30.0 gal/bed	18.4 gal/bed

Hot Water Demand per Fixture Detail Sizing

Fixture	Gallons of water per hour per fixture (calculated at a final temperature of 140º)
Basins, private lavatory	2
Basins, public lavatory	8
Bathtubs	20
Showers	75
Service sink	30

Method of Sizing

1. Determine the number of fixtures required for the application and calculate the total hot water demand for those fixture.

Number of Fixtures x Gallons of Water per Hour per Fixture = Possible Maximum Demand

2. Determine the Probable Hot Water Demand for the application.

Probable Hot Water Demand = Possible Maximum Demand x 0.25

3. Compare the Probable Hot Water Demand with the 1st Hour Performance Ratings of the Phase III Indirect Waters or with the Heat Master Direct Fired Water Heaters.

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