Book excerpt: Health care HVAC systems serve facilities in which the population is uniquely vulnerable and exposed to an elevated risk of health, fire, and safety hazard. These heavily regulated, high-stakes facilities undergo continuous maintenance, verification, inspection, and recertification, typically operate 24/7, and are owner occupied for long life. The HVAC systems in health care facilities must be carefully designed to be installed, operated and maintained in coordination with specialized buildings services, including emergency and normal power, plumbing and medical gas systems, automatic transport, fire protections and a myriad of IT systems, all within a limited building envelope.