Deferred Maintenance in Healthcare: The Risks, the Reality, and the Path Forward

Aging buildings, nonexistent budgets, and growing compliance demands are leaving many facilities managers grappling with increased deferred maintenance. And with changes on the horizon that could reshape healthcare delivery, there’s even more pressure to make every dollar count.

Deferred maintenance, or delayed repairs and replacements, can create serious risk in hospital environments, from operational failures and escalating long-term costs to disruptions in patient care. But as capital planning becomes a greater priority, many healthcare leaders are choosing to rethink the conversation. Instead of seeing deferred maintenance as purely a liability, they’re treating it as a strategic deferred investment, one that helps maximize asset performance, reduce risk, and stretch budgets further.

In a recent podcast, Mark Mochel, Strategic Account Executive at Brightly Software, and Jonathan Flannery, Senior Associate Director at the American Society for Healthcare Engineering (ASHE), discussed how healthcare organizations can take a more intentional approach to deferred investment and use better planning to protect what matters most: patient health and safety.

Read on for a recap or listen to the full episode on demand here. 

The true cost of delays

Deferred maintenance is often "one of healthcare’s most overlooked challenges." As Mochel explained, it’s the act of postponing repairs or replacements to control costs or focus on immediate needs. The short-term relief can be tempting, but the long-term consequences add up quickly: higher expenses, avoidable downtime, and increased operational strain.

And the scope of the problem is significant. Across thousands of healthcare facilities and more than 90,000 tracked assets, roughly 56% have exceeded their expected useful life. For HVAC equipment, that number climbs to 60%. 

In healthcare, the risk isn’t theoretical. It’s immediate and operational. When power goes out, patient care stops. When medical gas systems fail, patients can be harmed. If a vacuum system goes down, surgeries and procedures may need to be postponed entirely. These are not minor inconveniences -- they’re disruptions that directly impact safety, outcomes, and hospital capacity.

Flannery also pointed to a common planning pitfall: moving forward with new construction or expansion plans while ignoring the condition of existing buildings. During master planning, “If you don’t level set with what you have today and where you’re at, it becomes very risky,” he shared.

The goal isn’t always replacement. Sometimes, smarter investment means making targeted improvements that extend the life of valuable assets. Flannery recalled a standout example where a team chose to upgrade 20- to 30-year-old air handlers that were “built much better than anything you could buy at the time” rather than replacing them, saving significantly while improving performance.

Shifting from reactive to strategic

With a strong preventive maintenance program supported by a modern CMMS, facilities teams can keep critical assets running longer, reduce disruptions, and gain more control over day-to-day operations. That stability also helps protect limited funding so hospitals can prioritize patient services, expand care offerings, or invest where it matters most.

But even with great PM in place, assets don’t last forever. Eventually, stopgap fixes fail, and when replacement planning isn’t deliberate, breakdowns become emergencies. Reactive repairs can cost several times more than planned replacements, while creating compliance exposure and reducing capacity. The impact is felt far beyond the maintenance shop.

This is where asset investment planning (AIP) becomes essential. By tracking condition, performance, risk, and replacement timelines, healthcare leaders can anticipate needs earlier, build a defensible case for funding, and connect asset decisions directly to clinical outcomes. This is how facilities teams can move from “we need this fixed” to “here’s what will happen if we don’t.”

A unified path forward

Deferred maintenance is not just a facilities issue. It’s an organization-wide risk and planning challenge tied to compliance, capital allocation, operational continuity, and patient safety. As Mochel put it: “What it ultimately requires is that all the cards are on table, all the data is on the table – it’s facilities, it’s clinicians, it’s administrators, it’s the C-suite. Everybody’s looking at the same cards, that’s a good scenario.”

In other words, deferred maintenance doesn’t have to be the “black sheep” of the maintenance program. But it does require intention. Today’s healthcare leaders have an opportunity to shift the narrative, treating deferred maintenance as a set of strategic investment decisions backed by clear objectives, real data, and an honest understanding of potential risks and tradeoffs.

Designed for healthcare teams, Brightly’s all-in-one TheWorxHub CMMS helps make proactive maintenance more continuous, consistent, and trackable, so teams can stay ahead instead of constantly catching up. And Brightly’s Origin capital planning software supports long-term lifecycle planning, helping organizations move from tactical maintenance to true asset lifecycle management (ALM) with patient safety and operational reliability at the center.

Click to listen to the full Safe by Design: Proactive Maintenance for Code and Care podcast episode on demand now. 

Or check out Mochel’s recent blog post about Rethinking Deferred Maintenance and Master Planning in Healthcare to learn more about strategic healthcare investment.