By Jonathan Hart, P.E., Contributing Writer

Healthcare facilities rarely draw attention when they are operating at their best. Power stays on, air stays clean, water flows safely and clinical teams can focus on patient care without interruption. Yet behind that stability is a growing set of pressures that healthcare facility managers can no longer absorb quietly. 

In the year ahead, staffing shortages, rising regulatory scrutiny and accelerating adoption of AI are converging to reshape the way healthcare facilities are managed. 

While these forces are not new, their combined impact is becoming harder to ignore. Facilities managers are being asked to maintain uptime, ensure compliance and modernize operations with fewer people and tighter margins. The result is a need for more deliberate, forward-looking operational strategies. 

Staffing shortages as structural constraint 

Workforce shortages are increasingly constraining healthcare facilities departments that keep hospitals running safely and reliably. Facilities teams are being asked to maintain complex infrastructure, respond to emergencies and support compliance efforts even as skilled trades vacancies persist. 

Sixty-four percent of respondents said staffing needs have grown over the past three years, according to the 2024 Hospital Operations Survey by the American Society for Health Care Engineering (ASHE). Yet only 27 percent have actually added maintenance staff. Over one-half of facility leaders also identified recruitment and retention as a top operational challenge. 

These gaps amplify operational risk. With fewer qualified personnel available, technicians often spend more time on administrative and coordination tasks instead of hands-on maintenance, inspections and repairs that directly affect safety and reliability. Deferred maintenance and slower response times can cascade into broader operational disruptions, creating pressure on staff and facility systems. 

In 2026, these shortages are bound to continue. In fact, 53 percent of skilled workers say a shortage of qualified candidates will be their biggest challenge at work this year — a 3 percent increase from 2025, according to a new survey from the National Fire Protection Association (NFPA). 

Even as labor shortages remain at a standstill, the most effective facilities managers will approach labor strategically this year, using workflow improvements and targeted task management to ensure technical expertise is focused on high-value work. By reducing inefficiencies and clarifying roles, managers can maintain safe, reliable operations despite persistent staffing pressures. 

Regulatory scrutiny intensifies 

Regulatory oversight in healthcare facilities is no longer defined by periodic surveys or inspection cycles. Accrediting bodies are placing greater emphasis on continuous readiness, expecting documentation, system performance and compliance decisions to be defensible at any time. For facilities managers, this emphasis shifts compliance from a scheduled activity to a daily operational responsibility. 

As requirements tied to life safety and emergency preparedness evolve, reliance on institutional knowledge or manual tracking becomes increasingly risky. In 2026, facilities teams need consistent, repeatable processes and real-time access to current codes and standards to support instant decision-making on the ground. When compliance is embedded into everyday workflows, healthcare facilities are better positioned to maintain safe environments of care without pulling resources from core operations. 

AI accelerates operational change 

Against this backdrop, AI is shifting from experimentation to practical application in healthcare facilities management. Historically, skilled trades and facilities teams have been cautious adopters of technology, particularly tools perceived as removed from hands-on work. Now, that mindset is changing. 

NFPA’s recent skilled trades survey found that 35 percent of respondents expect increased technology deployment to be their organization’s top priority in 2026. In a sector defined by physical work and regulatory responsibility, that emphasis signals a meaningful shift. 

Early adoption is visible among larger health systems, which are using AI to streamline back-office functions, including scheduling, payroll and routine administrative tasks. While these applications might not yet be visible to all workers, their impact is tangible: Staff spend less time on repetitive tasks and more time on inspections, maintenance and problem-solving that require judgment and experience. 

AI also is expected to support codes and standards research, interpretation and staff training. For facilities managers navigating complex regulatory environments, digital tools can surface relevant requirements faster, improve consistency, and aid onboarding. 

These tools do not replace expertise. They require oversight and cannot perform physical inspections or high-stakes decision-making. Those managers who prioritize implementing AI tools in 2026 will be the most successful, understanding that their value lies in augmentation, not total automation. 

Building a resilient operating model 

As these trends converge, healthcare facilities managers are entering a period of structural change. Staffing shortages force sharper prioritization of labor. Regulatory scrutiny increases the cost of errors. AI offers new ways to manage complexity without expanding headcounts. 

This year, successful facilities managers will align these forces into a cohesive operating model by using technology to protect scarce human expertise, embedding compliance into daily operations and investing in systems that support long-term resilience rather than short-term fixes. 

Healthcare facilities will continue to depend on skilled professionals to keep critical systems running safely and reliably. The difference is that the most effective organizations will pair that expertise with smarter tools and clearer processes, ensuring facilities teams are equipped to meet rising demands in an increasingly complex environment. 

Jonathan Hart, P.E., is technical lead, fire protection engineering, with the National Fire Protection Association.