Unlocking NPC-5 Compliance | P2S

Unlocking NPC-5 Compliance

How P2S Transforms Hospital Resilience

Unlocking NPC-5 Compliance

Embarking on the journey towards NPC-5 compliance is a crucial endeavor with several significant milestones. The first milestone entails conducting a campus assessment, which must be completed by January 1, 2024. But what exactly is NPC-5, and why should it matter to your facility?


NPC-5 is a compliance level for utility infrastructure systems at acute care hospitals throughout California. The compliance is administered by HCAi (formerly OSHPD), which oversees hospital facilities across the state and aims to increase the level of resiliency for hospitals to operate through seismic earthquake events.

The regulations require hospitals to add storage of water, sewer, and generator fuel holding primarily through large storage tanks connected to specific campus buildings that provide critical functions for hospital operations. The tanks require a significant amount of space, either underground or on grade, so careful planning will be necessary to have sufficient area.

Photo: ZCL | Xerxes. (2019). Water and Wastewater [Infographic]. Shawcor. https://www.xerxes.com/wp-cont...


NPC-5 compliance is required to be completed by January 1, 2030, for all licensed acute care hospitals in California. There are a variety of progress deadlines to the regulations along the way, starting with the January 1, 2024, requirement to complete a campus assessment detailing the total capacities required to be stored during a seismic event in compliance with HCAi and CDPH guidelines.

Between 2024 and 2030, several other steps, including permitting the design solution and starting the construction process, will also be required.


Hospitals are hubs to provide critical medical aid for communities, especially during earthquake seismic events. Because of this, hospitals are essential to keep operational so patients can continue to receive care that requires utilities like water, use of drainage and backup up electrical power. Complying with NPC-5 helps hospitals achieve the goal of staying open during the worst natural disasters.

For Who?

All licensed acute care hospitals throughout California are required to comply with NPC-5 requirements as part of their licensure with CDPH and HCAi (formerly OSHPD). This includes existing buildings that will continue to provide acute care services beyond 2030 that were previously constructed before the NPC-5 requirements being enacted. New buildings constructed during the last several years are likely to have included the holding tanks required and the NPC-5 designation through the permitting and construction process.


Hospital owners will need to wade through the process of compliance over the next 6+ years by surrounding themselves with knowledgeable design professionals, construction managers, and contractors to achieve completion prior to 2030. Given the impact to most campuses for locating the holding tanks relative to space on each site, hospitals will need to align the NPC-5 compliance plan with master plans for future buildings, demolition of existing structures, and overall layout so all campus needs can live in one cohesive solution.

Photo: ZCL | Xerxes. (2019). Water and Wastewater [Infographic]. Shawcor. https://www.xerxes.com/wp-cont...

How Can P2S Help?

P2S is currently helping many hospital owners in Southern and Northern California with the first step of the NPC-5 compliance path for submitting campus assessments in close collaboration with each campus and the HCAi Seismic Compliance Unit. Given the wide breadth of knowledge P2S has gained on the subject, we can custom tailor the assessments and compliance strategies to fit each campus’ unique challenges while optimizing for hospital operations, maintenance preferences, and reliability concerns.

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