ICRA 2.0 Protocols.
Class III–V Containment in Occupied Healthcare.

ICRA 2.0 is the second edition of the Infection Control Risk Assessment, administered by the American Society for Healthcare Engineering (ASHE), an AHA personal membership group. It is the framework hospitals use to determine what containment, ventilation, and worker-protocol controls are required when construction or restoration work is performed in or near patient-care environments. Most U.S. hospitals require ICRA 2.0 certification as a vendor pre-qualification.

Type A — inspection or non-invasive activity (removing ceiling tile, painting without sanding, electrical trim work). Type B — small-scale, short-duration activity creating minimal dust (drilling small holes, minor plumbing work). Type C — any work that generates a moderate-to-high level of dust or requires demolition or removal of any fixed building component (sanding walls, removing flooring or wallpaper, light electrical work above ceilings). Type D — major demolition and construction activities including new construction. Restoration work after a water, fire, or biohazard loss in a healthcare environment usually falls into Type C or Type D.

Group 1 — Low risk: office areas. Group 2 — Medium risk: cardiology, echocardiography, endoscopy, nuclear medicine, physical therapy, radiology/MRI, respiratory therapy. Group 3 — Medium-high risk: emergency room (non-trauma), labor and delivery, laboratories (specimen), newborn nursery, outpatient surgery, pediatrics, pharmacy, post-anesthesia care, surgical units. Group 4 — Highest risk: any area caring for immunocompromised patients — bone marrow transplant, burn unit, cardiac cath lab, central sterile supply, intensive care units, negative pressure isolation rooms, oncology, operating rooms including C-section rooms.

ICRA 2.0 publishes a matrix that maps the Construction Activity Type (A–D) crossed with the Patient Risk Group (1–4) to a required Class (I–V). Lower combinations require minimal precautions; higher combinations require full negative-pressure containment. As an example: a Type C activity (light demolition) in a Group 4 area (ICU) yields Class IV — full anteroom, hard barriers, continuous negative pressure with HEPA exhaust, monitored ingress and egress, and post-construction clearance. The same Type C activity in a Group 1 area (office) yields Class II — barrier systems, walk-off mats, HEPA vacuum cleanup. The matrix is non-negotiable; it dictates the entire scope.

Hard-wall containment (drywall on wood or steel framing — not plastic alone), full anteroom for clean entry and exit, negative pressure inside the work area maintained at -0.01 in. w.g. minimum continuously, HEPA filtration of all exhausted air, sticky walk-off mats, sealed waste removal, daily HEPA vacuuming, dedicated PPE doffing area, and post-construction air clearance prior to barrier removal. DRR documents pressure logs continuously throughout the project and ties them to the daily field report your facility infection prevention team receives.

Class V applies to the highest-precaution work in the highest patient-risk areas — typically Type D activity in Group 4 environments such as bone marrow transplant or active OR suites. It carries every Class IV requirement plus additional facility-specific protocols negotiated case-by-case with infection prevention. DRR has performed Class IV work in active occupied healthcare environments and our SOPs accommodate Class V escalation.

The hospital's Infection Prevention Coordinator (or equivalent) issues the ICRA permit before any work begins. The permit specifies the Class, the duration, and the daily verification protocol. Most facilities require the permit to be physically posted at the work area entrance and signed daily by the contractor's supervisor. DRR's project managers carry hospital ICRA permit packets as a standard kit item.

ICRA 2.0 awareness training (8-hour) for all field staff, ICRA 2.0 expanded training (24-hour) for supervisors, plus IICRC certifications (S500, S520) for the underlying restoration competency. Healthcare projects also receive a project-specific orientation with the facility's infection prevention team covering site access, badging, PPE doffing flow, and waste handling.

It doesn't suppress speed — it disciplines it. DRR can mobilize, pre-stage barrier materials, and start a Class IV containment build within the same on-site dispatch window as a non-healthcare emergency. The difference is that the work itself doesn't begin behind the containment until the ICRA permit is issued, the negative-pressure rig is verified, and the HEPA exhaust is operating to spec — usually within hours of arrival rather than minutes.

Yes. We have completed restoration projects in active accreditation cycles, including coordinating temporary fire-watch protocols when life-safety system shutdowns are unavoidable, and producing the documentation packet (ICRA permit, pressure logs, post-clearance air quality, lift-of-barrier sign-off) that your facility uses in its accreditation file. We bill Xactimate-ready scopes that map cleanly to property and casualty carrier expectations alongside the FGI compliance record.