Health care is a highly regulated entity in the US, which makes it perfect for applying the NFPA Fire & Life Safety Ecosystem™. The presentation looks at five facility types: university medical center, regional hospital, community hospital, nursing home, and outpatient surgical center. A review of each “gear” in the system shows that all health care facilities face challenges in all aspects of the Ecosystem. Audience members are assigned one of the five types of facilities upon entry to the presentation. Participants are asked to discuss how a facility type is affected by specific concepts found under each “gear.” Aspects of the discussion may be considered controversial, including owner oversite, consultant interpretations, AHJ interaction, designer application, and government regulation. The audience will participate in an open discussion about the challenges of health care delivery, as well as the areas where these facilities have excelled. The overall concept is that there is a major need for education on all levels of the Ecosystem.