Activate elective surgery throttle KL Damansara dengue spike

Auto-generated from DBCA, CWFA agents based on the prior 24-hour signal window.


Replicate Penang oncology pathway to JB and Ipoh

Auto-generated from SLPA, PSCA agents based on the prior 24-hour signal window.


Pre-order cold-chain insulin for Sabah facility

Auto-generated from PSCA agents based on the prior 24-hour signal window.


Auto-generated from FAOA agents based on the prior 24-hour signal window.


Escalate: clinical waste vendor non-compliance at 2 facilities


Activate elective surgery throttle at KL Damansara ahead of dengue spike

Dengue trajectory at KL Damansara (FAC-01) is breaching bed-capacity headroom; throttling category-3 electives for 7 days preserves ward and ICU capacity and avoids forced cancellations. MoH weekly dengue case-count Petaling district: 412 -> 478 (W-on-W +16%).

Early-warning dengue signals consistent with 2024 outbreak precursor

Admissions forecast for KL Damansara now exceeds available med-surg headroom inside the 72-hour window. Throttling category-3 electives (joint-replacement, hernia, cosmetic) frees 14-18 beds per day and keeps ICU buffer >=20% as MoH dengue protocol mandates.

Aedes Index Klang Valley: 2.2 -> 2.7 in 12 days (iDengue), MET monsoon pattern matches 2024 outbreak precursor

Dengue admissions at KL Damansara: 22 active inpatients (+22% WoW), forecast 33 by D+3

Med-surg bed occupancy FAC-01: 83% (threshold 85%), ICU 8/14 utilised

MET Malaysia 14-day rainfall anomaly +38% over Klang Valley (monsoon-dengue correlation r=0.71, 2019-2025)

Throttle category-3 electives at FAC-01 for 7 days; auto-reschedule via HIS

Open 12 contingency beds in Ward 5B (currently soft-closed) and pre-stage IV fluids per MoH dengue protocol

Notify Allianz, AIA, Great Eastern case managers of reschedules to preserve service-level credit

Early-warning conditions met; p=0.45 of bed-shortage trigger within 5-7 days absent action. Conservative throttle on lowest-acuity electives preserves RM 1.9M downside protection without revenue loss.

Elective OT demand exceeds capacity; staged throttle keeps roster within MMC limits

Roster simulation shows on-call anaesthetist and medical-ward nursing cover cannot safely run full elective list alongside surging dengue inflow without breaching MMC hours-per-week limits. Throttling category-3 electives keeps rostering within compliance and prevents burnout-driven sick leave.

OT minutes at KL Damansara (FAC-01): 2,010 vs 2,140 needed; 130 min deficit

Anaesthetist roster gap at FAC-01: 3 sessions short across the 7-day horizon vs MMC safe-staffing reference

Nurse hours-per-week at FAC-01: 47.8 average vs 48.0 MMC ceiling; 9 nurses on dengue secondment

Locum cost to backfill full schedule: RM 38k/day at current Klang Valley spot rate

Historical pairing (2024 dengue wave): unthrottled facilities recorded 11% nurse sick-leave spike inside 10 days

Re-route category-1/2 (oncology, cardiac) electives onto retained list; preserve full theatre access

Re-roster 6 OT nurses to dengue-ward augmentation; document under MMC roster-change protocol

Submit weekly compliance attestation to MMC and Private Healthcare Facilities and Services Act register

Without throttle, p=0.55 of MMC roster-compliance breach within 10 days and resultant escalation to Pharmacy Board / MoH joint inspection. Reputational and licensing risk.

Aedes Index - Klang Valley (iDengue)

Aedes Index above MoH 2.5 watch threshold


Penang oncology pathway has demonstrated durable margin and outcome advantages; replicating to JB (FAC-07) and Ipoh (FAC-10) before competitors close the gap secures RM 2.9M annualised contribution.

Penang oncology model is replication-ready and economics are robust

The Penang protocol (multidisciplinary tumour board, navigator-led patient journey, integrated radiotherapy) consistently outperforms group average on outcomes and margin. Catchment analysis confirms JB and Ipoh have addressable demand (1,840 and 1,210 oncology cases/yr respectively).

Penang oncology 30-day readmission: 6.5% vs group avg 11.4% (24 months, n=2,118)

Penang oncology EBITDA margin: 28.2% vs JB 18.7% / Ipoh 16.9% (FY26 YTD)

Catchment oncology demand (Iskandar Malaysia): 1,840 cases/yr, 41% private-payer mix (Allianz, AIA, AXA, Great Eastern)

Catchment oncology demand (Kinta Valley): 1,210 cases/yr, 37% private-payer mix

Competitive scan: Sunway and IHH announced JB oncology expansions (2026 H2 commissioning)

Approve RM 4.2M capex envelope for JB + Ipoh oncology pathway build-out (linac upgrade at FAC-10)

Second 4 Penang oncologists for 6-month rotation; align with MMC credentialing windows

Lock insurer panel pricing with Allianz, AIA, AXA, Great Eastern before competitor launches

Pathway evidence base is solid; replication economics confirmed. p=0.42 of full uplift in FY26 if business case is approved this quarter; downside is opportunity cost of competitor moves.

Formulary and cold-chain supply lines viable at JB and Ipoh

94% formulary match achievable via existing Pharmaniaga and Zuellig contracts. Remaining 11 SKUs (mostly biologics) need cold-chain re-qualification and Pharmacy Board notification under PHFSA. No critical lead-time blockers.

Pharmacy SKU readiness: 88% of Penang oncology formulary (161/183) procurable at JB and Ipoh; cold-chain mapping under review

Cold-chain capacity at JB (FAC-07): 480L pharmacy-grade vs 320L typical oncology load; Ipoh (FAC-10): 420L vs 290L

Pharmacy Board audit window: open through Q3 2026; pre-clearance feasible

Pharmaniaga lead time on Trastuzumab biosimilar and Pembrolizumab: 11-13 days (no allocation constraints reported)

PDPA mapping for oncology patient registry: re-use Penang DPIA template; 4-week sign-off path

Submit Pharmacy Board SKU notification for 11 biologic additions at FAC-07 and FAC-10

Pre-position 60-day buffer of cytotoxics and biosimilars at JB and Ipoh pharmacy hubs

Validate cold-chain temperature logging (2-8C) against Pharmacy Board GDP audit checklist

Without pre-clearance, p=0.35 of Pharmacy Board notification delay slipping launch 30-45 days. Manageable but on the critical path.

Oncology Pathway Replication Readiness Score

Pathway readiness building; remediation actions on cold-chain SKUs in flight


Pre-order cold-chain insulin shipment for Sabah facility

Insulin days-on-hand at Sabah facility (FAC-12) has fallen below the Pharmacy Board's 7-day safe-stock floor; pre-ordering a refrigerated air shipment closes the gap before clinical risk materialises.

Sabah insulin stock will breach safe-stock floor without immediate action

Demand at FAC-12 has risen with the East Malaysia diabetes screening campaign; combined with monsoon-related ferry delays to Sandakan and Tawau clinics, the next scheduled road resupply will not arrive in time. A pre-ordered cold-chain air shipment via Kota Kinabalu re-stocks within 48 hours and stays within Pharmacy Board GDP audit thresholds.

Lantus 100U/mL - 1,720 doses on hand at Sabah facility (FAC-12); 1,840 forecast 7-day demand

Days-on-hand: 6.5 vs Pharmacy Board minimum 7.0; below floor for first time in 6 weeks

MET Sabah monsoon advisory: ferry/road disruption probability 0.58 over next 5 days

Substitute SKU (Novomix 30) on hand: 320 doses, unit cost +38% vs Lantus; clinical switch not recommended in stable patients

Pharmacy Board GDP audit window: cold-chain temperature deviations >2 hrs trigger root-cause investigation

Place expedite order with Pharmaniaga: 2,400 doses Lantus 100U/mL on next-available MAS Cargo cold-chain to KK

Pre-stage temperature loggers (2-8C) and notify FAC-12 pharmacy lead of arrival window

Update Pharmacy Board stock-position return for the next reporting cycle

Early signal: pre-order now uses standard 5-day Pharmaniaga lead time and avoids paying expedite premium later. p=0.33 of stockout risk if no action over 10 days; cost of action is low.

Lantus Days-on-Hand - Sabah (FAC-12)

Days-on-hand dropped below 7.0 Pharmacy Board minimum


Pre-cool 4 OT suites 02:00-04:00 to dodge TNB peak

Shifting OT pre-cooling to 02:00-04:00 off-peak window cuts TNB peak-demand charges without affecting daytime OT thermal envelope; the FAC-03 pilot demonstrated RM 240k/month at scale.

Pre-cooling shifts load out of TNB peak window with no clinical impact

BMS scheduling can drop OT suite setpoints between 02:00 and 04:00 (off-peak) to bank thermal mass, then return to standard setpoints before first case. Independent validation at FAC-03 (Penang) over 90 days showed RM 21k/month saving per OT pair with zero infection-control or particulate-count deviations.

TNB peak (14:00-22:00) demand at KL Damansara HVAC chillers: 596 kW vs 540 kW off-peak

TNB ToU tariff differential: RM 0.52/kWh peak vs RM 0.29/kWh off-peak

FAC-03 pilot result (Q1 2026): RM 84k/month saved across 4 OT suites; ASHRAE 170 envelope compliant

OT environmental compliance: ISO Class 7 particulate counts within tolerance during ramp

Biomed sign-off: chiller short-cycle risk mitigated by 30-minute lockout in BMS logic

Deploy BMS schedule to OT suites 3-6 at KL Damansara (FAC-01); enable 02:00-04:00 pre-cool block

Run 14-day shadow-monitoring with biomed before locking schedule; report exceptions to Chief of Staff

Reconcile against TNB monthly invoice and Private Healthcare Facilities and Services Act energy register

Pattern matching predicts a peak-demand spike; pre-cooling pilot validated last quarter at FAC-03 with no clinical incidents. Low cost of action.

OT HVAC Peak-Hour Demand kW - KL Damansara

Peak-hour HVAC demand rising into peak window


Clinical waste manifest and pickup compliance has degraded at FAC-04 (Subang) and FAC-09 (Melaka); without immediate cure-notice and back-up vendor activation, MoH inspection risk and ward-level suspension exposure rise.

Clinical waste vendor compliance breach exposes group to PHFSA action

Manifest discrepancies and missed pickup windows at FAC-04 and FAC-09 mean PHFSA Schedule 6 compliance scoring has fallen below the licensing renewal floor. A cure-notice plus immediate qualification of contingency vendor (Cenviro / Tex Cycle) protects the group from a worst-case 14-day clinical waste service suspension at affected wards.

1 manifest discrepancy and 1 late-pickup at FAC-04 (Subang) in past 14 days; second incident pattern emerging at FAC-09

PHFSA Schedule 6 compliance score: 0.81 (threshold 0.90)

MoH circular MOH/PHFSA/2025/09: enforcement focus on private clinical waste manifest accuracy in 2026

Contingency vendor capacity: Cenviro confirmed 1.8 t/day spare capacity in Klang Valley and Melaka corridor

PDPA mapping: patient-linked waste labelling remains compliant; no data-handling escalation needed

Issue 14-day cure notice to incumbent vendor with weekly KPI checkpoints

Qualify Cenviro and Tex Cycle as contingency vendors at FAC-04 and FAC-09 within 10 days

Brief MoH compliance liaison proactively; escalate to Group CEO if score does not return above 0.85 inside 21 days

Early signal: trajectory consistent with vendor under operational strain. p=0.35 of escalation if not addressed. Cure-notice and contingency vendor sounding-out are low-cost moves.

PHFSA Schedule 6 Compliance Score - FAC-04 & FAC-09

Compliance score declining toward 0.75 escalation trigger


Dengue trajectory at KL Damansara (FAC-01) is breaching bed-capacity headroom; throttling category-3 electives for 7 days preserves ward and ICU capacity and avoids forced cancellations. MoH weekly dengue case-count Petaling district: 412 -> 521 (W-on-W +26%).

Bed pipeline tightening; dengue admissions rising

Aedes Index Klang Valley: 2.3 -> 2.9 in 13 days (iDengue), MoH watch-list

Dengue admissions at KL Damansara: 29 active inpatients (+38% WoW), forecast 44 by D+3

Med-surg bed occupancy FAC-01: 86% (threshold 85%), ICU 9/14 utilised

MET Malaysia 14-day rainfall anomaly +38% over Klang Valley (monsoon-dengue correlation r=0.71, 2019-2025)

Throttle category-3 electives at FAC-01 for 7 days; auto-reschedule via HIS

Open 12 contingency beds in Ward 5B (currently soft-closed) and pre-stage IV fluids per MoH dengue protocol

Notify Allianz, AIA, Great Eastern case managers of reschedules to preserve service-level credit

Trajectory points to >85% bed occupancy persisting through next week; p=0.62 of forced cancellations in 72-96h window if no throttle. RM 1.9M downside intact under base case.

OT staffing gap opens as anaesthetist leave overlaps dengue ward demand

OT minutes at KL Damansara (FAC-01): 1,920 vs 2,140 needed; 220 min deficit

Anaesthetist roster gap at FAC-01: 3 sessions short across the 7-day horizon vs MMC safe-staffing reference

Nurse hours-per-week at FAC-01: 47.8 average vs 48.0 MMC ceiling; 9 nurses on dengue secondment

Locum cost to backfill full schedule: RM 38k/day at current Klang Valley spot rate

Historical pairing (2024 dengue wave): unthrottled facilities recorded 11% nurse sick-leave spike inside 10 days

Re-route category-1/2 (oncology, cardiac) electives onto retained list; preserve full theatre access

Re-roster 6 OT nurses to dengue-ward augmentation; document under MMC roster-change protocol

Submit weekly compliance attestation to MMC and Private Healthcare Facilities and Services Act register

Aedes Index - Klang Valley (iDengue)

Aedes Index trending toward MoH 3.0 trigger


Penang oncology 30-day readmission: 6.3% vs group avg 11.4% (24 months, n=2,150)

Penang oncology EBITDA margin: 28.4% vs JB 19.0% / Ipoh 17.1% (FY26 YTD)

Catchment oncology demand (Iskandar Malaysia): 1,840 cases/yr, 41% private-payer mix (Allianz, AIA, AXA, Great Eastern)

Catchment oncology demand (Kinta Valley): 1,210 cases/yr, 37% private-payer mix

Competitive scan: Sunway and IHH announced JB oncology expansions (2026 H2 commissioning)

Approve RM 4.2M capex envelope for JB + Ipoh oncology pathway build-out (linac upgrade at FAC-10)

Second 4 Penang oncologists for 6-month rotation; align with MMC credentialing windows

Lock insurer panel pricing with Allianz, AIA, AXA, Great Eastern before competitor launches

Pathway maturity converging on launch-readiness. p=0.58 of capturing full RM 2.9M annualised uplift if launch starts within 30 days; delay risk compounding.

Pharmacy SKU readiness: 91% of Penang oncology formulary (167/183) procurable at JB and Ipoh; 9 SKUs require cold-chain re-qualification

Cold-chain capacity at JB (FAC-07): 480L pharmacy-grade vs 320L typical oncology load; Ipoh (FAC-10): 420L vs 290L

Pharmacy Board audit window: open through Q3 2026; pre-clearance feasible

Pharmaniaga lead time on Trastuzumab biosimilar and Pembrolizumab: 11-13 days (no allocation constraints reported)

PDPA mapping for oncology patient registry: re-use Penang DPIA template; 4-week sign-off path

Submit Pharmacy Board SKU notification for 11 biologic additions at FAC-07 and FAC-10

Pre-position 60-day buffer of cytotoxics and biosimilars at JB and Ipoh pharmacy hubs

Validate cold-chain temperature logging (2-8C) against Pharmacy Board GDP audit checklist

Pathway readiness approaching 0.85 launch threshold


Lantus 100U/mL - 1,540 doses on hand at Sabah facility (FAC-12); 1,840 forecast 7-day demand

Days-on-hand: 5.9 vs Pharmacy Board minimum 7.0; trending down 0.7/day

MET Sabah monsoon advisory: ferry/road disruption probability 0.58 over next 5 days

Substitute SKU (Novomix 30) on hand: 320 doses, unit cost +38% vs Lantus; clinical switch not recommended in stable patients

Pharmacy Board GDP audit window: cold-chain temperature deviations >2 hrs trigger root-cause investigation

Place expedite order with Pharmaniaga: 2,400 doses Lantus 100U/mL on next-available MAS Cargo cold-chain to KK

Pre-stage temperature loggers (2-8C) and notify FAC-12 pharmacy lead of arrival window

Update Pharmacy Board stock-position return for the next reporting cycle

p=0.52 of crossing critical 5-day floor inside 48h. Pre-order placed now arrives within Pharmacy Board safe stock window. RM 720k stockout exposure if held.


TNB peak (14:00-22:00) demand at KL Damansara HVAC chillers: 605 kW vs 540 kW off-peak

TNB ToU tariff differential: RM 0.52/kWh peak vs RM 0.29/kWh off-peak

FAC-03 pilot result (Q1 2026): RM 84k/month saved across 4 OT suites; ASHRAE 170 envelope compliant

OT environmental compliance: ISO Class 7 particulate counts within tolerance during ramp

Biomed sign-off: chiller short-cycle risk mitigated by 30-minute lockout in BMS logic

Deploy BMS schedule to OT suites 3-6 at KL Damansara (FAC-01); enable 02:00-04:00 pre-cool block

Run 14-day shadow-monitoring with biomed before locking schedule; report exceptions to Chief of Staff

Reconcile against TNB monthly invoice and Private Healthcare Facilities and Services Act energy register

Peak-demand charge trajectory mirrors April; p=0.55 of crossing RM 260k monthly billing if untreated. Low-risk control change.

Peak-hour HVAC demand approaching 600 kW threshold


2 manifest discrepancies and 1 late-pickup at FAC-04 (Subang) and FAC-09 (Melaka) in past 14 days

PHFSA Schedule 6 compliance score: 0.76 (threshold 0.90) - inside escalation band

MoH circular MOH/PHFSA/2025/09: enforcement focus on private clinical waste manifest accuracy in 2026

Contingency vendor capacity: Cenviro confirmed 1.8 t/day spare capacity in Klang Valley and Melaka corridor

PDPA mapping: patient-linked waste labelling remains compliant; no data-handling escalation needed

Issue 14-day cure notice to incumbent vendor with weekly KPI checkpoints

Qualify Cenviro and Tex Cycle as contingency vendors at FAC-04 and FAC-09 within 10 days

Brief MoH compliance liaison proactively; escalate to Group CEO if score does not return above 0.85 inside 21 days

p=0.48 of inspection finding inside 45 days; cure-notice path still available. RM 1.4M suspension downside if escalation continues unchecked.


Dengue trajectory at KL Damansara (FAC-01) is breaching bed-capacity headroom; throttling category-3 electives for 7 days preserves ward and ICU capacity and avoids forced cancellations. MoH weekly dengue case-count Petaling district: 412 -> 587 (W-on-W +42%).

Bed pipeline collapsing under dengue inflow

Aedes Index Klang Valley: 2.4 -> 3.1 in 14 days (iDengue), MoH circular MOH/DGH/2026/14 issued

Dengue admissions at KL Damansara: 38 active inpatients (+62% WoW), forecast 54 by D+3

Med-surg bed occupancy FAC-01: 89% (threshold 85%), ICU 11/14 utilised

MET Malaysia 14-day rainfall anomaly +38% over Klang Valley (monsoon-dengue correlation r=0.71, 2019-2025)

Throttle category-3 electives at FAC-01 for 7 days; auto-reschedule via HIS

Open 12 contingency beds in Ward 5B (currently soft-closed) and pre-stage IV fluids per MoH dengue protocol

Notify Allianz, AIA, Great Eastern case managers of reschedules to preserve service-level credit

If electives proceed as scheduled, p=0.78 of stat-bed shortage within 72h and forced cancellations triggering insurer service-level claims (Allianz, Great Eastern). Estimated downside RM 1.9M (refunds, transfers, brand damage).

Clinical roster cannot safely cover both dengue surge and full elective load

OT minutes available at KL Damansara (FAC-01): 1,840 vs 2,140 needed for full elective schedule

Anaesthetist roster gap at FAC-01: 3 sessions short across the 7-day horizon vs MMC safe-staffing reference

Nurse hours-per-week at FAC-01: 47.8 average vs 48.0 MMC ceiling; 9 nurses on dengue secondment

Locum cost to backfill full schedule: RM 38k/day at current Klang Valley spot rate

Historical pairing (2024 dengue wave): unthrottled facilities recorded 11% nurse sick-leave spike inside 10 days

Re-route category-1/2 (oncology, cardiac) electives onto retained list; preserve full theatre access

Re-roster 6 OT nurses to dengue-ward augmentation; document under MMC roster-change protocol

Submit weekly compliance attestation to MMC and Private Healthcare Facilities and Services Act register

Aedes Index breached 3.0 threshold (D-1); MoH Aedes >2.5 flag active


Penang oncology 30-day readmission: 6.1% vs group avg 11.4% (24 months, n=2,184)

Penang oncology EBITDA margin: 28.7% vs JB 19.2% / Ipoh 17.4% (FY26 YTD)

Catchment oncology demand (Iskandar Malaysia): 1,840 cases/yr, 41% private-payer mix (Allianz, AIA, AXA, Great Eastern)

Catchment oncology demand (Kinta Valley): 1,210 cases/yr, 37% private-payer mix

Competitive scan: Sunway and IHH announced JB oncology expansions (2026 H2 commissioning)

Approve RM 4.2M capex envelope for JB + Ipoh oncology pathway build-out (linac upgrade at FAC-10)

Second 4 Penang oncologists for 6-month rotation; align with MMC credentialing windows

Lock insurer panel pricing with Allianz, AIA, AXA, Great Eastern before competitor launches

Window of advantage is narrowing as 2 competitors (Sunway, IHH) announced JB oncology expansions. p=0.72 that delaying replication >60 days erodes 30-40% of capturable share. Annualised upside RM 2.9M at risk.

Pharmacy SKU readiness: 94% of Penang oncology formulary (172/183) procurable via Pharmaniaga and Zuellig at JB and Ipoh within 14 days

Cold-chain capacity at JB (FAC-07): 480L pharmacy-grade vs 320L typical oncology load; Ipoh (FAC-10): 420L vs 290L

Pharmacy Board audit window: open through Q3 2026; pre-clearance feasible

Pharmaniaga lead time on Trastuzumab biosimilar and Pembrolizumab: 11-13 days (no allocation constraints reported)

PDPA mapping for oncology patient registry: re-use Penang DPIA template; 4-week sign-off path

Submit Pharmacy Board SKU notification for 11 biologic additions at FAC-07 and FAC-10

Pre-position 60-day buffer of cytotoxics and biosimilars at JB and Ipoh pharmacy hubs

Validate cold-chain temperature logging (2-8C) against Pharmacy Board GDP audit checklist

Pathway readiness score crossed 0.85 launch threshold


Lantus 100U/mL - 1,200 doses on hand at Sabah facility (FAC-12); 1,840 forecast 7-day demand

Days-on-hand: 4.6 vs Pharmacy Board minimum 7.0 for chronic-disease essentials

MET Sabah monsoon advisory: ferry/road disruption probability 0.58 over next 5 days

Substitute SKU (Novomix 30) on hand: 320 doses, unit cost +38% vs Lantus; clinical switch not recommended in stable patients

Pharmacy Board GDP audit window: cold-chain temperature deviations >2 hrs trigger root-cause investigation

Place expedite order with Pharmaniaga: 2,400 doses Lantus 100U/mL on next-available MAS Cargo cold-chain to KK

Pre-stage temperature loggers (2-8C) and notify FAC-12 pharmacy lead of arrival window

Update Pharmacy Board stock-position return for the next reporting cycle

p=0.74 of stockout within 5 days absent pre-order. Stockout would force substitution to Novomix at 38% higher unit cost and risk MoH chronic-disease KPI breach; estimated downside RM 720k (clinical risk, substitution premium, brand).

Lantus Days-on-Hand - Sabah (FAC-12)

Days-on-hand crossed below 5.0 critical floor


TNB peak (14:00-22:00) demand at KL Damansara HVAC chillers: 612 kW vs 540 kW off-peak

TNB ToU tariff differential: RM 0.52/kWh peak vs RM 0.29/kWh off-peak (Industrial E2 schedule)

FAC-03 pilot result (Q1 2026): RM 84k/month saved across 4 OT suites; ASHRAE 170 envelope compliant

OT environmental compliance: ISO Class 7 particulate counts within tolerance during ramp

Biomed sign-off: chiller short-cycle risk mitigated by 30-minute lockout in BMS logic

Deploy BMS schedule to OT suites 3-6 at KL Damansara (FAC-01); enable 02:00-04:00 pre-cool block

Run 14-day shadow-monitoring with biomed before locking schedule; report exceptions to Chief of Staff

Reconcile against TNB monthly invoice and Private Healthcare Facilities and Services Act energy register

p=0.68 of repeating last month's RM 280k peak-demand charge if no pre-cooling. Patient-comfort risk minimal given ASHRAE OT envelope tolerances; clinical risk negligible.

Peak-hour HVAC demand exceeded 600 kW threshold for 3rd consecutive day


3 manifest discrepancies and 1 late-pickup at FAC-04 (Subang) and FAC-09 (Melaka) in past 14 days; current vendor: SWM Environment-affiliated

PHFSA Schedule 6 compliance score: 0.71 (threshold 0.90) - below licensing renewal floor

MoH circular MOH/PHFSA/2025/09: enforcement focus on private clinical waste manifest accuracy in 2026

Contingency vendor capacity: Cenviro confirmed 1.8 t/day spare capacity in Klang Valley and Melaka corridor

PDPA mapping: patient-linked waste labelling remains compliant; no data-handling escalation needed

Issue 14-day cure notice to incumbent vendor with weekly KPI checkpoints

Qualify Cenviro and Tex Cycle as contingency vendors at FAC-04 and FAC-09 within 10 days

Brief MoH compliance liaison proactively; escalate to Group CEO if score does not return above 0.85 inside 21 days

p=0.62 of MoH inspection finding within 30 days based on historical patterns; consequence is up to 14-day suspension of clinical waste service at affected wards. Estimated downside RM 1.4M (operational disruption, regulator escalation, brand).

Compliance score breached 0.75 escalation trigger