A Checklist-Based Framework for Assessing the Functional Conversion Potential of Existing Buildings for Healthcare Uses

The COVID-19 pandemic exposed structural and organizational vulnerabilities in healthcare systems, highlighting the urgent need to strengthen community-based care provision. In Italy, Mission 6 of the National Recovery and Resilience Plan (NRRP) promotes the development of Community Health Facilities (CHFs), where the adaptive reuse of existing buildings represents a strategic yet technically complex solution. However, such interventions are often undertaken in the absence of integrated and operational evaluation frameworks specifically tailored to this context. This study proposes a checklist-based decision-support framework for the ex-ante assessment of the suitability of existing buildings for conversion into low-complexity healthcare facilities. The model is developed through the systematic integration of scientific literature, regulatory requirements, and technical standards, ensuring both methodological consistency and practical applicability. It is structured as a hierarchical multicriteria system focused on the intrinsic building characteristics, encompassing key dimensions including building flexibility, state of conservation and maintenance, environmental safety, accessibility, fire safety compliance, and energy performance. Each criterion is operationalized through discrete scoring scales grounded in applicable technical standards and regulatory references, enabling standardized, transparent, and comparable evaluations. The proposed framework supports the identification of critical constraints and enhances the consistency, replicability, and robustness of public decision-making processes in the context of healthcare infrastructure planning.