Certification Standards Are Being Established for Health Clubs

Check around your club. Do you know where your AED is? Is there appropriate signage for emergency exits and fire extinguishers? Do you have an appropriate emergency response policy in place?

Now check your staff's professional background, especially personal trainers and fitness instructors. Do they have three or more years' experience? Do they have proper certification? How about your members? Have they filled out a health history questionnaire? If not, have they signed a waiver?

Chances are, most club operators already can answer “yes” to these questions. However, club operators who cannot answer “yes” to all these questions may need to make some changes to their operating procedures if the club certification standards being developed are passed and become common in the industry.

Currently, the club industry is in the process of creating a standard for a voluntary certification that some people see as crucial to establishing the legitimacy of the industry. The goal of the standard, some in the industry say, is to help make fitness clubs a more respected resource in the eyes of the public. Doctors would be more comfortable sending their patients to a certified health club for post rehabilitation or simply to lose weight, for example. The same comfort level would apply to insurance providers.

NSF International, Ann Arbor, MI, a not-for-profit, non-governmental organization, is coordinating the development of the standard that ensures balanced input from public health officials, consumer representatives and industry leaders. Others represented in the development of the standard include manufacturers, trade associations, regulators, program administrators, retailers and other stakeholders from the health and fitness community.

NSF Draft Standard 341: Health/Fitness Facilities is the official title of the certification standard. Health/fitness facilities are defined in the draft as commercial (for-profit), community (not for profit), corporate and clinical (medical fitness) facilities. The American College of Sports Medicine's (ACSM) Health/Fitness Facility Standards and Guidelines, Third Edition, was used as the basis for NSF Draft Standard 341. (For requirement categories, see the sidebar on page 36.)

The people on the joint committee who voted on the standard, which currently is in its 13th revision, represent a who's who of organizations in the industry. The International Health, Racquet and Sportsclub Association (IHRSA), the American Council on Exercise (ACE) and ACSM are just a few of the industry bodies who are helping to develop this standard.


IHRSA says its participation in the process is guided by five principles. Facility certification standards must be practical and should reflect current responsible industry practices, grow the health club industry by increasing consumer confidence in the safety of accredited facilities, attract positive attention from the medical community with an increase in the number of patient referrals to health clubs, and attract positive attention from employers, insurance companies and other potential third-party payers, according to IHRSA.

Thomas Richards, IHRSA's senior manager of public policy and a member of the joint committee, voted against the draft of the standard last fall.

“Generally, the draft did not align with our guiding principles,” Richards says. “We are still hopeful that a reasonable standard will be created that can be embraced by the industry.”

Others who voted against the standard, such as Geoff Dyer, founder of Lifestyle Family Fitness, St. Petersburg, FL, also are not necessarily against standards. They simply have issues with some of the language in the draft of the standard. Dyer says the ultimate objective of the standard is for clubs to operate in a safe manner.

“I think it's the right move for the industry to establish standards for clubs to abide by,” Dyer says. “Setting rules is easy. Getting clubs to abide by those rules is more of a challenge. We have a cottage industry, and you've got to take into account that a lot of the independent club owners need to be able to comply with the overall standards so it's fair for everyone.”

David Herbert, an Ohio attorney who has written extensively on negligence and risk management in the club industry, is a non-voting member of the committee. Herbert is against the current draft of the standard.

One of Herbert's main problems with the standard is the definition of acceptable accrediting organizations for personal trainer certifying companies. The NSF definition lists the National Commission of Certifying Agencies (NCCA) as the agency to provide third-party approval for certifying agencies. Herbert says the definition also should include the U.S. Department of Education and the Council for Higher Education Accreditation, both of which IHRSA included in addition to the NCCA in its recommendation about certification companies for personal trainers. IHRSA made recommendations similar to Herbert's in its comments to NSF regarding acceptable accrediting organizations for both personal trainers and fitness instructors.

“The industry has done an awful lot since 2005 to comply with IHRSA's recommendation,” Herbert says. “At this point, to take those five years and throw them out the window, when all of these organizations have gone through accreditation in one fashion or another, would be contrary to what IHRSA recommended a long time ago.”

Graham Melstrand, vice president of operations for ACE, voted for the standard. Melstrand says the standard could be beneficial not just for members but for the referring community — physical therapists, physicians and dieticians, to name a few.

This type of standard has been a goal of physical educators and exercise science professionals for at least 30 years, he says.

“There's a reason, I believe, that our participation and our influences in the industry are so low, and that's because no standard currently exists,” Melstrand says. “What we hear about and what makes the news are the worst practices, and those are the ones that people tend to focus in on.”

The purpose of the certification from a pragmatic standpoint, Melstrand says, is to enhance business and make the industry more attractive to a larger percentage of the population. The certification cannot be used solely as a marketing piece, Melstrand adds.

“We have to have substantive change to earn the confidence of the medical professionals,” he says. “One of the goals of this is to have a standard to say, ‘We've met this standard. We've met this certification. And that should give you some confidence in our people, in our staff, in our facility.’ If the bar isn't set at a reasonable level, there's really no point to it.”

Next Page: How Much Would it Cost?

Stephen Tharrett, president of Club Industry Consulting, Highland Village, TX, was a co-author of the ACSM standards. A member of the joint committee, Tharrett voted for the NSF standard.

“One of the things we try to clarify is the standard wasn't intended to create a duty of care for the entire industry,” Tharrett says. “It's not like the ACSM standards, which sort of were designed to be like an industry scope of standards. NSF was designed to be a standard that would lead to an accreditation for those clubs that wanted to.”

Art Curtis, CEO of Millennium Partners Sports Club Management, Boston, is not a voting member but has a keen interest in the standard's proceedings. Curtis, who was elected as president of the IHRSA board of directors last month, closely followed the voting process last fall on the NSF Web site.

Curtis supports the idea of facility certification but wonders how many in the industry will embrace the standard and be early adopters of facility certification.

“Is everybody going to do that? Absolutely not,” he says. “In the surveys that IHRSA did, there's probably 10 or 15 percent of the respondents that just don't want anybody in any way, shape or form telling them what to do and how to run their business and setting any kind of standards. That's probably not going to change.”


Most full-service clubs would not incur any unusual expenses to comply with the standard, Dyer says. The cost to add an automatic external defibrillator (AED), which is something required in the draft of the standard, would be about $900 plus the cost of having someone trained to use an AED while on duty. Many clubs already require their trainers and group exercise staff to be CPR certified, Dyer says, so putting them through AED training would not be a huge burden to the clubs.

Melstrand also says higher costs won't result from the standard.

“It might require the development of some systems that have some upfront costs, but I think if they did a very careful analysis of their business, they're probably already equipped to implement most of these things the way they exist right now,” Melstrand says, referring to the standards for the education and credentialing of staff.

The costs for a club to adhere to the principles of the standard would vary according to the size of the club, its amenities and its staff size. Once the standard is adopted, NSF says it will be one of the certification organizations that will certify clubs to the standard.

Tharrett says the cost not to comply with the standard would be greater in the long run than the costs to comply.

“If physicians started referring people to facilities [that were certified], then the operators that hadn't got that accreditation would definitely be at a disadvantage in the marketplace for that particular segment,” Tharrett says.

Ken Reinig, senior vice president of Association Insurance Group, Lakewood, CO, says clubs that do not adhere to the standard might be charged higher rates than certified clubs.

“It poses some liability issues for those health clubs that have chosen not to go through the steps of certification because it clearly sends a message that they were not interested in the protocols for safety, the environment in their facility, checking on their staff, etc.,” Reinig says.

The insurance industry, Reinig adds, may be slow to respond but would eventually take a position that if clubs are not certified, then they may not get coverage from insurance companies.


Last October, in an official ballot, the committee voted 10-9 in favor of the standard. The standard is scheduled for a second public commenting period sometime this spring, according to NSF. At that time, industry professionals once again can voice their opinion about the draft standard and offer suggestions for additions and subtractions.

The main question the industry has to ask itself, Melstrand says, is what impact could a standard have on the industry's future?

“If we're good enough and we're happy with the 13 percent of the population that are members of facilities, if we want to continue to recycle the same individuals who are already active and embrace physical activity, then we're probably fine the way we are,” Melstrand says. “If we want a significant portion of the population, if we want the referral from the medical community, if we ever want to be considered for reimbursement, then we have to behave as a mature and professional industry.”

Next Page: Sidebar: Requirements for Certification


NSF International's Draft Standard 341 outlines several categories of requirements that a club would need to adhere to in order to be recognized as a certified facility. Those categories are:

• Pre-activity screening for new members and prospective users
• Orientation, education and supervision of new members and prospective users
• Risk management and emergency policy standards
• Criteria for professional staff and independent contractors
• Compliance with federal and local regulations
• Facility operating practices
• Signage


One of the provisions of NSF Draft Standard 341 is an emergency response policy that states an on-site coordinator, or at least a staff member who is responsible for a facility's level of emergency readiness, should be in the club and able to assist in an emergency.

That policy would not fit with key-card clubs, such as Anytime Fitness, Hastings, MN, and Snap Fitness, Chanhassen, MN, whose model is based on being open 24 hours a day but having staff on site for just 40 hours a week. The current standard's definition of a staffed facility requires one or more persons to be on duty during operating hours.

Mark Daly, spokesperson for Anytime Fitness, says the company is working with Art Curtis, CEO of Millennium Partners Sports Club Management and president of the IHRSA board of directors, to draft a version of the standard that would apply to key-card, partially-staffed clubs.

“It's my understanding that they're going to work hard to accommodate us and in fact create a second set of standards if a first set of standards is adopted,” Daly says.

If a version of the NSF standard that relates specifically to key-card clubs passes, Daly says Anytime Fitness would use that standard in its marketing.

“We're an IHRSA-member club, and we use that as a selling point,” Daly says. “If we were an NSF-certified club as well, that is something we would promote.”

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