The Centers for Medicare and Medicaid Services (CMS) recently published a final rule updating fire safety requirements for healthcare facilities in an effort to increase patient safety and adapt to the needs of an aging population. The new rule adopts provisions of the National Fire Protection Association’s (NFPA) 2012 edition of the Life Safety Code (LSC), as well as provisions of the NFPA’s 2012 edition of the Health Care Facilities Code (HCFC). The 2012 edition of the LSC is more aligned with current state building codes and accreditation standards for Medicare- and Medicaid-participating facilities while the HCFC contains detailed provisions specific to healthcare and ambulatory care facilities.

Facilities affected by this rule include critical access hospitals; long-term care (LTC) facilities; inpatient hospice facilities; programs for all-inclusive care for the elderly; religious non-medical healthcare institutions; ambulatory surgical centers (ASCs); and intermediate care facilities for individuals with intellectual disabilities (ICF-IIDs). The rule includes changes to construction, protection and operational issues affecting safety from fire, smoke and panic that include the following:

  • Healthcare facilities located in buildings taller than 75 feet are required to install automatic sprinkler systems by July 5, 2028.
  • Healthcare facilities must also have a fire watch or building evacuation if their sprinkler system is out of service for more than 10 hours.
  • LTC facilities will be able to place fixed-seating in their corridors and place certain decorations in patient rooms, such as hanging pictures. Fireplaces in smoke compartments will be permitted without a one-hour fire wall rating.
  • Inpatient facility kitchen and/or cooking areas now may have an entrance from the hallway so that residents are able to make themselves a meal or snack.
  • All ASCs’ doors to hazardous areas must be self-closing or must close automatically and alcohol-based hand rub dispensers may be placed in corridors to allow for easier access.
  • Roller latches will be prohibited in existing and new healthcare occupancies (defined as a facility having four or more patients on an inpatient basis) for corridor doors and doors to rooms containing flammable or combustible materials. Such doors will be required to have positive latching devices instead.
  • ICF-IIDs must have expanded sprinkler requirements to include habitable areas, closets, roofed porches, balconies and decks in new facilities. Heat-detection systems must be installed in attics that are not used for living purposes and sprinklers installed in attics that are used for living purposes, including storage and fuel-fired equipment.

CMS may choose not to enforce provisions of the final rule if state fire and safety codes provide equal protection or are deemed stricter, or the agency may grant waivers if the application of a provision would impose an unreasonable hardship on the facility. The effective date of the final rule is July 5, 2016, unless a specific provision states otherwise.