On May 4, 2016, CMS is publishing a final rule amending fire safety standards applicable to the following types of Medicare- and Medicaid-participating health care facilities: hospitals, critical access hospitals, long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IIDs), ambulatory surgery centers (ASCs), hospices that provide inpatient services, religious nonmedical health care institutions, and programs of all-inclusive care for the elderly facilities. As part of this significant update to the current standards, CMS is adopting the National Fire Protection Association’s (NFPA) 2012 edition of the Life Safety Code (LSC) and provisions of the 2012 edition of the NFPA Health Care Facilities Code. In addition to promoting patient safety and health, CMS contends that “adopting the 2012 LSC would simplify and modernize the construction and renovation process for affected health care providers and suppliers, reduce compliance-related burdens, and allow for more resources to be used for patient care.” Nevertheless, CMS estimates that the rule will cost $95 million over 12 years, with $18 million in costs during the first year of implementation, $12 million annually for years 2 and 3 of implementation, and $6 million annually for years 4-12. The greatest costs are associated with a requirement that high-rise buildings containing health care occupancies to be protected by automatic sprinkler systems; facilities that are not already required to do so will have 12 years from publication to comply with this requirement.

The rule addresses numerous other fire/health safety requirements, including the following:

  • Health care facilities must have a fire watch or building evacuation when a sprinkler system is out of service for more than 10 hours.
  • Roller latches are prohibited on corridor doors and doors to rooms containing flammable or combustible materials.
  • For ASCs, all doors to hazardous areas must be self-closing or must close automatically.
  • ICF-IIDs are subject to expanded sprinkler and heat detection requirements, and their hazardous areas must be separated by smoke partitions.
  • Facilities will be allowed to place fixed furniture in the corridors, although the placement of furniture or equipment must not obstruct accessible routes required by the Americans with Disabilities Act.
  • LTC facilities will be permitted to have fireplaces meeting certain standards.

The rule generally is effective July 5, 2016, although certain provisions have a delayed effective date.