Sprinklers Required in All Long-Term Care Facilities by 2013

The Centers for Medicare & Medicaid Services issued a final rule Wednesday that requires all U.S. long-term care facilities to be equipped with sprinkler systems by Aug. 13, 2013. The rule also requires them to maintain their automatic sprinkler systems once they are installed.

The rule stems from the Life Safety Code, an NFPA code whose 2000 edition CMS adopted five years ago. The 2000 edition required newly constructed buildings containing health care facilities to have automatic sprinklers installed throughout the building, but it did not require existing buildings to have sprinkler systems throughout if they met certain construction standards, ranging from the size of the buildings to the types of material used in their construction. If an existing building undergoes a major renovation, it must install them in the renovated sections only.

But this changed in the 2006 edition of the code, when NFPA decided to include a sprinkler system requirement for all long-term care facilities. "We support the NFPA in its decision. We decided to proceed with this rule, without proposing adoption of the NFPA 2006 edition of the LSC, because we want to avoid further delay in requiring an automatic sprinkler system in long term care facilities," CMS said in yesterday’s final rule, which mentions a Government Accountability Office report ("Nursing Home Fire Safety: Recent Fires Highlight Weaknesses in Federal Standards and Oversight," GAO-04-660, July 16, 2004, http://www.gao.gov/new.items/d04660.pdf) that examined the 2003 long-term care facility fires in Hartford and Nashville that killed 31 residents.

That report recommended stronger fire safety standards for unsprinklered facilities. As an interim step, CMS in 2006 began requiring long-term care facilities, at minimum, to install battery-operated smoke detectors in residents’ sleeping rooms and public areas unless they had a hard-wired smoke detector system in resident rooms and public areas or a sprinkler system installed throughout the facility.

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