CMS has announced a proposed rule updating Medicare/Medicaid fire safety standards. In particular, CMS proposes to adopt the National Fire Protection Association's (NFPA) 2012 edition of the Life Safety Code (LSC) and the Health Care Facilities Code (HCFC), with some modifications, including changes in the areas of emergency preparedness requirements, for which CMS recently announced a proposed rule. CMS also redefined "health care occupancy" to eliminate exceptions for small facilities. The LSC sets out fire safety requirements for new and existing buildings. Currently, CMS applies the 2000 edition of the LSC to facilities to ensure the health and safety of all patients, family and staff in every provider and supplier setting. The 2012 edition of the LSC, however, is more aligned with current state building codes and accreditation standards for Medicare- and Medicaid-participating facilities. HCFC contains more detailed provisions specific to healthcare and ambulatory care facilities.
The proposed rule affects hospitals, critical access hospitals, long-term care facilities, intermediate care facilities for individuals with intellectual disabilities, ambulatory surgery centers, religious nonmedical healthcare institutions, Programs of All Inclusive Care for the Elderly and inpatient hospice facilities. For example, one change affecting all facilities is that both aerosol and nonaerosol alcohol-based hand rub dispensers may be installed under certain conditions. Another important change mostly affecting hospitals is that high-rise buildings over 75 feet must be fully sprinklered within 12 years.
Notwithstanding a lower standard in the 2012 edition of LSC, under CMS's adoption, most affected facilities would be required to implement a fire watch (the assignment of individuals to monitor an area for the express purpose of signaling for emergencies) or a building evacuation if a sprinkler system is out of service for more than four hours. Additionally, facilities with windowless anesthetizing locations will need to install smoke control systems.
CMS plans to continue the current waiver process for specific LSC requirements for facilities that can show that such a waiver would not adversely affect patient and staff health and safety and that the specific requirement from which a waiver is sought would impose an unreasonable hardship on the facility.
CMS currently is soliciting comments for recommendations and changes or amendments from the public. Final comments are due to CMS by June 16, 2014. This schedule suggests that CMS likely will adopt the 2012 edition of the LSC to be effective sometime after April 2015, as CMS will need a significant period of time to review and address the public comments it receives.
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