Healthcare Construction Certificate - Level 1

Building Codes & Standards for

Healthcare

Healthcare Construction Certificate - Level 1

Building Codes and Standards

• Codes• Defend-in-Place

• Walls• Sprinklers• Fire Alarm

Healthcare Construction Certificate - Level 1

Important Dates for Healthcare Facilities

• 2012 Edition NFPA Life Safety Code 101• CMS enforcement date: 11/1/16• TJC enforcement date: 11/7/16• DHS enforcement: 10/1/17

• 2015 ICC codes ( IBC, IEBC, IMC, IECC ) • 2014 FGI Guidelines - Ventilation only• Wisconsin enforcement: 5/1/18

Healthcare Construction Certificate - Level 1

Building Codes for Healthcare

2012 NFPA 101 Major Changes:• Cooking Open to the Corridor• Gas Fireplaces in sleeping compartments• Fixed Furniture in 8’ Corridor• Combustible Decoration options• Relative Humidity in OR’s

Healthcare Construction Certificate - Level 1

New Referenced Codes and StandardsCategorical Waivers based on partial

use of 2012 LSC NO longer applicable

-2012

-2010

-2009

-2011

-2010

-2012

-2010

-2010

-2011

-2010

-2012

-2011Chapter 43

Building Renovations

(Risk-Based, Elec, Med Gas, Ventilation, Equip)

-2012 HEALTH CARE CODE

2012 LSC

Healthcare Construction Certificate - Level 1

National Fire Protection Association - NFPA

2012 NFPA 99 Health Care Facilities Code• Chap 4 Risk Assessments• Chap 5 / 11 Medical Gas Systems and Equipment• Chap 6 / 10 Electrical Systems and Equipment• Chap 9 Heating, Ventilation, and Air (HVAC)• Chap 14 Hyperbaric Facilities• Chap 15 Features of Fire Protection

Healthcare Construction Certificate - Level 1

Unique Building Features in Healthcare

• Healthcare –Compartmentalization creates the ability to defend in place

Healthcare Construction Certificate - Level 1

Unique Building Features in Healthcare

• Electrical distribution systems

• Multiple “Transfer Switches”

• Isolated power systems with line isolation monitors or protect for wet locations in OR’s or GFI’s

• Life Safety Circuits for life support systems

• Diesel Generator Back-up

Healthcare Construction Certificate - Level 1

Unique Building Features in Healthcare

• Medical Gas systems

• Life safety to patients

• Labeling

• Clean

Healthcare Construction Certificate - Level 1

Unique Building Features in Healthcare

• Ventilation

• Smoke control

• Pressurization

• Filtration

Healthcare Construction Certificate - Level 1

Unique Building Features in Healthcare

• Sprinklers

• Fire protection system

• Active system

• Testing

Healthcare Construction Certificate - Level 1

Conflicts Exist in Code Adoptions Most Restrictive Applies

• Codes are not always in alignment

• NFPA sometimes conflicts with ICC

• State can Adopt a more stringent rule

• Most restrictive rule or code applies

• “The Difficulty” – plans cannot always clearly indicate what code standards are being applied to the existing construction

Healthcare Construction Certificate - Level 1

Healthcare Construction Certificate - Level 1

Healthcare Construction Certificate - Level 1

DHS Plan Review Applications

Healthcare Construction Certificate - Level 1

State Level

• DSPS – Department of Safety and Professional Services• Building and Structures Plan Review

• ICC – International Code Council – IBC, Energy, Fuel Gas, Existing Building Code, and Mechanical Code

• State Plumbing, Elevator, Pressure Vessels (Boilers & Hyperbaric).

• SPS 316 – Electrical – NFPA 70

• SPS 314 – State Fire Prevention – NFPA 1

• SPS 364 adopts FGI Design Guidelines (ventilation)

Healthcare Construction Certificate - Level 1

OSHA and DNR - Asbestos

• OSHA and DNR – Asbestos

• OSHA – 1910.1001(J)(2)i) Building & facility owners shall determine the presence, location and quantity of ACM and/or PACM at work site

• NR 447 – Pre-inspection is required prior to ANY demolition or renovation– Demolition: Wrecking or taking out of any load supporting structural member

– Renovation: Altering a facility or one or more facility components in any way

Healthcare Construction Certificate - Level 1

OSHA and DNR - Asbestos

• Identify friable and non-friable materials

– Obvious loose or crumbling ACM or suspect ACM

– Floor coverings and/or mastics

• DNR “FAQ’s” @ http://http://dnr.wi.gov/topic/Demo/AsbestosFAQ.html– The age of a building does not matter

– ACM are still made and available.

– Re-use of materials also increases the possibility that asbestos containing materials may be in a newer buildings.

– Remember multiple regulators DNR, DHS, OSHA, EPA, and local AHJs E.G. Milwaukee

• Thanks to Bill Best for this info

Healthcare Construction Certificate - Level 1

OSHA Silica Rule

Healthcare Construction Certificate - Level 1

Design Standards FGI Guidelines

• Facilities Guidelines Institutes (FGI):• Design and Construction of Health Care• State of Wisconsin: 2014 FGI Edition in SPS 364• The Joint Commission : 2014 FGI Edition

– 2013 Edition ASHRAE 170 Standard– HVAC provisions adoption by DSPS in 2018– Infection Control Risk Mitigation– Ventilation of Construction Zone

Healthcare Construction Certificate - Level 1

FGI Ventilation Table (Partial)

Healthcare Construction Certificate - Level 1

Assisted Living Facilities

• State of Wisconsin:– CBRF Community-Based Residential Facility

• DHS 83

– RCAC Residential Care Apartments Complex• DHS 89

– AFH Adult Family Homes• DHS 88

– Small CBRF’s (5-8 bed) per WCBC Code to UDC “Uniform Dwelling Code”

Healthcare Construction Certificate - Level 1

The Joint Commission Certification

• Management Plans:– Environment of Care

Environmental Safety, Security, Hazardous Materials and Waste, Fire Safety Medical Equipment Management, Utilities Systems

– CMS Validation Surveys by DHS

– Hospitals and Nursing Homes

Healthcare Construction Certificate - Level 1

Defend-in-Place Principle

• Smoke compartment walls and doors to provide measures of safety– Divide building into zones

• Zones provide evacuation options

• Horizontal evacuations (preferred)

• Vertical evacuation if necessary

• Building evacuation only if necessary

Healthcare Construction Certificate - Level 1

Life Safety Principles

• Save all patients and staff

• Control spread of fire

• Maybe extinguish fire at origin

• RACE: (Some Fire Departments like “ACER”)

• R – Rescue from room of origin

• A – Activate alarm system

• C – Contain the fire (close the door – positive latch)

• E – Evacuate or Extinguish (if possible)

Healthcare Construction Certificate - Level 1

Fire Safety Technology

• Sprinkler design– Standard sprinkler heads until 1990’s have RTI: 80

– Quick response sprinkler heads have RTI: 50

• Life savings and control of fire spread:– New sprinkler heads have changed the Life Safety Code parameters

and philosophy

– QR’s – defined new wall type – Smoke Resistant “Smoke-Tight” walls

• Formerly all walls rated like “Fire Barriers”

• Smoke Resistant walls require quality Maintenance

Healthcare Construction Certificate - Level 1

Fire Safety Technology

• Full Building Sprinkler Credits– Construction Type

– Travel Distance

– Delayed Egress Locking

– Hazardous Room Enclosures

– Corridor Walls and Doors

– Smoke Dampers

– Window Sizes

Healthcare Construction Certificate - Level 1

Life Safety Plan

Healthcare Construction Certificate - Level 1

Walls Provide Time

• Critical Areas e.g.:– Operating Rooms

– Nurseries – NICU’s

– ICU’s

– CCU’s

– Psychiatric Units

– Emergency Dept.

Healthcare Construction Certificate - Level 1

Wall Types: Sound Smoke Tight or Fire Rated

• Fire Walls

• Fire Barriers

• Smoke Barriers

• Shaft Enclosures

• Smoke-Tight Walls – Smoke Protection Only– Sound Walls for FGI Requires Sound Privacy Acoustics

– Rated Walls have a FRR-Fire Resistive Rating

– Smoke Tight Walls have a Zero-”0” Rating but must be tight fitting CMS has a “Gap Memo”

– Conflict with NFPA 101 and IBC regarding smoke tight ceilings

Healthcare Construction Certificate - Level 1

Walls – Functional Uses• Building Separations – Fire Walls

• Occupancy Separations – Fire Barriers

• Hazardous Areas Separations – Fire Barriers

• Vertical Separations: Shafts – Stairs / Equipment

• “Smoke / Fire” Barrier Compartments

• Corridor Walls – “Smoke Tight” or “Fire Partitions”

• Horizontal Exits – “Used in the place of Stairs” for Exit Distance Compliance

• Stair Extensions – Exit Passageways – “Horizontal Tunnel or Shaft”

Healthcare Construction Certificate - Level 1

Smoke Zones

• Smoke Barrier compartment or Smoke Zones– 1-Hour Fire Barrier Wall

– Wall Floor to Deck

– Exterior to Exterior

– Doors 20 minute – Must self close. No Latching Required – but allowed

– Higher Ratings Than 1-Hour Will Require Additional Hardware

Healthcare Construction Certificate - Level 1

Room Separation – “Smoke Tight Walls Only”• Approved Automatic Sprinkler

System (AASS) – Philosophical Change:– Fire Barrier Separation

– Evacuation Critical

• QR – Residential Heads Sprinkler Protection– Sprinklers Heads As Life Saving Devices

– Glass Allowed but Smoke Tight Walls?

– Reduction in Barriers and Dampers Use

Healthcare Construction Certificate - Level 1

Building Separations – Fire Barriers

Healthcare Construction Certificate - Level 1

Fire Barriers & Door Assemblies

• Hazardous Areas:– Soiled utility rooms

– Store & supply rooms – size critical on design

– Equipment Rooms

– Oxygen storage rooms

– Mechanical & boiler rooms

– Trash & chute rooms

– Maintenance shops

– Paint shops

Healthcare Construction Certificate - Level 1

Floors-Shafts-Smoke Containment

• Mechanical Rooms & Shaft Design

• Vertical Sections of Hospitals– Floor to Floor Separation

– Shaft to Floor

– Floor Penetrations

Healthcare Construction Certificate - Level 1

Open Stairs & Shaft Walls

• Connecting Floor Levels: – Stairs

– Ventilation Shafts

– Pipe Shafts

– Electrical Shafts

– Lobbies-Atriums

– Open Stair Exceptions

– Smoke Control

Healthcare Construction Certificate - Level 1

Smoke Barrier Doors & Walls

Healthcare Construction Certificate - Level 1

Smoke Barrier Compartment Zones

• Define Areas of Refuge w/ Horizontal Evacuation

• Options to Total Evac.– RACE Terminology

• Rescue

• Alarm

• Control

• Evacuate or Extinguish

Healthcare Construction Certificate - Level 1

Security Doors – Special Locking or Access Control

Healthcare Construction Certificate - Level 1

Questions ?