Planning for the Adoption of NFPA 101 - 2012

Chad E. Beebe, AIA, SASHE

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• With more than 11,000 members, ASHE is the largest association devoted to optimizing the health care physical environment. As a trusted industry resource, ASHE is committed to our members, the facilities they build and maintain, and the patients they serve.

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Adoption of NFPA 101 - 2012

• Then:

o Why NFPA 101?

• Now:

o What is ASHE working on?

• Future:

o Changes to expect with adoption of the 2012

“THEN” CMS History

1920s to early 1940s

1940s

• Pre WWII – “nursing type care” long hospital stays

1940s

• War was won with “Industrial Might”

o Lots of jobs

o Wage Control

o Benefits added

• Employer provided Healthcare

1945

• Hill-Burton Act

• The need to develop Americas Infrastructure

1960s

1980s

201?

National Building Code (BOCA)

Uniform Building Code (ICBO)

Standard Building Code (SBCCI)

101 Life Safety Code (NFPA)

1909 1997 2013 1960 1940 1945 1980

0

20

40

60

80

100

120 Admits (millions)

Hospitals (thousands)

Beds (millions)

“NOW” What ASHE is working on:

Unified Code

“The way to better, more realistic codes and standards for healthcare facilities is through collaboration and cooperation”

“THE FUTURE” What to Expect:

When will CMS adopt the 2012?

• Notice of intended rulemaking posted

• Could take 12-18 months once started

• CMS has evaluated the 2012 edition

o Received support from AHA/ASHE

o Received support from TJC

• The adoption date is….. ?????

Survey and Certification Letters

• CMS Memo’s to State Agencies

• Revisions to State Operations Manual

S&C 13-58

• Issued August 30th, 2013

• Covers several “categorical waivers”

Medical Gas Master Alarms

• Allows substitution of a centralized computer system for one Category 1 medical gas master alarm.

Openings in Exit Enclosures

• Permits existing openings in exit enclosures to mechanical equipment spaces if they are protected by fire-rated door assemblies.

Emergency Generators and Standby Power Systems

• Reduces the annual diesel-powered generator exercising requirement from two (2) continuous hours to one hour and 30 minutes.

Doors

• Allows more than one delayed-egress lock in the egress path where the clinical needs require specialized security measures or when a patient requires specialized protective measures for safety.

Suites

(1) one of the required means of egress from sleeping and non-sleeping suites allowed to be through another suite

(2) an increase in sleeping room suite size up to 10,000 ft2.

Extinguishing Requirements

• Reduction in the testing frequencies for sprinkler system vane-type and pressure switch type waterflow alarm devices to semiannual, and electric motor-driven pump assemblies to monthly.

Clean Waste & Patient Record Recycling Containers

• Allows the increase in size of containers used solely for recycling clean waste or for patient records awaiting destruction outside of a hazardous storage area to be a maximum of 96-gallons

S&C 12-21

• Corridor Width

• New “Effective” Corridor width

– Fixed furniture allowed

– Rolling carts, equipment and movement aids allowed

Bench c.c.

5’-

0”

8’-

0”

6’-

0”

Decorations

• Increases the amount of wall space that may be covered by combustible decorations

o 20% Not Sprinklered

o 30% Sprinklered

o 50% Sprinklered in patient room (less than 4)

Kitchens

Allows certain types of alternative type kitchen cooking arrangements including kitchens, serving less than 30 residents, to be open to corridors as long as they are contained within smoke compartments

Fireplaces

• Allows the installation of direct vent gas fireplaces in smoke compartments containing patient sleeping rooms and the installation of

• solid fuel burning fireplaces in areas other than patient sleeping areas

S&C 13-25

• OR Relative Humidity

• lowering the humidity requirement for operating rooms and other anesthetizing locations from at least 35percent to at least 20 percent.

How to request a categorical waiver

• Document your desire and that you comply with the waiver provisions in your policy and procedures manual.

• Verbally announce that you are requesting the waivers at each entrance interview

• Check with your State Agency and verify the waivers will be accepted for licensing

Other Changes…

Other Changes…

• 18.1.3.4.1*. (2012) Patients who are “litterborne” were changed to “incapable of self-preservation” because the term “litterborne” was not defined in the Code.

Other Changes…

• 18.1.1.4.3.1. (2003) New text establishes threshold for major and minor rehabilitation for determination of when a smoke compartment needs to be sprinklered as part of a rehabilitation.

o Major = 50 percent, or more than 4500 ft2

o Minor = not more than 50 percent, and not more than 4500 ft2

Other Changes…

• Provisions on door locking expanded to include locking for specialized protective measures for patient safety (e.g., infant abduction concerns); delayed egress locking provision revised to remove former limitation of one such device per egress path

Other Changes…

18.2.5.7.2.4 Provisions concerning intervening rooms are deleted and replaced with maximum travel distance requirements.

Other Changes…

• NFPA 110 Now allows use of maintenance free batteries in lieu of checking fluid levels and specific gravity

Other Changes…

• Doors can be disguised

NFPA 101 Changes Still to Come…

Smoke Compartments

2000

• Size = AC 22,500 Square Feet

• Size = NH 22,500 Square Feet

2015

• Size = AC 40,000 Square Feet

• Size = NH 22,500 Square Feet

Corridor Projections

• Corridor Projections = 6” • Corridor Projection = 4” ?

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