By August 13, 2013, nursing homes must have automatic fire sprinklers as a precondition of participating in the Medicare/Medicaid reimbursement program. But the road to this regulation has been a long time coming, says an article in NFPA Journal.
There has never been a fire in a sprinklered healthcare facility in the United States that resulted in multiple deaths, according to the article. But as sprinklers were not uniformly required, multiple fire-related deaths in this type of occupancy were not an unusual occurrence.
As recently as 2003, 16 residents died as a result of a fire in a nursing home that was started by a patient setting her bed alight. Unlike previous nursing home fires, the Greenwood Health Center in Hartford, Conn. had many passive fire protection technologies in place — fire-resistant gypsum wall boards, smoke barriers dividing the facility into 11 compartments, properly maintained smoke detectors, portable fire extinguishers throughout — but no complete-coverage sprinkler system. These were also missing at another facility, the NHC Healthcare Center in Nashville, Tenn., where 15 died in a fire that same year.
These two incidents proved to be a last straw for the nursing home industry, which on average suffered 15.8 deaths per year in multiple-death nursing home fires between 1966 and 1975. From 2002 to 2011, that figure dropped to 3.1 deaths per year driven by code requirements and government regulation, in particular the national adoption of NFPA 101 - Life Safety Code by nursing homes in 1970, according to the article.
In 2004, the Government Accountability Office issued a study that recommended the Centers for Medicare & Medicaid Services (CMS) make nursing home sprinkler systems a requirement. The National Fire Protection Association had similar language already under consideration for the Life Safety Code. The nursing home industry then decided to request language for mandatory sprinklers in all existing nursing homes, which CMS granted in a final ruling in 2008.
Having automatic fire sprinkler systems allows nursing home facilities certain design liberties, such as providing baby boomers more home-like amenities that carry a greater fire risk or providing hand sanitizer dispensers in hallways, a previously verboten Class A flammable liquid.
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