1. Call to order. Call meeting to order by Chair David Klein at 8:00 a.m. on August 26, 2015 at the InterContinental Milwaukee Hotel, Milwaukee, WI.

Transcription

1 AGENDA NFPA Technical Committee on Health Care Occupancies NFPA 101 and NFPA 5000 First Draft Meeting Wednesday-Thursday, August 26-27, 2015 InterContinental Milwaukee Milwaukee, WI 1. Call to order. Call meeting to order by Chair David Klein at 8:00 a.m. on August 26, 2015 at the InterContinental Milwaukee Hotel, Milwaukee, WI. 2. Introduction of committee members and guests. For a current committee roster, see page Approval of June 26-27, 2013 second draft meeting minutes. See page The process staff PowerPoint presentation. See page Correlating committee minutes with direction for 2018 editions. See page Core chapters, first revisions of interest staff review. 7. FPRF egress modeling. Smoke compartment size report. See page 35. Journal in-compliance column. See page 64. Additional work. See page FPRF AHC occupant load factor. Report foreign. See page 67. Report domestic. See page Australian nursing home fire report link. See page Corridor projections. See page Corridor ceilings. Wall termination 1 of 2. See page 124. Wall termination 2 of 2. See page Health care occupancy changed to ambulatory health care. See page Missing corridor door latch. See page 140. Page 1 of 316

2 14. Monitoring exterior valves. See page NFPA 101 First Draft preparation. For Public Input, see page NFPA 5000 First Draft preparation. For Public Input, see page Other business. 18. Future meetings. 19. Adjournment. Enclosures Page 2 of 316

3 Address List No Phone Health Care Occupancies Safety to Life David P. Klein Chair US Department of Veterans Affairs 810 Vermont Avenue, NW, Suite 800 Mail Code: (10NA8) Washington, DC Alternate: Peter A. Larrimer U 11/2/2006 SAF-HEA Ron Coté Secretary (Staff-Nonvoting) National Fire Protection Association 1 Batterymarch Park Quincy, MA /14/2015 Ron Coté SAF-HEA 1/1/1991 SAF-HEA Kenneth E. Bush Principal Maryland State Fire Marshals Office 301 Bay Street, Lower Level Easton, MD International Fire Marshals Association Alternate: Charles J. Giblin III E 1/1/1978 SAF-HEA Wayne G. Carson Principal Carson Associates, Inc. 35 Horner Street, Suite 120 Warrenton, VA Alternate: William E. Koffel SE 1/1/1988 SAF-HEA Michael A. Crowley Principal JENSEN HUGHES 8827 West Sam Houston Parkway Suite 150 Houston, TX Alternate: Eric R. Rosenbaum SE 1/1/1985 SAF-HEA Samuel S. Dannaway Principal S. S. Dannaway Associates, Inc. 501 Sumner Street, Suite 421 Honolulu, HI SE 1/16/2003 SAF-HEA Buddy Dewar Principal National Fire Sprinkler Association, Inc. 200 West College Avenue Tallahassee, FL Alternate: Eric Gleason M 10/23/2003 SAF-HEA Alice L. Epstein Principal CNA Insurance Ten Town Plaza, Suite 208 Durango, CO I 8/5/2009 SAF-HEA Martin J. Farraher Principal Siemens Industry, Inc Houston Road Rockford, IL Alternate: Peter W. Tately M 08/09/2012 SAF-HEA John E. Fishbeck Principal The Joint Commission One Renaissance Boulevard Oakbrook Terrace, IL Alternate: Anne M. Guglielmo E 4/1/1996 SAF-HEA Gary Furdell Principal State of Florida Agency for Healthcare Administration 4347 South Canal Circle North Fort Myers, FL E 8/5/2009 SAF-HEA Michael O. Gencarelli Principal US Department of the Navy NAVFAC HQ: Medical Facilities Design Office (MDFO) 1322 Patterson Avenue, Suite 1000 Washington, DC E 8/9/2011 SAF-HEA Page 3 of 316 1

4 Address List No Phone Health Care Occupancies Safety to Life Robert J. Harmeyer Principal MSKTD & Associates 930 North Meridian Street Indianapolis, IN American Institute of Architects Alternate: Bruce D. Brooks SE 10/20/2010 SAF-HEA Donald W. Harris Principal California Office of Health Planning & Development Facilities Development Division 400 R Street, Room 200 Sacramento, CA /14/2015 Ron Coté SAF-HEA E 7/12/2001 SAF-HEA David R. Hood Principal Russell Phillips & Associates, LLC 500 Cross Keys Office Park Fairport, NY NFPA Health Care Section Alternate: A. Richard Fasano U 4/14/2005 SAF-HEA Richard M. Horeis Principal HDR Architecture, Inc Indian Hills Drive Omaha, NE SE 10/20/2010 SAF-HEA Henry Kowalenko Principal Illinois Department of Public Health Office of Health Care Regulation 525 West Jefferson Street, 4th Floor Springfield, IL Alternate: Dennis L. Schmitt E 3/4/2009 SAF-HEA James Merrill II Principal US Department of Health & Human Services Centers for Medicare & Medicaid Services (CMS) 7500 Security Boulevard, M/S S Balitmore, MD US Dept. of Health & Human Services/CMS CMS Alternate: Kenneth Sun E 3/2/2010 SAF-HEA Daniel J. O'Connor Principal Aon Fire Protection Engineering 4 Overlook Point Lincolnshire, IL Alternate: Dale D. Wilson I 1/1/1991 SAF-HEA Ben Pethe Principal Health Care Consultant 3224 Fountain Boulevard Tampa, FL SE 10/20/2010 SAF-HEA G. Brian Prediger Principal US Army Medical Command Headquarters Director, Facilities Engineering Division 2748 Worth Road, Suite 22 Fort Sam Houston, TX Alternate: Philip J. Hoge U 7/24/1997 SAF-HEA John A. Rickard Principal P3 Consulting 5838 Balcones Drive, Suite B Austin, TX SE 8/2/2010 SAF-HEA Richard Jay Roberts Principal Honeywell Life Safety 624 Hammer Lane North Aurora, IL Automatic Fire Alarm Association, Inc. M 10/20/2010 SAF-HEA Terry Schultz Principal Code Consultants, Inc Woodland Parkway, Suite 300 St. Louis, MO Alternate: Michael Zakowski SE 7/23/2008 SAF-HEA Page 4 of 316 2

5 Address List No Phone Health Care Occupancies Safety to Life Geza Szakats Principal Arup North America Ltd. 560 Mission Street, 7th Floor San Francisco, CA Alternate: Matthew W. Davy SE 8/2/2010 SAF-HEA Michael D. Widdekind Principal Zurich Services Corporation Risk Engineering 112 Andrew Court Centreville, MD /14/2015 Ron Coté SAF-HEA I 1/14/2005 SAF-HEA Fred Worley E 03/05/2012 Principal SAF-HEA Texas Department of Aging & Disability Services Long Term Care Regulatory Division PO Box , Mail Code E-250 Austin, TX Chad E. Beebe Voting Alternate ASHE - AHA PO Box 5756 Lacey, WA American Society for Healthcare Engineering U 03/05/2012 SAF-HEA Bruce D. Brooks Alternate Odell 2700 East Cary Street Richmond, VA American Institute of Architects Principal: Robert J. Harmeyer SE 08/11/2014 SAF-HEA Matthew W. Davy Alternate Arup 955 Massachusetts Avenue, Suite 400 Cambridge, MA Principal: Geza Szakats SE 04/08/2015 SAF-HEA A. Richard Fasano Alternate Russell Phillips & Associates Inc Elk Grove Boulevard Bldg. 3, Suite 12-H Elk Grove, CA NFPA Health Care Section Principal: David R. Hood U 8/5/2009 SAF-HEA Charles J. Giblin III Alternate Maryland State Fire Marshal s Office 1201 Reisterstown Road Pikesville, MD International Fire Marshals Association Principal: Kenneth E. Bush E 03/07/2013 SAF-HEA Eric Gleason Alternate National Fire Sprinkler Association PO Box Littleton, CO National Fire Sprinkler Association Principal: Buddy Dewar M 08/11/2014 SAF-HEA Anne M. Guglielmo Alternate The Joint Commission Department of Engineering One Renaissance Boulevard Oakbrook Terrace, IL Principal: John E. Fishbeck E 10/23/2013 SAF-HEA Philip J. Hoge Alternate US Army Corps of Engineers Humphreys Engineer Center Kingman Building, Suite 3MX 7701 Telegraph Road Alexandria, VA Principal: G. Brian Prediger U 10/20/2010 SAF-HEA William E. Koffel Alternate Koffel Associates, Inc Centre Park Drive, Suite 200 Columbia, MD Principal: Wayne G. Carson SE 1/1/1991 SAF-HEA Page 5 of 316 3

6 Address List No Phone Health Care Occupancies Safety to Life Peter A. Larrimer Alternate US Department of Veterans Affairs 1805 Constitution Blvd Valencia, PA Principal: David P. Klein U 11/2/2006 SAF-HEA Eric R. Rosenbaum Alternate JENSEN HUGHES 3610 Commerce Drive, Suite 817 Baltimore, MD Principal: Michael A. Crowley 07/14/2015 Ron Coté SAF-HEA SE 03/07/2013 SAF-HEA Dennis L. Schmitt Alternate Illinois Department of Public Health 525 West Jefferson Springfield, IL Principal: Henry Kowalenko E 04/08/2015 SAF-HEA Kenneth Sun Alternate US Public Health Service Centers for Medicare & Medicaid Services (CMS) 1600 Broadway, Suite 700 Denver, CO US Dept. of Health & Human Services/CMS CMS Principal: James Merrill II E 3/2/2010 SAF-HEA Peter W. Tately Alternate Siemens Building Technologies 927 Nottingham Road Pottstown, PA Principal: Martin J. Farraher M 10/27/2009 SAF-HEA Dale D. Wilson Alternate Aon Fire Protection Engineering 400 Overlook Point Lincolnshire, IL Principal: Daniel J. O'Connor I 08/09/2012 SAF-HEA Michael Zakowski Alternate Code Consultants, Inc Woodland Parkway, Suite 300 St. Louis, MO Principal: Terry Schultz SE 07/29/2013 SAF-HEA Pichaya Chantranuwat Nonvoting Member Fusion Consultants Co. Ltd/Thailand 81/55 Soi Phumijit, Rama 4 Road Prakanong, Klontoey Bangkok, Thailand SE 1/18/2001 SAF-HEA David M. Sine U 1/1/1989 Nonvoting Member SAF-HEA National Center for Patient Safety 209 West Summit Ann Arbor, MI National Association of Psychiatric Health Systems Ron Coté Staff Liaison National Fire Protection Association 1 Batterymarch Park Quincy, MA /1/1991 SAF-HEA Page 6 of 316 4

7 Minutes NFPA Technical Committee on Health Care Occupancies NFPA 101 and NFPA 5000 Second Draft Meeting June 26-27, 2013 DoubleTree Hotel San Diego, California 1. Call to Order. The meeting was called to order by Chair David Klein at 8:00 a.m. on June 26, 2013 at the DoubleTree Hotel, San Diego, California. 2. Introduction of Committee Members and Guests. TECHNICAL COMMITTEE MEMBERS PRESENT NAME David Klein, Chair Ron Coté, Nonvoting Secretary Chad Beebe Alt. to D. Erickson Kenneth Bush, Principal Wayne Chip Carson, Principal Michael Crowley, Principal Samuel Dannaway, Principal Buddy Dewar, Principal Joshua Elvove Alt. to S. Dannaway Alice Epstein, Principal Douglas Erickson, Principal Martin Farraher, Principal COMPANY US Department of Veterans Affairs National Fire Protection Association American Society for Healthcare Engineering Maryland State Fire Marshal s Office Rep. International Fire Marshals Association Carson Associates, Inc. The RJA Group, Inc. S. S. Dannaway Associates, Inc. Rep. American Society of Safety Engineers National Fire Sprinkler Association, Inc. Self Rep. American Society of Safety Engineers CNA Insurance TME, Inc. Rep. American Society for Healthcare Engineering Siemens Industry, Inc. Rep. National Electrical Manufacturers Assn. BLD/SAF-HEA Second Draft Meeting Minutes Page 1 Page 7 of 316

8 A. Richard Fasano Alt. to D. Hood Russell Phillips & Associates, Inc. Rep. NFPA Health Care Section John Fishbeck, Principal The Joint Commission Gary Furdell, Principal State of Florida Agency for Healthcare Administration Robert Harmeyer, Principal MSKTD & Associates Donald Harris, Principal California Office of Health Planning and Development Philip Hoge US Army Corps of Engineers Alt. to G. Brian Prediger David Hood, Principal Russell Phillips & Associates, LLC Rep. NFPA Health Care Section Richard Horeis, Principal HDR Architecture, Inc. Robert Kleinheinz National Fire Sprinkler Association Alt. to B. Dewar William Koffel Koffel Associates, Inc. Alt. to W. Carson Henry Kowalenko, Principal Illinois Department of Public Health Peter Larrimer US Department of Veterans Affairs Alt. to D. Klein Daniel O Connor, Principal Aon Fire Protection Engineering G. Brian Prediger, Principal U. S. Army Medical Command Headquarters John Rickard, Principal Katus, LLC Richard Roberts, Principal Honeywell Life Safety Rep. Automatic Fire Alarm Association, Inc. Eric Rosenbaum, Principal Hughes Associates, Inc. Rep. American Health Care Association Terry Schultz, Principal Code Consultants, Inc. Saundra Stevens, Principal Adams County Regional Medical Center Geza Szakats, Principal Arup North America Ltd. Dale Wilson Aon Fire Protection Engineering Alt. to D. O Connor Fred Worley, Principal Texas Department of Aging & Disability Services GUESTS NAME Amy Carpenter Phil Jose Tracy Vecchiarelli COMPANY Ledhardt Rodgers Pioneeer Network P. R. Jose & Associates NFPA BLD/SAF-HEA Second Draft Meeting Minutes Page 2 Page 8 of 316

9 TECHNICAL COMMITTEE MEMBERS ABSENT NAME Michael Gencarelli, Principal James Merrill, Principal Ben Pethe, Principal Michael Widdekind, Principal COMPANY US Department of the Navy US Department of Health & Human Services Health Care Consultant Zurich Services Corporation 3. Approval of Previous Meeting Minutes. The August 15-17, 2012 meeting minutes were approved with one correction. Alternate Josh Elvove who attended the First Draft meeting as a guest and whose company affiliation was shown as GSA asked that it be noted that he attended as an individual and not as a representative of GSA. 4. The New Process. Staff used the PowerPoint slides included in the agenda to explain the Second Draft phase of the revision process. 5. Definitions Task Group. Mike Crowley volunteered to represent the committee on the Correlating Committee task group that will draft the assignment of defined terms to the various technical committees. In future revision cycles each committee will have responsibility for handling changes to the defined terms assigned to it. 6. Hazardous Materials Task Group. David Klein volunteered to represent the committee on the Correlating Committee s task group that will address hazardous materials within NFPA 101 and NFPA 5000 before working with other NFPA committees. 7. Home Health Care Study (and Misc. Items). The task group consisting of Ken Bush Chair, Pete Larrimer, and Saundra Stevens did not report. Eric Rosenbaum was added to the task group replacing Tom Jaeger. The subject was retained on the agenda. 8. Making Ambulatory Health Care Chapters Self-Standing. The task group consisting of Bill Koffel Chair, Mike Crowley, Philip Hoge and Brian Prediger reported on the second day of the meeting. Associated Second Revisions were developed. The task group was discharged. 9. NFPA 101 Second Draft (formerly ROC) Preparation. Public Comments were addressed and Second Revisions drafted. 10. NFPA 5000 Second Draft (formerly ROC) Preparation. Public Comments were addressed and Second Revisions drafted. 11. Other Business. Core Chapter Changes. Staff advised that none of the changes made to the core chapters at the Second Draft meetings in May required any correlative actions by the Health Care Occupancies Committee. Correlating Committee Notes. Correlating Committee Notes prepared on the First BLD/SAF-HEA Second Draft Meeting Minutes Page 3 Page 9 of 316

10 Draft, and which should have been entered as official Public Comments, were addressed. A Committee response was generated on each Note. The Responses will be published as part of the Second Draft Report. Relative to the occupant load factor for ambulatory health care uses, the committee requested that the Correlating Committees process Second Correlating Revisions to revise the factor in Table of NFPA 101 and Table of NFPA 5000 from 100 sq ft to 150 sq ft regardless of what the BLD/SAF-MER committee does with the occupant load factor for business uses. Committee Input or Trail Balloons. The Committee Inputs generated at the First Draft meeting, for purposes of raising an issue so that it might be further addressed in the Second Draft meeting, were reviewed. Phase-in Period for Sprinklers in Existing High-Rise Buildings. A Second Revision was developed to revise NFPA to continue the trend started with the 2012 edition so that there will be 6-, 9-, and 12-year phase-in periods. Reference Error. The committee was advised that there is a reference error in NFPA (3) where the reference should be to and not to The error might lead the user to believe that the requirement for sprinklers, as a condition for permitting locked doors for patient special needs, applies only to nursing homes. The intent is that all types of health care facilities must be sprinklered in order to use the locking provisions. By a unanimous vote of 22 to 0, the committee directed that a Tentative Interim Amendment be processed to correct the error. Fireplace Combustion Air. The committee confirmed that it is the intent of the provisions of NFPA / (2) that the requirements of NFPA 54 be followed relative to combustion air makeup. Corridor Encroachments and Cane Detection. Second Revisions were drafted to add annex text explaining that locations where corridor encroachments exceed those permitted by accessibility regulations might need to be provided with cane detection. Ambulatory Health Care Smoke Compartment Size. A task group was formed to address the subject of ambulatory health care smoke compartment size for the next revision cycle. The task group consists of Josh Elvove Chair, Chip Carson, Alice Epstein, John Fishbeck and Gary Furdell. The subject is retained on the agenda. Class I Flammable Liquids Stored Below Grade. The committee discussed that NFPA 30 is stricter than NFPA 45 on the subject of Class I flammable liquids stored below grade. It was agreed that NFPA 45 governs laboratories, but NFPA 30 governs flammable liquids storage even in a laboratory building. Next Revision Cycle. The committee agreed to meet in a 2 1/2-day meeting, tentatively scheduled for late 2015, to prepare its portion of the First Draft Report that will produce the 2018 editions of NFPA 101 and NFPA Adjournment. On Wednesday, June 26 the meeting was recessed at 4:40 p.m. to permit task groups to meet. On Thursday, June 27 the meeting was reconvened at 8:00 a.m. The meeting was adjourned at 12:35 p.m. Minutes prepared by Ron Coté and Linda McKay BLD/SAF-HEA Second Draft Meeting Minutes Page 4 Page 10 of 316

11 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA 101 / 5000 First Draft Meetings InterContinental Hotel Milwaukee, Wisconsin July and August 24-28, 2015 NFPA First Draft Meeting At this and all NFPA committee meetings we are concerned with your safety If the fire alarm sounds, please egress the building nfpa.org 2 Page 11 of 316 1

12 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Members Please verify/update your contact information on roster attached to sign-in list Members categorized in any interest category who have been retained to represent the interests of ANOTHER interest category (with respect to issues addressed by the TC) shall declare those interests to the committee and refrain from voting on those issues throughout the process nfpa.org 3 NFPA First Draft Meeting Guests All guests are required to sign in and identify their affiliations Participation is limited to TC members or those individuals who have previously requested time to address the committee Participation by other guests is permitted at the Chair s discretion nfpa.org 4 Page 12 of 316 2

13 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Members and Guests Use of audio recorders or other means capable of reproducing verbatim transcriptions of this meeting is not permitted nfpa.org 5 Annual 2017 Revision Cycle Key Dates Public Input Stage (First Draft): First Draft Meeting: July and August 24-28, 2015 Posting of First Draft for Balloting Date: before October 26, 2015 Posting of First Draft for Public Comment: March 7, 2016 Comment Stage (Second Draft): Public Comment Closing Date: May 16, 2016 Second Draft Meeting Period: TBD - June 1 to July 25, 2016 Posting of Second Draft for Balloting Date: September 5, 2016 Posting of Second Draft for NITMAM: January 16, 2017 Tech Session Preparation: NITMAM Closing Date: February 20, 2017 NITMAM / CAM Posting Date: April 17, 2017 NFPA Annual Meeting: June 4-7, 2017 (Boston) Standards Council Issuance: Issuance of Documents with CAM: August 10, 2017 nfpa.org 6 Page 13 of 316 3

14 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Voting During the First Draft Meeting Either Principal or Alternate can vote; not both All Principals are encouraged to have an Alternate Voting (simple majority) during meeting is used to establish a sense of agreement on First Revisions Voting (simple majority) during meeting is also used to establish Public Input resolution responses and to create Committee Inputs nfpa.org 7 NFPA First Draft Meeting General Procedures Follow Robert s Rules of Order Discussion requires a motion nfpa.org 8 Page 14 of 316 4

15 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Motion to End Debate, Previous Question, or to Call the Question Not in order when another member has the floor Requires a second Not debatable and DOES NOT automatically stop debate 2/3 affirmative vote immediately closes debate, returns to the original motion Less than 2/3 allows debate to continue nfpa.org 9 NFPA First Draft Meeting Committee member actions: Member addresses the chair Receives recognition from the chair Member introduces the motion Another member seconds the motion nfpa.org 10 Page 15 of 316 5

16 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Committee chair actions: Restates the motion Calls for discussion Ensures all issues have been heard Calls for a vote Announces the vote result nfpa.org 11 nfpa.org 12 Page 16 of 316 6

17 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Committee Actions and Motions: Resolve Public Input (PI) Create a First Revision (FR) Create a Committee Input (CI) a placeholder used to solicit Public Comments and permit further work at Second Draft stage nfpa.org 13 NFPA First Draft Meeting Resolve a Public Input (PI) Committee develops a Committee Statement (CS) to respond to (i.e., resolve) a Public Input Committee indicates in CS its reasons for not accepting the recommendation and/or points to a relevant First Revision PI does not get balloted nfpa.org 14 Page 17 of 316 7

18 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Create a First Revision (FR) FR is created to change current text or add new text Committee Statement (CS) is developed to substantiate the change Associated PIs get a committee response, often simply referring to the relevant FR Each FR gets balloted nfpa.org 15 NFPA First Draft Meeting Create a Committee Input (CI) Committee is not ready to incorporate a change into the First Draft but wants to receive Public Comment on a topic that can be revisited at Second Draft stage Committee Statement (CS) is developed to explain committee s intent CI is not balloted nfpa.org 16 Page 18 of 316 8

19 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Committee Statements (Substantiation): All Public Input must receive a Committee Statement Provide a valid technical reason Do not use vague references to intent Explain how the submitter s substantiation is inadequate Reference a First Revision if it addresses the intent of the submitter s Public Input nfpa.org 17 NFPA First Draft Meeting Formal Voting on First Revisions In-meeting votes establish a sense of agreement on the development of First Revisions (FR) FRs are secured by electronic balloting ( 2/3 of completed ballots affirmative, and affirmative by 1/2 voting members) Only the results of the electronic ballot determine the official position of the committee on the First Draft nfpa.org 18 Page 19 of 316 9

20 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Ballots Only First Revisions (FR) are balloted Public Inputs and Committee Statements not balloted Reference materials are available First Draft, PI, CI, and CS Voting options: Affirmative on all FRs Affirmative on all FRs with exceptions specifically noted Ballot provides option to vote affirmative with comment Vote to reject or abstain requires a reason nfpa.org 19 NFPA First Draft Meeting Electronic Balloting Web-based balloting system Alternates are encouraged to return ballots Ballot session will time out after 90 minutes Use submit to save your work ballots can be revised until the balloting period is closed nfpa.org 20 Page 20 of

21 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Click link provided in ballot Sign in with NFPA.org username and password nfpa.org 21 NFPA First Draft Meeting Select either Affirmative All or Affirmative with Exception(s) nfpa.org 22 Page 21 of

22 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting Use See FR- # link to review all First Revisions Use edit election to change individual votes or to modify vote after submitting ballot nfpa.org 23 NFPA First Draft Meeting Make selection: Affirmative with Comment, Negative, or Abstain No selection defaults to affirmative Must include comment (reason) on each vote other than Affirmative nfpa.org 24 Page 22 of

23 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin NFPA First Draft Meeting To complete ballot click Participant Consent and Submit Return to edit any votes by ballot due date nfpa.org 25 NFPA First Draft Meeting Balloting Initial ballot Circulation of negatives and comments electronic balloting is re-opened to permit members to change votes Any First Revision that fails ballot becomes a Committee Input (CI) nfpa.org 26 Page 23 of

24 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin Legal Antitrust Matters Must comply with state and federal antitrust laws Participants are to conduct themselves in strict accordance with these laws Read and understand NFPA s Antitrust Policy which can be accessed at nfpa.org/regs nfpa.org 27 Legal Antitrust Matters (cont d) Participants must avoid any conduct, conversation or agreement that would constitute an unreasonable restraint of trade Conversation topics that are off limits include: Profit, margin, or cost data Prices, rates, or fees Selection, division or allocation of sales territories, markets or customers Refusal to deal with a specific business entity nfpa.org 28 Page 24 of

25 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin Legal Antitrust Matters (cont d) NFPA s standards development activities are based on openness, honesty, fairness and balance Participants must adhere to the Regulations Governing the Development of NFPA Standards and the Guide for the Conduct of Participants in the NFPA Standards Development Process which can accessed at nfpa.org/regs Follow guidance and direction from your employer or other organization you may represent nfpa.org 29 Legal Antitrust Matters (cont d) Manner is which standards development activity is conducted can be important The Guide of Conduct requires standards development activity to be conducted with openness, honesty and in good faith Participants are not entitled to speak on behalf of NFPA Participants must take appropriate steps to ensure their statements whether written or oral and regardless of the setting, are portrayed as personal opinions, not the position of NFPA Be sure to ask questions if you have them nfpa.org 30 Page 25 of

26 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin Legal Patents Disclosures of essential patent claims should be made by the patent holder Patent disclosures should be made early in the process Others may also notify NFPA if they believe that a proposed or existing NFPA standard includes an essential patent claim NFPA has adopted and follows ANSI s Patent Policy It is the obligation of each participant to read and understand NFPA s Patent Policy which can accessed at nfpa.org/regs nfpa.org 31 TC Struggles with an Issue TC needs data on a new technology or emerging issue Two opposing views on an issue with no real data Data presented is not trusted by committee Code Fund Lends a Hand TC rep and/or staff liaison submits a Code Fund Request Requests are reviewed by a Panel and chosen based on need / feasibility Research Project Carried Out Funding for project is provided by the Code Fund and/or industry sponsors Project is completed and data is available to TC Page 26 of

27 NFPA 101 / 5000 First Draft Meetings Milwaukee, Wisconsin Document Information Pages About Current and Previous Editions Issued TIAs, FIs, Errata Archived revision information such as meeting and ballot information, First Draft Reports (previously ROPs), Second Draft Reports (previously ROCs), and Standards Council and NITMAM information Next Edition Technical Committee Document scope Table of contents Articles Research and statistical reports Latest codes and standards news on NFPA Today blog feed Free access Revision cycle schedule Posting & closing dates Submit public input/comments via electronic submission system. Meeting and ballot information First Draft Report and Second Draft Report NITMAM information Standard Council Decisions Private TC info (*red asterisk) Ballot circulations, informational ballots and other committee info Committee name and staff liaison Committee scope and responsibility Committee list with private information Committee documents (codes & standards) in PDF format Committees seeking members Online committee membership application Have a productive meeting Page 27 of

28 MINUTES Joint Teleconference / Adobe Connect Meeting of NFPA Correlating Committee on Building Code (BLD-AAC) NFPA Correlating Committee on Safety to Life (SAF-AAC) March 10, Call to Order. Teleconference / Adobe Connect meeting called to order by SAF- AAC Chair Bill Koffel at 11:00 a.m. Eastern on March 10, BLD-AAC Chair Jim Quiter was unable to attend. 2. Attendance Roll Call. Staff called the roll of BLD-AAC and SAF-AAC and recorded the members who responded as being present. The following members were in attendance: NAME COMPANY BLD-AAC SAF-AAC William Koffel Koffel Associates, Inc. Non-Voting Chair Member Jerry Wooldridge Reedy Creek Improvement District Secretary Chad Beebe ASHE AHA Rep.: TC on Board and Care Facilities Non-Voting Member Non-Voting Member Wayne Carson Shane Clary David Collins John Devlin Salvatore DiCristina Victor Dubrowski Carson Associates, Inc. Rep.: TC on Fundamentals Bay Alarm Company Rep.: Signaling Systems Correlating Committee Principal: Wayne Moore The Preview Group, Inc. Rep.: TC on Means of Egress Aon Fire Protection Engineering Corp. Rep.: TC on Fire Protection Features Rutgers, The State University of New Jersey Rep.: Bulding Code Development Committee Code Consultants, Inc. Re.: TC on Educational and Day- Care Occupancies Non-Voting Member Non-Voting Member Non-Voting Member Principal Non-Voting Member Non-Voting Member Alternate to Non-Voting Member Non-Voting Member Non-Voting Member Non-Voting Member Page 28 of 316

29 NAME COMPANY BLD-AAC SAF-AAC David Frable US General Services Administration Principal Randy Gaw Rep.: TC on Detention & Correctional Occupancies Non-Voting Member Non-Voting Member John Harrington FM Global Principal Howard Hopper UL LLC Principal Principal Stephen Hrustich Gwinnett County Fire & Emergency Principal Services Rep.: International Association of Fire Chiefs Jonathan Humble American Iron and Steel Institute Principal Gerald Jones Rep: Building Seismic Safety Principal Council/Code Resource Support Committee J. Edmund Kalie Jr. Prince George s County Government Principal Gary Keith FM Global Alternate Principal: John Harrington David P. Klein US Department of Veteran Affairs Rep.: TC on Health Care Occupancies Non-Voting Member Non-Voting Member Amy Murdock Isaac Papier Henry Paszczuk Ronald Reynolds Eric Rosenbaum Faimeen Shah Jeffrey Tubbs Robert Upson Joseph Versteeg Leon Vinci Code Consultants, Inc. Rep.: TC on Mercantile & Business Occupancies Honeywell, Inc. Rep.: National Electrical Manufacturers Association Connecticut Dept. of Public Safety Rep.: TC on Interior Finish & Contents Virginia State Fire Marshal s Office Rep.: International Fire Marshals Association Jensen Hughes Rep.: American Health Care Association Vortex Fire Engineering Consultancy Arup Rep.: TC on Assembly Occupancies National Fire Sprinkler Association Principal: Jeffrey Hugo Versteeg Associates Rep.: TC on Alternative Approaches to Life Safety Health Promotion Consultants Rep: American Public Health Association Principal: Jake Pauls Non-Voting Member Non-Voting Member Principal Non-Voting Member Non-Voting Member Alternate Non-Voting Member Principal Non-Voting Member Principal Principal Non-Voting Member Alternate Non-Voting Member BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, Page 29 of 316

30 The following members were not in attendance: NAME COMPANY BLD-AAC SAF-AAC James Quiter Arup Chair Principal Sam Francis American Wood Council Principal Raymond Hansen US Department of the Air Force Principal John Kampmeyer, Sr. Triad Fire Protection Engineering Principal Corp. Russell Leavitt Telgian Corporation Principal Rep.: American Fire Sprinkler Association Michael Newman Johnson & Johnson Principal Rep.: NFPA Industrial Fire Protection Section Daniel O Connor Aon Fire Protection Engineering Principal Rep.: American Hotel & Lodging Association Richard Jay Roberts Honeywell Life Safety Rep.: National Electrical Manufacturers Association Principal The following guests were in attendance: NAME Kristin Bigda Ron Coté Allan Fraser Daniel Gorham Gregory Harrington Robert Solomon COMPANY National Fire Protection Association National Fire Protection Association National Fire Protection Association National Fire Protection Association National Fire Protection Association National Fire Protection Association 3. Minutes Approval. Minutes of the BLD-AAC November 8, 2013 and SAF-AAC November 7, 2013 meetings were approved as distributed. 4. Liaison Reports. Sprinkler Project. Bill Koffel presented the sprinkler project liaison report. There were no significant changes being made to NFPA 13, 13D and 13R (vis a vis NFPA 101/5000) in the current revision cycle (Annual 2015). NITMAMS are awaited. The NFPA 13 revisions include re-inserting the sprinkler exemption for apartment unit bathrooms. Fire Alarm Project. Shane Clary presented the fire alarm project liaison report. There were no significant changes being made to NFPA 72 (vis a vis NFPA 101/5000) in the current revision cycle (Annual 2015). NITMAMS are awaited. BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, Page 30 of 316

31 5. Supplemental Operating Procedures. SAF-AAC Chair Bill Koffel advised that he and BLD-AAC chair Jim Quiter will appoint a task group to review the supplemental operating procedures; compare its features to the NFPA Regulations Governing the Development of NFPA Standards (Regs); and determine what, if anything, needs to be retained in some form. Correlating committee members were asked to review the procedures; identify any items that need to be retained; and communicate such to staff. 6. Hazardous Materials NFPA 101. The NFPA 101 Hazardous Materials Task Group report was noted as received. Task Group Chair Jeff Tubbs was asked to submit the proposed changes as official Public Input, on behalf of the task group, by the July 6 closing date. Staff advised that the SAF-FUN, SAF-MEA, and SAF-FIR technical committees would each address the portion of the recommended changes that apply to their assigned chapters. Proposed new Annex C (a repository for information on the NFPA documents that address hazardous materials) would be addressed by SAF-FUN. The Correlating Committee would perform any needed correlation among the technical committee actions. 7. NFPA 101/ Edition Work Areas. The activity / plans updates from the technical committee chairs and the development of subject areas for focus during the 2018 edition revision cycle were handled together. The resulting issues, for consideration by the technical committees, follow: SUBJECT NOTES NFPA 101 NFPA 5000 Glossary of Terms Resilient design concepts Hazardous materials in NFPA 101 Hazardous materials in NFPA 5000 Smoke compartment size increase in health care Direction needed on how to proceed with definitions (ongoing) Emerging topic but may pilot a project for BLD/SAF-HEA in 2015 How should code regulate egress provisions related to health hazards and not just fire? (Jeff Tubbs Task Group) Review Chapter 34 provisions for things like dead ends and common path of travel Conditions needed to allow larger compartment size in hospitals/nursing homes All TCs based on definition assignments HEA Other TCs might consider FUN, MEA, FIR with AAC review HEA All TCs based on definition assignments HEA Other TCs might consider BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, IND HEA CO detection in Only residential occupancy BCF BCF Page 31 of 316

32 SUBJECT NOTES NFPA 101 NFPA 5000 residential B&C without CO provisions; Correlating Committee asked earlier for a TIA Security/safety/code conflicts (re: schools, in particular) Should have content to review from 12/2014 School Security/Safety Workshop Elevator use Home health care Means of egress remoteness Exterior wall assemblies and NFPA 285 Life safety sprinkler systems NFPA 13R attic protection Buildings under construction Term temporary Incorporate the latest and greatest information from ASME May consider joint NFPA 99/NFPA 101 project to address durable medical equipment (DME), safety measures, and backup power How is remoteness of exit access potentially impacted by vertical openings? Review FPRF report (June 2014) and determine if changes needed for NFPA 5000 Introduce discussion on scope, use and limitations of NFPA 13D and NFPA 13R for: - Other than residential occupancies - 5- and 6-story buildings integrating pedestal construction (13R) What is expected performance level? Lives saved but building lost Evaluate application of NFPA 241 to systems and buildings Expand definition to consider use of temporary systems as well as buildings/structures FUN re: doc Scope expansion; MEA, END; Other TCs might consider re: active shooter MEA, FUN HEA, possible co-ordination w/ RES MEA, FIR BCF, RES RES, BCF FUN FUN FUN re: doc Scope expansion; MEA, END; Other TCs might consider re: active shooter BSY, MEA, FUN MEA, FIR BLC, SCM BCF, RES, BLC RES, BCF FUN FUN BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, Page 32 of 316

33 SUBJECT NOTES NFPA 101 NFPA 5000 Location, design, hardening of egress stairs based on wind hazard Avoid stair designs that utilize glass on exterior walls. Alternatively, look at use of ASTM E1886, Standard Test Method for Performance of Exterior Windows, Curtain Walls, Doors, and Impact Protective Systems Impacted by Missile(s) and Exposed to Cyclic Pressure Differentials, and/or ASTM E1996, Standard Specification for Performance of Exterior Windows, Curtain Walls, Doors, and Impact Protective Systems Impacted by Windborne Debris in Hurricanes. See NIST NCST FIR, MEA FIR, MEA, SCM In-building storm shelter spaces Stair descent devices UMC technical review Roof egress Private homes/dwellings rented as B&Bs Life Safety Evaluation for assembly report on Joplin, MO tornado. Add scoping and reference to ANSI/NSSA/ICC 500 for certain occupancies. Add scoping, how many and where Close review for conflicts with 90A, 90B, and other NFPA documents (e.g., flexible air duct/connector length) New section on egress requirements for roofs with mechanical equipment Trend of private homeowners advertising their home for short stay rentals (airbnb.com) but not licensed or regulated in any way. Might be more of a Pub Ed issue. Various incl FUN (Scope); AXM, END, MER MEA, Various occupancies BSF MEA RES Continue the upgrading effort AXM Various incl FUN (Scope); AXM, END, MER, BLC, SCM BSY, MEA, Various occupancies BSY MEA RES AXM BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, Page 33 of 316

34 SUBJECT NOTES NFPA 101 NFPA 5000 occupancies Falls over guards in FPRF report AXM AXM arenas and stadia Opening protectives Chair convened a task group FIR FIR (door, windows) ratings Inspection, testing, Consider National Fire MEA MEA maintenance (ITM) of fire escape stairs Escape Assn materials Day-care age for selfpreservation FPRF report END END Ambulatory health care 2 FPRF reports HEA HEA occupant load factor Apartments for the elderly Is there a special risk or is special protection needed? Revisit 1981 edition of NFPA 101 RES RES Open malls Chair convened a task group MER MER Evacuation chairs Scoping and use of RESNA BSY standard Accessibility reference 2010 ADA; expected update BSY updating of ANSI A117.1 Green roofing systems FM Global has installation data sheet and approval standard SCM Tall timber buildings FPRF report BLC Height and area FPRF compilation, but no BLC objective criteria developed 8. Other Business. No other business was raised. 9. Next Meeting. The BLD-AAC and SAF-AAC correlating committees will meet to address NFPA 5000/101 First Draft correlation issues in December 2015 or early January Adjournment. The meeting was adjourned at 12:00 p.m. Eastern. Minutes prepared by Ron Coté and Kelly Carey BLD-AAC/SAF-AAC PRE-FIRST DRAFT PLANNING MEETING MINUTES - MARCH 10, Page 34 of 316

35 Egress Modelling in Health Care Occupancies Virginia Alonso TECHNICAL NOTES GIDAI Group, University of Cantabria Fire Protection Research Foundation July 2014 The Fire Protection Research Foundation One Batterymarch Park Quincy, Massachusetts, U.S.A Web: 1 Page 35 of 316

36 Acknowledgements The Fire Protection Research Foundation expresses gratitude to those that assisted with the development and review of the information contained in this report. The Research Foundation appreciates the guidance provided by the Project Technical Panel: Ken Bush, Maryland State Fire Marshal s Office Rita Fahy, NFPA Bob Harmeyer, MSKTD & Associates Rick Horeis, HDR Architecture, Inc. Dan O Connor, Aon Fire Protection Engineering Enrico Ronchi, Lund University Ron Cote, NFPA Staff Liaison Robert Solomon, NFPA Staff Liaison The author wants to express her gratitude to GIDAI s Group, especially to the Director of the Group, Dr. Daniel Alvear, and the researchers Dr. Orlando Abreu and Dr. Arturo Cuesta for their support in this Project. The content, opinions and conclusions contained in this report are solely those of the authors. About the Fire Protection Research Foundation The Fire Protection Research Foundation plans, manages, and communicates research on a broad range of fire safety issues in collaboration with scientists and laboratories around the world. The Foundation is an affiliate of NFPA. About the National Fire Protection Association (NFPA) NFPA is a worldwide leader in fire, electrical, building, and life safety. The mission of the international nonprofit organization founded in 1896 is to reduce the worldwide burden of fire and other hazards on the quality of life by providing and advocating consensus codes and standards, research, training, and education. NFPA develops more than 300 codes and standards to minimize the possibility and effects of fire and other hazards. All NFPA codes and standards can be viewed at no cost at Keywords: egress modelling, health care occupancy, smoke compartment, means of egress 3 Page 36 of 316

37 Abstract A proposed change for the 2015 edition of NFPA 101, Life Safety Code, would increase the maximum allowable size of a smoke compartment in health-care occupancies from 22,500 ft 2 (2,090 m 2 ) to 40,000 ft 2 (3,700 m 2 ) almost double the size (the maximum travel distance of 200 ft (61 m) to smoke barrier would remain the same). This change could affect the evacuation/relocation of patients during an emergency in a healthcare facility. In this work, the computational model STEPS is used for analysing different scenarios for sleeping areas in health care facilities. The results will provide input to the technical committee regarding the potential impact of this change. 1. Introduction The proposed change in the size of smoke compartments for health care facilities (from 22,500 ft 2 to 40,000 ft 2 ) will lead to an increase in the number of patients inside that smoke compartment. It is important to understand how this may impact the relocation process in health care occupancies. The relocation - or evacuation - procedure in a health care facility is complex and a well-defined strategy and an effective execution is necessary. It should be noted that most of the occupants in these environments are patients that are being treated for some illness and they are not capable to evacuate by themselves (self-evacuation). For this reason, the health care personnel have to be ready and trained to assist (assisted evacuation) the patients in their relocation to a another smoke compartment or safe place. It is well known that evacuation models are powerful tools to study the evacuation process in different scenarios and applications [1-5]. We can find several reviews [1, 3] that show the capabilities and limitations of these types of models. These reviews show that, apart from their use in the field of transportations (ships, aircraft and trains) [6-8], most of the egress models have been employed mainly for application to buildings. Apart from their possibilities, most of 4 Page 37 of 316

38 these models have been developed to consider the self-evacuation process instead of assisted evacuation. Unfortunately, just a few resources have been found related to assisted evacuation in these scenarios. Golmohammadi and Shimshak performed one interesting study [9]. They showed an analytical approximation to analyse the horizontal and vertical evacuation time, considering three types of patients: Type 1 (ambulant patients), Type 2 (nonambulant patients who use wheelchair) and Type 3 (nonambulant patients who are moved in their beds). Assuming a defined strategy (the staff members know exactly who has to relocate/evacuate and in which order) and based upon some basic evacuation principles, this analytical model permits the user to consider the number and category of patients and the number of personnel and availability of the elevator. Another study simulated the evacuation process in a hospital using the model G-HES - Glasgow Hospital Evacuation Simulator [10]. Although the modelling of this problem is scarce and limited, generally, it is agreed that it is necessary to differentiate between ambulant and nonambulant patients. Furthermore, all the patients have a preparation time that may depend on the type of illness or treatment. In some cases, this preparation time includes the processes to disconnect the patients from equipment, the movement of the patient from the bed to a wheelchair, stretcher or similar device or just other common pre-relocation activities such as getting dressed or gathering their belongings. It should be noted that the evacuation movement is also different in this kind of assisted evacuation or relocation. In this case, the health care personnel will relocate the patients and in many cases they will transport them in wheelchairs, stretchers or other transportation devices. Currently, there is a lack of data related to these preparation times and transportation speeds. Just a few papers present some ranges and limited values for these parameters. For example, Hunt, Galea and Lawrence present in [11] a study undertaken to quantify the preparation time and transportation speed of trained hospital staff in evacuating people with reduced mobility using different assistance devices. Other works such as [12] and [13] show possible ranges and values for preparation times considering different types of patients for the sleeping areas. 5 Page 38 of 316

39 The goal of the project was to analyse the impact of an increase in smoke compartment size on horizontal relocation of patients on a sleeping room floor in a health care facility. Based upon preliminary input data and a dedicated calibration of the model inputs in STEPS for the specific scope of this project, diverse scenarios were selected and modelled considering the proposed change in the smoke compartment. Furthermore, since the number of health care personnel can significantly vary in the same scenario, different ratios of patients to health care personnel members were studied to show the impact of this parameter in the relocation process of patients in this kind of environment. 2. Description of the evacuation model The evacuation model STEPS Simulation of Transient Evacuation and Pedestrian movements version 5.1 (June 2012) from Mott MacDonald [14] has been used for this Project. STEPS is a behavioural model [1] that has the capability to implement random input variables for the pre-evacuation and/or preparation times and unimpeded and/or transport speeds based on probability distribution function. STEPS permits the simulation of occupants in a normal or emergency situation within different types of buildings. Most current evacuation models, including STEPS, are mainly developed for simulating a self-evacuation process and they present several limitations for modelling an assisted evacuation process. The capabilities of STEPS in normal conditions mode permit the user to define task and routes for each occupant (patients and health care personnel) representing the transport of patients. 3. Occupant characteristics For this study, we considered two types of occupants: health care personnel and patients. It should be noted that other kind of occupants could be found in this scenarios such as visitors, doctors, other staff, etc. For this study, we considered the worst-case scenario, the night time for sleeping areas when only health care personnel and patients are assumed to be in the area. 6 Page 39 of 316

40 In any case, it would not be appropriate to model visitors and other transient occupants as part of the emergency relocation process. 3.1 Type of occupants Health Care Personnel These individuals will be responsible for assisting with the removal and the relocation of patients. The number of health care personnel may depend on the specific type of care provided by the hospital (or hospital floor). It can change depending on the use area (sleeping room / treatment room) or time of day. It should be noted that for this study we considered the worstcase scenario, the night time for sleeping rooms when the staff available for evacuation is presumed to be at the minimum. Patients Based on their ability to evacuate by themselves, we considered the following type of patients: Type 1 Ambulant patient with reduced mobility. Type 2 - Nonambulant patients who need to be assisted using a wheelchair or similar device. Type 3 - Nonambulant patients who need to be assisted by using a stretcher, blanket or similar device and that may have to be moved using a blanket drag. It is assumed that this type of patient may include the patients connected to any medical equipment. For the evacuation or relocation process, all the patients in the hospital were assumed to be assisted by health care personnel. 3.2 Main parameters Apart from the corresponding scenario and its characteristics (location of exits, dimensions, number of personnel, travel distances to the exit, etc.), the assisted relocation process in a health care facility can be described by several parameters that define the behaviors and movement of each health care personnel: 7 Page 40 of 316

41 - Pre-relocation time(t pres ). The time elapsed until each health care personnel member starts movement to relocate the patients. For this study, it was assumed that the personnel are already assembled in the corresponding smoke compartment and prepared for performing relocation processes. - Preparation time(t p ). The required time for preparing the patient for relocation. This time depends on the type of preparation and the ability of the corresponding personnel to be ready to move the patients: o With no devices (ambulant patients) o Move to a wheelchair o Move to a stretcher o Move to a blanket - Unimpeded walking speed(w S ). The walking speed of health care personnel moving toward a patient or returning to the next patient. - Transportation speed (w p ). The walking speed of health care personnel while transporting the patient to another safe compartment or while walking with the patients (ambulant patients). These parameters defined the behaviors of the personnel for performing the relocation process. Furthermore, based on his/her physical and psychological characteristics each member of the personnel will have his/her own pre-relocation time and unimpeded walking speed and the model employed a preparation time and transportation speed for each patient. It is well known that the evacuation process is a highly stochastic phenomenon [15, 16] due to the randomness of human behavior and the development of the emergency. The most realistic manner to represent this randomness is by considering the behavioral parameters (Pre-relocation time, preparation time, unimpeded walking speed and transportation speed) as a random variable. This means that the parameters will be defined by density distribution law and statistical parameters. Currently, there is a lack of data regarding these behavioral parameters. However, in order to accomplish this analysis, Tables 1 and 2 show some values for the input parameters based on different available studies. (The references for the study are shown in the table.) 8 Page 41 of 316

42 In general, the gathered data for preparation times for Type 1, 2 and 3 show a range of values. In order to use these parameters as random variables, it was assumed that they are normally distributed with a standard deviation of 3 sigma. Pre-relocation and preparation time, in contrast, is assumed to be log-normally distributed, with the mean and standard deviation shown in Table 1. Category Distribution law Mean [s] Sigma [s] Range [s] Health care personnel [9] Log-normal Type 1 [7] Normal Type 2[7] Normal Type 3[7] Normal Table 1. Pre-relocation and preparation time for patients Distribution law Mean [m/s] Sigma [m/s] Range [m/s] Unimpeded speed for health care personnel members [10] Normal Speed for ambulant patients with reduced mobility [10] Uniform Transportation speed for wheelchair [10] Normal Transportation Speed for stretcher [10] Normal Table 2. Unimpeded and transportation velocities for health care facilities There is also a lack of data regarding the transportation speed for a blanket carry. However, it should be noted that for transportation using blankets, two health care personnel members per patient are needed for the relocating process; therefore, for evacuation modelling purposes these patients were considered as Type Evacuation priority The evacuation process in a health care facility is a defined procedure established in the emergency plans of each hospital. In general, all areas or smoke compartments have a person in charge that will assign the responsibilities to each of the health care personnel in an emergency. Based on the corresponding number, types and location of patients each health care personnel member will relocate specific patients from their initial location (room) to a defined safe area. 9 Page 42 of 316

43 For this study, it was assumed that at the point the responsible persons established the necessity of relocating the patients from the affected smoke compartment, the health care personnel were gathered in a common meeting area within the compartment to receive specific instruction (evacuation procedure or priority). The emergency plans of hospitals usually establish a triage for getting as many patients out as possible. The default priority in these situations may be assumed as: - Patients in immediate danger (near the fire) - Ambulant patients - Type 1 - Patients requiring some transport assistance (wheelchair) - Type 2 - Patients requiring transport assistance (stretcher/blanket) - Type 3 - Patients who are being treated and/or would be difficult to relocate/evacuate (i.e. ICU, obese or psychiatric). These types of patients were not considered for this study This default priority was used as the relocation sequence for the modelling. 3.4 The application floor plan As explained above, the aim of this study was to show the potential impact on the relocation/evacuation process of a health care facility of increasing the size of the smoke compartment. It should be noted that health care facilities are complex environments that combine different kinds of activities and areas in the same facility such as treatment areas, sleeping areas, administration areas, etc. This report is focused on the analysis of varying the smoke compartment size in sleeping areas during night time, when, theoretically, the occupancy is higher and the number of health care personnel is limited. Several examples of actual health care floor plans were made available for this study and included different typologies of areas (treatment areas, sleeping areas, administrative areas, waiting areas, etc.). In order to create the smoke compartments that most closely represent the current area limit (22,500 ft 2 ) and the proposed limit (40,000 ft 2 ), one of the floor plans was adapted to obtain a hypothetical floor plan for a sleeping area. 10 Page 43 of 316

44 The hypothetical floor plan for a sleeping area (see Figure 1) had a plus-shape with four smoke compartments of approximately 20,000 ft 2 (19,172 ft 2 ). Furthermore, this configuration maintained the 200 ft travel distance from the most remote point to an exit for each compartment. As Figure 1 shows, each of the smoke compartments in the middle section contained 18 rooms Figure 1. Layout of adapted sleeping area floor plan 11 Page 44 of 316

45 To study the impact of increasing the size of the smoke compartment, the smoke barrier between compartments 1 and 2 was removed in order to consider these two areas as one large smoke compartment (39,424 ft 2 ). The following scenarios were considered. Scenario 1 A fire situation in smoke compartment 1 leading to the relocation of patients to the adjacent smoke compartments (see Figure 2). SMOKE COMPARTMENT 3 SMOKE COMPARTMENT Nursing station SMOKE COMPARTMENT 4 Figure 2. Layout of Scenario 1 The patients from the 18 rooms were relocated to the smoke compartments 2, 3 and 4. Furthermore, each side of the floor plan had two exits (at the same distance). It was assumed that the relocation of the patients were divided evenly into the adjacent areas causing a minimum impact in the other smoke compartments as follows: Patients from room 1 to room 4 were relocated to smoke compartment 2 Patients from room 5 to room 9 were relocated to smoke compartment 3 Patients from room 10 to room 13 were relocated to smoke compartment 2 12 Page 45 of 316

46 Patients from room 14 to room 18 were relocated to smoke compartment 4 In general, the rooms in health care facilities are single or double occupancy. For Scenario 1, the rooms 2, 6, 14 and 16 were considered as a double occupancy. This means that there were 22 patients inside the smoke compartment 1 (Scenario 1). Furthermore, it was assumed that 3 patients were Type 1, 4 patients were Type 2 and 15 patients were Type 3. It was not possible to know previously the distribution of patients in each room. For this reason, the patients were randomly assigned to the room. To do this, a random generator software created a series of 22 numbers corresponding with the numbers of the room. It should be noted that numbers from 19 to 22 correspond with the double occupancy rooms. The numbers output from the random generator software established where the patients were located: the initial 3 numbers indicated the number of room for patients type 1, the following 4 corresponded with patients type 2, and the last 15 numbers corresponded with patients type 3. The established distribution of the patients can be seen below in Figure 3. This was input manually into STEPS. It should be noted that the location of patients will define the evacuation procedure (the order of patient s evacuation). To reproduce the evacuation procedure, the defined evacuation routes should be implemented into the model manually by the user, for this reason the location of patients should be known before performing the simulations. 13 Page 46 of 316

47 Type 1 Type 2 Type 3 Figure 3. Distribution of patients in scenario 1 Different ratios of health care personnel were analyzed in order to show the impact of this parameter for assisted evacuation procedures. As it has been shown above, the type of patient defines the number of required personnel for their relocation (one or two) and in many cases two persons are required for preparation of patients although just one is required for his/her relocation. For this reason, emergency groups formed by two health care personnel members were considered as follows (it is assumed that two staff members are required for relocating each patients): Scenario 1.1: 6 emergency groups (12 health care personnel). Scenario 1.2: 4 emergency groups (8 health care personnel). Scenario 1.3: 3 emergency groups (6 health care personnel). 14 Page 47 of 316

48 Based on the number of emergency groups (EG) and the triage, Table 3 shows the relocation procedure simulated for each scenario. Scenario 1.1 Rooms EG (T1) 5 2 (T3) EG EG 3 6 (T1) 6 (T3) 3 1 EG (T2) 16(T31) 11 EG EG 6 14 (T1) 16 (T32) Scenario 1.2 Rooms EG (T1) EG (T1) 6 (T3) 4 2 (T3) EG (T1) 14 (T2) 16(T31) EG (T32) Scenario 1.3 Rooms EG (T1) 7 6 (T3) 4 2 (T3) 1 EG (T1) 15 16(T31) EG (T1) 14 (T2) 16(T32) EG Emergency Group, T1 Type 1, T2 Type 2, T3 Type 3, Tx1 and Tx2 patients from double occupancy rooms Table 3. Relocation process for Scenario 1 Scenario 2 For Scenario 2 the smoke barrier between smoke compartments 1 and 2 was removed considering a smoke compartment of 39,424 ft 2 (see Figure 4). A total of patients in 36 rooms had to be relocated to smoke compartments 3 and 4 through four exits. 15 Page 48 of 316

49 SMOKE COMPARTMENT 3 EXIT 1 EXIT EXIT 3 EXIT 4 SMOKE COMPARTMENT 4 Figure 4. Layout of scenario 2 Considering the use of the nearest exit and that all the exits were available, the relocation procedure was: Room 1 to room 9 use the Exit 2 to the smoke compartment 3 Rooms 19 to room 27 use the Exit 1 to smoke compartment 3 Rooms 10 to room 18 use the Exit 4 to smoke compartment 4 Rooms 28 to room 36 use the Exit 3 to smoke compartment 4 Type 1 Type 2 Type 3 Figure 5. Distribution of patients in scenario 2 16 Page 49 of 316

50 For Scenario 2, rooms 2, 6, 14, 16, 20, 24, 32 and 34 were considered as a double occupancy. This means that there were a total of 44 patients to relocate in the adjacent smoke compartments. In this case, it was assumed that there are 6 patients Type 1, 8 patients Type 2 and 30 patients Type 3. The patients were randomly distributed in the rooms generating a series of 44 number with a random number generator (see Figure 5). Similar to Scenario 1, for Scenario 2 different ratios of patients to health care personnel were simulated (it is assumed that two staff members are required for relocating each patient): Scenario 2.1: 12 EG (24 health care personnel) Scenario 2.2: 8 EG (16 health care personnel) Scenario 2.3: 6 EG (12 heath care personnel) Scenario 2.1 Rooms EG (T31) EG (T32) 1 34 (T3) EG (T3) EG (T31) EG (T32) EG EG 7 6 (T2) (T3) EG (T3) EG 9 20 (T2) 3 22 EG (T2) (T31) EG (T2) 2 (T31) 32 (T32) EG (T32) 33 Scenario 2.2 Rooms EG (T2) 14 (T32) EG (T2) EG (T3) 27 EG (T31) 36 EG (T31) (T32) EG (T32) (T3) 33 EG 7 6 (T2) 6 (T3) 2 (T31) EG (T31) 2 (T32) Scenario 2.3 Rooms EG (T2) 16 (T31) (T32) 27 EG (T32) EG (T2) 6 (T3) EG (T2) 14 (T31) EG (T32) 2 (T31) (T3) 26 EG (T32) 20 (T3) 32 (T31) 35 EG Emergency Group, T1 Type 1, T2 Type 2, T3 Type 3, Tx 1 and Tx 2 patients from double occupancy rooms Table 4. Relocation process for Scenario 2 17 Page 50 of 316

51 Table 4 shows the relocation procedure for the different scenarios considering the number of emergency groups and the triage. It is assumed that the staff members serve the whole compartment in Scenario Computational modelling 4.1 Introduction This section/chapter presents the implementation of the inputs for the computational modelling of the defined scenarios with the STEPS model. STEPS permits the user to import CAD files (*.DXF) in order to build the geometry of the floor plan. The model represents the geometry by default as a fine network of 0.5 x 0.5 m (see Figure 6). Note that the size of the cell may impact on the results, however this discussion is out of this work [17]. Figure 6. Geometry used in STEPS of a sleeping area in a health care facility The model STEPS [14] in normal conditions mode permits the implementation of different tasks adjusted to routes and sub-routes for each occupant. These routes are based on the prefixed relocation procedures for each emergency group (Table 3 and 4). It was simulated that each health care personnel member used the prefixed routes to reach the different checkpoints - rooms and final destination or other smoke compartment. The schema of relocation for each health care personnel member is shown in Figure 7. As Figure 7 shows, the checkpoint 1 was the initial starting point, or the place where the health care personnel member goes to get the instruction (relocation procedure). Furthermore, each member has his own pre relocation time (t pres ) and unimpeded walking speed (w s ) these 18 Page 51 of 316

52 parameters are generated by STEPS based upon the probability distribution functions and statistical parameters shown in tables 1 and 2. Checkpoint 1 Initial location Checkpoint 2 Room 1 Checkpoint 3 Final location 1 (other smoke compartment) Checkpoint 4 Room 2 Checkpoint 5 Final location 2 (other smoke compartment) Checkpoint n Room n Checkpoint n Final location n (other smoke compartment) Figure 7. Schema for evacuating patients by using STEPS model From the initial location (checkpoint 1), the health care personnel members used the defined routes to reach the corresponding locations/ rooms in the defined order. The type of patient defined the random preparation time inside each room. After the preparation time t pi i=1,..room n, each health care personnel member transported the patient through the defined route. This route was assigned with a coefficient that decreased the unimpeded walking speed of the health care personnel member the transportation walking speed could not be directly assigned to the routes. Based on data from Table 2, the following coefficients were obtained: Type of patients Coefficient Type Type Type Table 5. Coefficient assigned to the routes employed by each type of patients 19 Page 52 of 316

53 4.1 Results In order to obtain a significance sample of evacuation times, 100 simulations were run for each scenario. Furthermore, these samples were statistically treated in order to obtain the mean value and standard deviation. Likewise, 90 th and 95 th percentiles were obtained to show a most confidence values for evacuation/ relocation times Scenario 1 For Scenario 1.1, 22 patients were relocated and assisted by 6 emergency groups based on the evacuation procedure shown in Table 3. Table 6 shows the results for the evacuation times. Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 30:13 02:25 33:24 34:32 20:10 37:16 Table 6. Results for Scenario 1.1 As Table 6 and histogram in Figure 8 shows, the mean evacuation time for Scenario 1.1 is 30:13 min. with a range between 20:10 min. and 37:16 min. Furthermore, in order to obtain results with a defined confidence level, the percentiles 95 th and 90 th show evacuation times of 34:32 min. and 33:24min. 20 Page 53 of 316

54 Frequency Evacuation Times (min) Figure 8. Histogram for Scenario 1.1 Table 7 and the corresponding histogram (Figure 9), show the relocation times for Scenario 1.2 where the 22 patients were relocated by 4 emergency groups. The mean evacuation time was 43:08 minutes with a 90 th percentile of 46:13 min. and 95 th percentile of 47:01 minutes. Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 43:08 02:16 46:13 47:01 38:24 49: Table 7. Results for Scenario 1.2 Frequency Evacuation Time (min) Figure 9. Histogram for Scenario Page 54 of 316

55 In scenario 1.3 (table 8 and figure 10), when the number of health care personnel is the lowest (3 emergency groups), the mean evacuation time is 59:34 with a 90 th percentile of 65:04 min and a 95 th percentile of 66:23 min Frequency Evacuation Time (min) Figure 10. Histogram for scenario 1.3 Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 59:34 04:09 65:04 66:23 47:02 70:37 Table 8. Results for scenario Scenario 2 In Scenario 2, the size of the smoke compartment has been increased to almost 40,000 ft 2 and there are 44 patients. For Scenario 2.1, 12 emergency groups had to relocate the 44 patients to the smoke compartments 3 and 4. As Table 9 and the histogram in Figure 11 show, the mean evacuation time was 37:14 min. with a range of values between 31:43 min. and 44:08 min. Furthermore, in this case, the 90 th and 95 th percentiles were 40:21 min. and 40:39 min. 22 Page 55 of 316

56 Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 37:14 02:21 40:21 40:39 31:43 44:08 Table 9. Results for Scenario Frequency Evacuation Time (min) Figure 11. Histogram for Scenario 2.1 For Scenario 2.2 (Table 10 and Figure 12), the mean evacuation time for relocating the 44 patients by 8 EG was 49:31 min. Furthermore, the percentiles 90 th and 95 th of the evacuation time were 53:33 min and 54:47 min. Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 49:31 02:51 53:33 54:47 43:46 57:08 Table 10. Results for Scenario Page 56 of 316

57 Frequency Evacuation Time (min) Figure 12. Histogram for Scenario 2.2 For the last Scenario 2.3 (Figure 13 and Table 11), 6 EG needed a mean evacuation time of 67:42 min. to relocate 44 patients. Furthermore, the 90 th and 95 th percentiles of the evacuation time are 72:39 min. and 76:59 min. Standard Percentile Percentile Minimum Maximum Mean (min) deviation (min) 90 th (min) 95 th (min) (min) (min) 67:42 04:37 72:39 76:59 59:42 83:40 Table 11. Results for Scenario Page 57 of 316

58 30 25 Frequency Evacuation Time (min) Figure 13. Histogram for Scenario Discussion of results Based on the modelling assumptions, the relocation times are summarized below in Table 12. The assumptions made included a random distribution of patients in each smoke compartment distribution for Scenario 1 and 2 differed. Another assumption that was made was that the staff served all patients throughout the compartment, which led to longer travel distances for each staff member in Scenario 2 due to the larger compartment. Scenario Mean evacuation 90 th percentile of the 95 th percentile of the time (min) evacuation time (min) evacuation time (min) :13 33:24 34: :14 40:21 40: :08 46:13 47: :31 53:33 54: :34 65:04 66: :42 72:39 76:59 Table 12. Comparison of evacuation times for all the scenarios An interesting result obtained from this study was the high impact of the number of health care personnel in the relocation process. As Table 12 shows, for Scenario 1.1 (ratio 1:2) the mean evacuation times (30:13 min) decreased more than 12 minutes compared to scenario 1.2 (43:08 25 Page 58 of 316

59 min) with a ratio 1:3 and more than 19 minutes for Scenario 1.3 (59:34 min.) with a ratio 1:4. These differences were similar for Scenario 2. In this case, the mean evacuation time for Scenario 2.1 (37:14 min) decreased around 12 minutes compared to Scenario 2.2 (49:31 min) and up to 30 minutes for Scenario 2.3 (67:42 min). As Table 12 shows, comparing the different sizes of the smoke compartments with equivalent ratios of patient/health care personnel (Scenario , and Scenario ) for sleeping areas, we can see that the mean evacuation times are up to 7 minutes longer more than 23 %. (06:59 min. between scenarios 1.1 and 2.1, 06:23 min. between scenarios 1.2 and 2.2 and 8:08 min. for scenarios 1.3 and 2.3). We can see that these differences were even bigger for the percentiles of evacuation times (more than 10 minutes between the 95 th percentiles of scenario 1.3 and 2.3). While the compartment size may play a role in this difference, the assumptions made during modelling may play a role as well including assumptions related to patient distribution and the area that each staff member served. Future work should consider these variables. 5. Future research The development of this project has shown the necessity of further research regarding the assisted evacuation/relocation process. This would improve the understanding of this phenomenon, the effectiveness of the relocation strategies adopted to relocate patients during an emergency in a health care facility and its impact in the increase of the size of the smoke compartment in this kind of environment. This work highlights the lack of actual data about the parameters that defines an assisted evacuation in a hospital. Future works should offer more reliable data about the preparation times and transportation speeds in this kind of scenarios. Experiments and drills would permit 26 Page 59 of 316

60 to collect and analyze these parameters in order to obtain the probability distribution function that defines these random variables. The present work is focused on sleeping areas, it would also be necessary to analyze other types of areas within health care facilities such as treatment areas whose characteristics differ from the sleeping areas. Another important issue is the limitation of the current models for assisted evacuation. The model STEPS permits the user to calibrate its inputs in order to overcome most of these limitations. However, some restrictions should be taken into account: 1- The number and category of patients, the evacuation procedures and the location per room have to be previously defined by user. 2- The relocation routes (from each room to the corresponding exit or smoke compartment) have to be previously defined by user. 3- The transportation speed is represented as a reduction of the walking speeds of the staff member not as a random variable itself. 4- STEPS does not reproduce the wheelchair / stretcher movement. Further works should deal with these issues by including new modules to the current evacuation models or obtaining new models that permits to model an assisted evacuation process. Any future work should consider the impact of the location of the patients on the relocation time as well as the impact of the staff service areas (i.e. if staff were limited to nursing station areas rather than serving a full smoke compartment). 6. Conclusions The aim of this project was to study the impact of increasing the size of the smoke compartment in a health care facility and the impact of staff to patient ratios on the relocation process of patients. The evacuation or relocation process in these kind of scenarios is a complex 27 Page 60 of 316

61 phenomenon that needs a well-defined strategy and an effective deployment, especially in case of fire. This study was focused on the horizontal movement of the patients from the affected smoke compartment and assembling them in adjacent compartments. Furthermore, this work analysed the sleeping areas in a hospital during the night time, which was assumed to be worst case, considering all the rooms occupied and low ratios of patients/health care personnel. The analysis of the different ratios of health care personnel assistance during an emergency showed that this is an important factor that can highly impact the evacuation procedure and the required times for relocation. Based on the assumptions made during the analysis, including how patients were located and the service areas of the staff, results of evacuation modelling in a health care facility showed that changes to the parameters studied could have the potential to increase the evacuation time up to 8 minutes. As noted, this increase is affected by the distribution of patients in their rooms and the selected evacuation procedures, so these issues should be included in further study. As we can see in figure 5 and table 4, for Scenario 2 the distances traveled by the staff member during the relocation process may increase. For example in Scenario 2.1, the Emergency Group 1 relocates patients from rooms 9, 16, 11 and 25, once the EG has relocated the patients from room 11 to the adjacent smoke compartment, this EG has to travel a distances bigger than 200 ft. to reach the following patient located in room References [1] E.D. Kuligowski, R.D. Peacock, B.L. Hoskins. A Review of Building Evacuation Models, Technical Note 1680 (2nd edition), NIST, Gaithersburg, [2] C.J.E. Castle. Guidelines for Assessing Pedestrian Evacuation Software Applications Centre for Advanced Spatial Analysis University College London, London (2007) (Paper 115). [3] G. Santos, B.E. Aguirre, A critical review of emergency evacuation simulation models, in: Proceedings of the NIST Workshop on Building Occupant Movement during Fire Emergencies, Gaithersburg, 2004, pp Page 61 of 316

62 [4] S.M.V. Gwynne, E.R. Galea, M. Owen, P.J. Lawrence, L. Filippidis, Review of modelling methodologies used in the simulation of evacuation, J. Build. Environ., 34 (1999), pp [5] S.M.V. Gwynne, E.D. Kuligowski, Application modes of egress simulation, in: Proceedings of the Pedestrian and Evacuation Dynamics, Wuppertal (2008). [6] J.A. Capote, D. Alvear, O. Abreu, A. Cuesta, V. Alonso A real-time stochastic evacuation model for road tunnels Saf. Sci., 52, 2013, pp [7] J.A. Capote, D. Alvear, A. Abreu, A. Cuesta, V. Alonso, A stochastic approach for simulation human behavior during evacuation process in passenger trains, Fire Technol., 44 (4), 2012, pp [8] R.W. Bukowski, R.D. Peacock, W.W. Jones, Sensitivy examination of the airexodus aircraft evacuation simulation model, in: Proceedings of the International Aircraft Fire Cabin Research Conference, Atlantic City, USA, 1998, pp [9] D. Golmohammadi, D. Shimshak, Estimation of the evacuation time in an emergency situation in hospitals, Computer & Industrial Engineering, 61 (2001), [10] C. Johnson, Using Computer Simulations to Support A Risk-Based Approach for Hospital Evacuation, Technical Report, University of Glasgow, [11] A. Hunt, E. Galea, P Lawrence, An analysis of the performance of trained staff using movement assist devices to evacuate the non-ambulant, Proceedings of Human Behavior on Fire, Cambridge, UK, [12] J.J. Fruin, Service Pedestrian Planning and Design, MAUDEP, Elevator World Educational Services Division, Mobile, Alabama, 1971, reprinted [13] MSC Circ. 1248, Interim Guidelines for Evacuation Analyses for New and Existing Passenger Ships International Maritime Organization, [14] STEPS Simulation of Transient and Pedestrian movements: User Manual, unpublished, available with egress model from Mott MacDonald. [15] J.D. Averill, Five grand challenges in pedestrian and evacuation dynamics, in: Proceedings of the 5th Conference on Pedestrian and Evacuation Dynamics, Gaithersburg, Page 62 of 316

63 [16] D. Alvear, O. Abreu, A. Cuesta, V. Alonso, A new method for assessing the application of deterministic or stochastic approach in evacuation scenarios. Fire Safety Journal, Vol. 65, 2014, pp [17] J. Lord, B. Meacham, A. Moore, R. Fahy, G. Proulx, Guide for evaluating the predictive capabilities of computer egress models, NIST Report GCR , Page 63 of 316

64 NFPA NFPA Journal Page 64 of Page 1 of 2 1/6/2015 ADVERTISEMENT NFPA.ORG HOME CODES + STANDARDS SAFETY INFORMATION TRAINING RESEARCH MEMBER ACCESS CATALOG SIGN-IN CART () Official magazine of the National Fire Protection Association NFPA Journal Search: > JOURNAL HOME Home January February 2015 NFPA 101 ARCHIVED ISSUES JOURNAL MOBILE APP ADVERTISING AUTHOR INDEX SUBJECT INDEX CONTENT DISCLAIMER ABOUT NFPA JOURNAL NFPA.ORG ADVERTISEMENT. Author(s): Ron Cote. Published on December 29, A YEAR AGO, my column in this space [ Size Issue, January/February 2014] addressed the pros and cons of a proposed change for the 2015 edition of NFPA 101, Life Safety Code, to increase the allowable smoke compartment size in hospitals from 22,500 square feet (2,100 square meters) to 40,000 square feet (3,720 square meters). The proposal was rejected by NFPA members at the technical reports session of the Conference & Expo in June. The proponents for the change including members of the Life Safety Technical Committee on Health Care Occupancies (SAF-HEA), health care facilities engineers who are members of the American Society for Healthcare Engineering, and other health care industry practitioners and regulators plan to revisit the issue as part of the revision cycle that will produce the 2018 edition of NFPA 101. The premise for the increase in smoke compartment size for new construction remains viable. New hospitals in the U.S. are designed to the Facility Guidelines Institute (FGI) Guidelines for Design and Construction of Health Care Facilities, which allots a greater amount of floor space to individual patients. The FGI Guidelines help ensure that a new smoke compartment of 40,000 square feet has an occupant load similar to that traditionally associated with a 22,500-square-foot smoke compartment, so that additional patients will not be placed at risk of fire within the smoke compartment. Further, smoke compartment size will be prevented from becoming excessive, because a current code requirement limits the travel distance to reach a door to another smoke compartment to 200 feet (61 meters). In order to meet the travel limitation, any smoke compartment that approaches 40,000 square feet will need access to more than one adjacent smoke compartment. A smoke compartment of typical proportions situated at an end of a rectangular-shaped building, so that it accesses only one adjacent smoke compartment along its narrow dimension, might approach 30,000 square feet (2,790 square meters) before exceeding the 200-foot travel limitation. In other words, the 40,000-square-foot compartment size might not be realized due to the travel limitation.

65 NFPA NFPA Journal Page 65 of Page 2 of 2 1/6/2015 Any public input for increasing smoke compartment size, and any revisions to that input made by the SAF-HEA committee in its preparation of a first revision, will need to address the shortfalls identified by the NFPA membership when it rejected the change in Namely, existing smoke compartments in hospitals that were not designed to the FGI Guidelines, and which are currently limited to 22,500 square feet, must not be permitted to be made larger. NFPA 101 applies both to new construction and existing building arrangements. Any provision for increased smoke compartment size should be crafted to permit the same language to be used in Chapter 18 for new facilities and Chapter 19 for existing. That would seem to rule out any mandate for compliance with the FGI Guidelines, as they are applicable only to new construction. A substitute criterion that could be applied to new and existing facilities is a maximum patient load per smoke compartment. Additionally, the SAF-HEA committee should work to codify criteria necessary to permit the increase in smoke compartment size to be offered to nursing homes. The closing date for public input for processing the 2018 edition of NFPA 101 as part of the Annual 2017 Revision Cycle is July 6, Visit nfpa.org/101 and go to the link that reads, The next edition of this standard is now open for Public Input. RON COTE, P.E., is principal life safety engineer at NFPA. Add a comment... Comment using... David Landrum North Las Vegas, Nevada If the requirement of additional space is attached to infection control standards... Reply Like 3 hours ago David Landrum North Las Vegas, Nevada The issue here is not to examine NFPA 101 provisions, protections or application, it is rather to analize Facility Guidelines Institute (FGI) Guidelines for Design and Construction of Health Care Facilities, which allots a greater amount of floor space to individual patients; for what reason? Or what was the basis for this mandated increase? Equipment? Size of beds or what causes the requirement if more space? Reply Like 3 hours ago Facebook social plugin Home Contact Terms of Use 2015, National Fire Protection Association

66 Cote, Ron From: Sent: To: Subject: Kimball, Amanda Wednesday, March 18, :45 PM Cote, Ron; Daniel O'Connor Enrico Ronchi; Ken Bush; Richard Horeis; Fahy, Rita; Robert Harmeyer; Solomon, Robert Health Care Egress Study Panel Members, Some good news, we have set aside funding from the Code Fund for a second phase project to the earlier work done by Virginia on health care egress modeling. This will be a larger project where additional variables and situations can be considered. I will be in touch as this Phase 2 project is developed. I look forward to working with you all again. Also related to this issue, a project team at WPI is undertaking a project on egress modeling in health care (building off the Foundation s project). The project group has been working with Professor Meacham and Fire Safe North America to assess staff assisted horizontal evacuation in hospital facilities for different size smoke compartments. Their goal is to use computational egress modeling to develop an parametric analysis of the evacuation of a smoke compartment. In an attempt to understand some of the gaps in the available data they have developed a survey. If you could provide your input, that would be greatly appreciated by the project team. The link to the survey is: The timeline for collecting responses is fairly short, maybe a week or so. Thanks, Amanda Amanda Kimball, P.E. Research Project Manager Fire Protection Research Foundation 1 Batterymarch Park, Quincy, MA USA akimball@nfpa.org 1 Page 66 of 316

67 TECHNICAL NOTES Evaluating Occupant Load Factors for Ambulatory Heath Care Facilities Javier Cuesta Daniel Alvear GIDAI Group, University of Cantabria (Spain) Fire Protection Research Foundation March 2014 Page 67 of 316

68 Acknowledgements The Fire Protection Research Foundation expresses gratitude to those who assisted with the development and review of the information contained in this report. The Research Foundation appreciates the guidance provided by the Project Technical Panel: Chad Beebe, ASHE Phil Hoge, US Army Corps. of Engineers David Klein, US Department of Veteran s Affairs Bill Koffel, Koffel Associates (MD) Robert Salomon, NFPA Rachel Miller, ARA Ron Cote, NFPA Staff Liaison (MA) Special thanks are expressed to the National Fire Protection Association (NFPA) for funding this project through the annual Code Fund. The authors of this report would like to thank the collaboration of the Health Care Services of Cantabria and Madrid, the Marqués de Valdecilla University Hospital, the Santa Clotilde Hospital, and the University of Cantabria. They also express their gratitude to Dr. Arturo Cuesta and Dr. Orlando Abreu for their contributions and support of this project. 2 Page 68 of 316

69 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Abstract The NFPA 101 Life Safety Code and NFPA 5000 Building Construction and Safety Code apply the occupant load factor for business occupancies of 9.33 m 2 /person (100 feet 2 /person) to ambulatory health care facilities. It has been questioned whether this use is appropriate. As a result, we collected and analyzed data on ambulatory health care facilities in order to provide more information to the Technical Committee on Healthcare Occupancies of NFPA. 1. Introduction Occupant load factor is essential to determining and calculating the means of egress required in a facility. NFPA Standards (NFPA 101, Life Safety Code and NFPA 5000, Building Construction and Safety Code) establish a unique value for an occupant load factor of 9.33 square meters/person (100 square feet/person) of gross floor area for ambulatory heath care use, based on business occupancies. It has been questioned whether the occupant load factor for business occupancies is appropriate for ambulatory health care facilities. Additionally, there is an interest in making the ambulatory health care occupancy chapter completely independent of the business occupancy chapter. According to NFPA Standards, ambulatory health care occupancy is that used to provide services or treatment simultaneously to four or more patients that provides, on an outpatient basis, one or more of the following: (1) treatment for patients that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others; (2) anesthesia that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others; (3) emergency or urgent care for patients who, due to the nature of their injury or illness, are incapable of taking action for self-preservation under emergency conditions without the assistance of others. It should be noted that inside an ambulatory health care facilities there are areas very similar to those found in business facilities, such as offices, administration rooms, and even consultation rooms. However, there are also other areas that are completely different, such as operating rooms, adult day care rooms, and waiting rooms. The goal of this project was to collect and process data regarding actual occupant loads specifically in outpatient health care environments. For this purpose, site surveys were conducted in two types of ambulatory health care environments (primary health and urgent /treatment) in the city of Santander, Spain. 3 Page 69 of 316

70 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 2. Objectives The specific objectives of the project were: 1. To develop a questionnaire to be used in any type of ambulatory health care facility. These documents should be useful for future work or new stages of this project. 2. To collect a significant amount of data through site surveys and visits to ambulatory health care facilities. 3. To statistically analyze the information. 4. To evaluate the real occupant load factor for ambulatory health care facilities. 3. Methodology The methodology is divided into the following stages: 1. Contacts 2. Questionnaire 3. Data collection: Site surveys 3.1. Contacts We contacted three private health care institutions and three public health care institutions in the cities of Santander and Madrid (Spain). We sent a letter to their presidents or managers explaining the aim of the project to support the NFPA Technical Committee in evaluating the current occupant load factor. After the initial contact by mail, further contact was by and telephone. In some cases, we also had meetings with the person responsible for the facility or institution to explain in detail the scope, methodology, and required information (CAD drawings, number of staff, etc.). The selected sample covered a wide range of different health care facilities. The response of these institutions was positive, as long as we did not disrupt the normal operation in the facility and we did not increase staff workload. One private and three public institutions agreed to participate. The final sample consisted of 21 health care facilities of which 18 were mainly dedicated to primary health care activities and 3 to urgent/treatment care activities. In terms of area, we obtained a sample of 53 floors and m 2. Although this report does not include data from Madrid, we look forward to collecting data in facilities in Madrid to increase the total sample. 4 Page 70 of 316

71 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 3.2. Questionnaire Originally, the questionnaire was designed to obtain an occupant load factor for each area of the ambulatory health care facility, distinguishing among common areas, consulting rooms, administration areas, emergency areas and other areas. Therefore, the questionnaire identified the gross area and number of occupants in each of these areas. Occupants were classified into different categories: medical staff, patients, companions, administrative staff, and service staff. The questionnaire also took into account age, gender, and disability of the patients. There were various contacts between the members of the Project Technical Panel (PTP) and the GIDAI project team (via conference call and ). During a conference call, we presented the first draft of this questionnaire and preliminary results from a trial site survey. The definition of ambulatory health care facility was discussed, as well as the need to consider the total gross floor area. Later, panel members sent their comments by , indicating that this first draft was very ambitious and that it could be impractical during the on-site surveys. Thus, the questionnaire was simplified and adjusted. Three drafts of the questionnaire were created by GIDAI prior to settling on the final questionnaire. Figure 1 shows this document, which was approved by the members of the PTP. It is expected that this questionnaire can be used universally. Before the site survey, the questionnaire was sent to the contact person at each health care facility to provide them with an overview of data collection. However, the questionnaire was only completed by researchers of the GIDAI Group during visits. Figure 2 shows the instructions for completing the questionnaire. As Figure 2 shows, the questionnaire includes information regarding the building and the occupants per floor: General building information. The first part contains contact information and general data from the health care facility. o Name. The name of the person performing the survey. o Position. The position of the person performing the survey. o City. The city where the health care facility is located. o Phone. The contact telephone number. o . The contact . o Health Care Facility name. The name of the health care facility. o Number of Floors. The total number of floors in the building. o Floor Height. The height from the ground to the ceiling (in meters). o Internal code. GIDAI Group used an internal code for each building/office to ensure privacy of the data. 5 Page 71 of 316

72 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities o Date. The date the survey was completed. o Time. The time the survey was completed. Occupant load density. This part of the survey collected data regarding the area of each floor and its occupancy (number of persons), discriminating between staff, companions, and patients. o Floor Number. The number of the floor being analyzed and its type (i.e., Basement, 1 st floor, 2 nd floor, etc.). o Gross Floor Area (GFA). The floor area in square meters according to the NFPA definition: The floor area within the inside perimeter of the outside walls of the building under consideration with no deduction for hallways, stairs, closets, thickness of interior walls, columns, elevator and building services shafts, or other features. o Nº of staff. Total number of people working in the area under consideration, including medical, administrative, and service staff. o Nº of visitors (companions). Total number of people accompanying or visiting patients in the area under consideration. o Nº of patients. Total number of patients in the area under consideration, including both capable and incapable patients. o Nº of capable patients. This is the number of patients capable of evacuation by themselves. o Nº of incapable patients. This is the number of patients incapable of evacuation by themselves. o Type of disability. The most common type of impairment of incapable patients in the area under consideration. This is labelled as (1) physical, (2) sensory) or (3) cognitive. This questionnaire allows collection of additional information about means of evacuation as well. It should be noted that this data and the type of disability of the incapable patients are not relevant for the occupant load factor and they are not included in this report; however, these could be useful for future projects. Information regarding means of evacuation: o Nº of exits. The total number of floor exits. o Exit width (m). o Maximum evacuation distance (m). Remarks. This space is for including other important or relevant information. 6 Page 72 of 316

73 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Building General Information Name:.... Position: City:.. Phone: Occupant load density Health Care Facility name:... Nº of Floors:. Floor Height (m):.. Internal code: Date:.. Time:.. Floor Number Gross Floor Area Nº of Staff Nº of Visitors (companions) Nº of Patients Nº of Capable Patients Nº of Incapable Patients Type of Disability Nº of exits: Remarks Exit 1 width (m):. Maximum travel distance (m):. Exit 3 width (m):. Maximum travel distance (m):. Exit 2 width (m):. Maximum travel distance (m):. Exit 4 width (m):.... Maximum travel distance (m):. Fig. 1. Questionnaire for data collection. 7 Page 73 of 316

74 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Building General Information Name: The name of the person who is performing the survey Position: Indicate which is his/her position in the company City: city in which the building is located Phone : contact phone contact Occupant load density Floor Number Gross Floor Area.- METHODOLOGY TO COMPLETE THE QUESTIONAIRE Health Care Facility name: Indicate the name of the Health Care Facility Nº of Floors: Indicate the total number of floors in the building Floor Height (m): Indicate the floor height Internal code: An internal code that will be filled by GIDAI Date: Indicate the date when the survey has been filled Time: Indicate the time when the survey has been filled Indicate the floor number and its type, for example basement, 1 st floor, 2 nd floor, etc. Indicate the floor area within the inside perimeter of the outside walls of the building floor under consideration with no deductions for hallways, stairs, closets, thickness of interior walls, columns, elevator and building services shafts, or other features Nº of Staff Indicate the number of people who works in the floor (medical, administrative and service staff) Nº of visitors (companions) Indicate the number of people who goes with the patients Nº of Patients Indicate the total number of patients on the floor Nº of Capable Patients Indicate the number of patients capable for evacuation by themselves Nº of Incapable Patients Indicate the number of patients incapable for evacuation by themselves Type of Disability Indicate the most common type of impairment of incapable patients: 1 physical, 2 sensory, or 3 - cognitive Exit width: Indicate the width of each floor exit Nº of exits: Indicate the number of building exits Maximum travel distance (m): Indicate the maximum distances to each since Remarks: Indicates any other information about that may be considered important or relevant Indicate the Name and Surname of the person who has signed this survey Indicate the date when the survey has been signed Fig. 2. Instructions to complete the questionnaire. Signature of the person who has signed the survey 8 Page 74 of 316

75 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 3.3. Data collection: Site surveys Once the contact person accepted the requested collaboration, a date for the visit and data collection was arranged between November 2013 and February Before the visit, the CAD/pdf drawings were ordered to facilitate the tasks of the researcher. In some cases, access to this information involved a long administrative process due to security issues and requests for signed confidentiality agreements from GIDAI. Fortunately, GIDAI Group was able to obtain CAD/pdf drawings for all facilities included in the sample. In order to obtain detailed information about the sample, the health care facilities were asked to distinguish, identify, and define the different areas and types of medical care in the CAD/pdf drawings. The gross floor areas were analyzed according to the NFPA definition The floor area within the inside perimeter of the outside walls of the building under consideration with no deduction for hallways, stairs, closets, thickness of interior walls, columns, elevator and building services shafts, or other features (see Figure 3). Fig. 3. Analysis of gross floor areas. During some of the site surveys, it was necessary to use a laser meter in order to measure the actual dimensions and/or to have a reference measure. GIDAI researchers completed the site surveys by observing different areas of the ambulatory health care facilities. They manually counted the number of people in the common areas. For private areas, such as consultation and restricted areas (treatment departments, theaters, etc.), the building coordinator or staff members were asked for the occupancy data. Sometimes, the GIDAI researchers were accompanied by a staff member, who guided them through the facility explaining the most relevant information (layout, uses, busiest days, peak hours, number of staff in each area, etc.). 9 Page 75 of 316

76 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities In the majority of the analyzed facilities there were two or more floors dedicated to health care. 1 facility with one floor 14 facilities with 2 floors 4 facilities with 3 floors 1 facility with 4 floors 1 facility with 8 floors The GIDAI researchers visited each of the selected facilities and completed the questionnaires by floor, breaking down the total occupancy in terms of staff and visitors/companions. In addition, data for each floor were collected at different times (twice or three times), when a higher number of people were forecasted to be present. These data were used later for statistical analysis, to obtain a real occupant load factor by ambulatory health care floor and time. 4. Results The main objective of the project was to collect and analyze data regarding the current occupant loads, specifically in ambulatory health care facilities Data collected Data for 21 health care facilities and 53 floors at different times of the morning (twice or three times for each floor) were analyzed from site surveys. Data regarding the real number of people and gross floor area were collected. Table 5 in the Appendix shows the occupant load factors and number of people for the 148 site surveys that formed the sample. During data collection, the Spanish population suffered a flu epidemic that caused eight deaths in Cantabria. It is likely that this epidemic precipitated an increase of people in the health care facilities, especially from vulnerable populations (children, older people, and people with breathing and heart problems). In the ambulatory health care facilities, the researchers also observed people who required assistance for evacuation, such as older people with canes, people with crutches or wheelchairs, pregnant women, children and babies, and blind people. 10 Page 76 of 316

77 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Fig.4. Data collection in health care facilities. Furthermore, Table 5 in the Appendix includes the main activity of the facilities, distinguishing between primary care and urgent/treatment care, both on an outpatient basis. The first offers family medicine and physiotherapy (consultation) services, and therefore can offer services to patients who access the facility with an injury or illness (physical, sensory, or cognitive), although they do not receive specialty care. The second corresponds to facilities where many patients simultaneously receive medical treatment, anesthesia, or urgent care. Figure 5 represents the occupant load factors in m 2 /person and feet 2 /person of the 148 data points of the sample. The blue and red columns are the values obtained for primary and urgent/treatment health care respectively. Most of these occupant load factors are higher than the value established by NFPA Standards; only nine values are lower (6.08%). For primary health care facilities, some data points are much higher than the rest of the data, exceeding some of them by 60 m 2 /person (e.g., samples 74, 78, 79, 82, and 97). The rest of the values vary approximately between 10 and 40 m 2 /person. This dispersion is due to some of the analyzed floors containing unoccupied enclosures (machine rooms, multi-use rooms, libraries, etc.), which resulted in higher occupant load factors. In the case of ambulatory health care facilities, the values varied approximately between 10 and 90 m 2 /person. The highest values of the occupant load factor reached 140 to 144. These values correspond with an ambulatory health care facility where urgent care, medical treatment, and surgery are provided and they require more area per person. In contrast, the rest of the values correspond to ambulatory heath care facilities where there are also specialist consultations, making the occupancy density higher.. 11 Page 77 of 316

78 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Fig. 5. Occupant load factor for ambulatory health care floors Occupant load factor [m 2 /person] Occupant load factor [feet 2 /person] Data Points Page 78 of 316

79 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 4.2 Occupant Load Factor Two different analyses were conducted for the occupant load factor calculation. First, occupant load factors in primary health care and urgent/treatment health care were analyzed separately. Second, we examined whether the distributions of the two types of facilities came from the same population. If so, then they had the same probability distribution and could be combined and statistically analyzed to obtain an overall occupant load factor. Occupant Load Factor in Primary Health Care Facilities By statistically analyzing sample numbers 1 to 132 in Table 5 of the Appendix the following Occupant Load Factor was obtained for the floors of the primary health care facilities. OCCUPANT LOAD FACTOR (m 2 /person) OCCUPANT LOAD FACTOR (feet 2 /person) Mean Standard deviation Mean Standard deviation Table 1. Occupant load factor in primary health care facilities for gross floor area. As we can see in Table 1, the mean occupant load factor is clearly higher than the current value established by NFPA (9.33 m 2 /person). However, it should be noted that there is a high variability in the results (a standard deviation of m 2 /person). Occupant Load Factor in Urgent/Treatment Health Care Facilities A similar statistical analysis was carried out for data from the floors of the urgent/treatment health care facilities (sample numbers 133 to 148 in Table 5 of the Appendix), registering the following Occupant Load Factor (see Table 2). OCCUPANT LOAD FACTOR (m 2 /person) OCCUPANT LOAD FACTOR (feet 2 /person) Mean Standard deviation Mean Standard deviation Table 2. Occupant load factor in urgent/treatment health care facilities for gross floor area. 13 Page 79 of 316

80 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities A higher mean occupant load factor and standard deviation were observed than in the primary health care facilities. This is reasonable given that these facilities provide medical treatment, anesthesia, and urgent care, where access is restricted and more area is necessary per person. Overall Occupant Load Factors The Mann-Whitney and Kolmogorov-Smirnov tests were used to check whether the two samples came from the same population (hypothesis H 0 ) or if the values of one tended to exceed the values of the other (hypothesis H 1 ). The results of both tests confirmed hypothesis H 0 with a level of statistical significance of This meant that the empirical cumulative distribution functions of the two samples did not differ by location nor by shape with the given degree of certainty. This permitted the analysis of all values of the occupant load factors recorded in the site surveys as a single sample, to obtain the overall occupant load factor (see Table 3). OCCUPANT LOAD FACTOR (m 2 /person) OCCUPANT LOAD FACTOR (feet 2 /person) Mean Standard deviation Mean Standard deviation Table 3. Overall occupant load factor for gross floor area. The results indicated that the 9.33 m 2 /person occupant load factor could be a conservative value compared with the mean occupant load factor of m 2 /person obtained for the complete sample. Once again the standard deviation was very high (15.95 m 2 /person). 0.5 Relative Frequency [0,10) [10,20) [20,30) [30,40) [40,50) [50,60) [60,70) [70,80) [80,90) [90,100) Occupant Load Factor [m 2 /pers] Fig. 6. Relative frequency for the occupant load factors. 14 Page 80 of 316

81 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Figure 6 shows the relative frequency of the occupant load factors registered. The data points are grouped in ten intervals with a wide range of 10 m 2 /person (107 feet 2 /person). We noticed that 50 percent of the data were lower than 20 m 2 /person (214 feet 2 /person), and 73 percent were lower than 30 m 2 /person (321 feet 2 /person). 5. Future Work The visits to health care facilities permitted the researchers to examine the different areas that exist in a typical health care facility. Some of these areas are always empty during site surveys, such as machine rooms and multi-use rooms. (Number 1 in Figure 7), while others hold a fairly constant number of people, such as medical consultation, day care hospitals, and theaters (Number 2 in Figure 7), others are devoted to administrative use, such as admissions, and offices (Number 3 in Figure 7), and finally there are others where the number of people can be more variable and a higher occupant density is possible, such as waiting rooms and common areas (Number 4 in Figure 7) Fig.7. PDF drawing of a primary health care floor. The above findings suggest we should study the occupant load factor by considering the use of each area of the floor. With the data collected, we can obtain the patient-to-consultation ratio or visitors/companions-to-patient ratio, which would allow us to estimate the occupancy in waiting rooms and common areas. On the other hand, it should be noted that the occupant load factors obtained for health care facilities in the collection data are real values. Therefore, there would be a lower occupant load factor if we considered all enclosures are occupied and all medical services are working a totally capacity. 15 Page 81 of 316

82 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 5.1 Methodology In most of the provided CAD drawings for each facility there is detailed information about dimensions and different uses. During visits, the researcher verified this information. The researcher also counted the number of people in each area, distinguishing between patients, companions and staff, and made note of the number of active care positions (see Figure 8). Fig.8. Data collection in waiting rooms. The following formulas calculate the patients-to-consultation ratio or visitors/companions-topatient ratio for each data point in our sample. The number of patients in waiting rooms per consultation (the patients-to-consultation ratio) corresponds with Formula 1, dividing the number of patients in waiting rooms (N Patients-Waiting ) by the number of active care positions (N Active-Services ). Ratio Patients / Consultation N N Patients Wating Active Services (1) Formula 2 provides the companions-to-patient ratio dividing the total number of companions (N Total-Companions ) by the total number of patients (N Total-Patients ) for the floor of the facility. Ratio Companion / Patient N Total Companions N Total Patients (2) These parameters can be very useful to obtain an estimate of the occupancy in areas where this can change because companions can access the patient. 16 Page 82 of 316

83 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities 5.2 Results Table 6 in the Appendix presents the total number of patients in the common areas and the waiting rooms, as well as the total number of active care positions registered for each health care facility for the site surveys at different times (59 data points). With these data, we obtained the patients-to-consultation ratio (Ratio Patients/Consultation ) for each item of the sample. Similarly, the relation between the total number of companions and the total number of patients (Ratio Companions/Patient ) was calculated, although in this case the sample was formed using each floor of the health care facility during site surveys (see Table 7 of the Appendix). Table 4 shows the statistical analysis of these data, including the mean and standard deviation for each ratio. Ratio Patients / Consultation Mean Standard deviation Ratio Companions / Patient Mean Standard deviation Table 4. Statistical results for patient- to-consultation ratio and companions-to-patient ratio. Conclusions Data were collected using site surveys for several health care floors in order to analyze the occupant load factor for ambulatory health care facilities. Two types of outpatient activities were considered: primary care and urgent/treatment care. The first corresponds to facilities where the patients do not necessarily receive special care, although patients with an injury or illness that makes them incapable of evacuation by themselves can access these facilities. The second corresponds to facilities where the patients receive medical treatment, anesthesia, or urgent care, rendering them incapable of taking action for self-preservation under emergency conditions without the assistance of others. Data analysis showed that the samples from the two types of facilities came from the same population and therefore could be treated as a single sample. The overall occupant load factor was obtained, resulting in a mean value of m 2 /person ( feet 2 /person). This is higher than the current occupant load factor of 9.33 m 2 /person (100 feet 2 /person) required by NFPA Standards. However, the results were highly variable with a standard deviation of m 2 /person ( feet 2 /person) Furthermore, 50% of the data were lower than 20 m 2 /person (214 feet 2 /person). 17 Page 83 of 316

84 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities It should be noted that this data collection corresponds with real values of occupant load factors in ambulatory health care facilities by gross floor area. Each gross floor area can contain enclosures with different uses or activities, such as auxiliary services (machine rooms, multi-use rooms, cafeterias, etc.), medical services (consultations, surgeries, day care hospitals, etc.), administrative services (admissions, offices, etc.) and common areas (waiting rooms, halls, etc.), where the occupant load density is very different. This implies that there may be a lower occupant load factor for ambulatory health care facilities when all services operate, called the maximum occupant load factor. For this, the maximum number of people within different enclosures is easily obtained if the total number of medical services is known. However, the maximum number of people in common areas is not so easily obtained because of the variability in the number of companions and the number of patients waiting for assistance. We also obtained the patients-to-consultation ratio and visitors/companions-to-patient ratio. The results were a mean value of 1.21 and 0.44 respectively. These parameters can be useful to calculate the total number of people in the areas where companions can access the patient. 18 Page 84 of 316

85 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Appendix Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time Number of People Total Pat. Comp. Staff Gross Floor Area (m 2 ) Occupant Load Factor (m 2 /pers) Occupant Load Factor (feet 2 /pers) 1 0 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 5. Data collected from 148 ambulatory health care floors. 19 Page 85 of 316

86 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time Number of People Total Pat. Comp. Staff Gross Floor Area (m 2 ) Occupant Load Factor (m 2 /pers) Occupant Load Factor (feet 2 /pers) 33 0 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 5. Data collected from 148 ambulatory health care floors (cont.). 20 Page 86 of 316

87 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time Number of People Total Pat. Comp. Staff Gross Floor Area (m 2 ) Occupant Load Factor (m 2 /pers) Occupant Load Factor (feet 2 /pers) 68 5 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 5. Data collected from 148 ambulatory health care floors (cont.). 21 Page 87 of 316

88 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time Number of People Total Pat. Comp. Staff Gross Floor Area (m 2 ) Occupant Load Factor (m 2 /pers) Occupant Load Factor (feet 2 /pers) Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Table 5. Data collected from 148 ambulatory health care floors (cont.). 22 Page 88 of 316

89 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time Number of People Total Pat. Comp. Staff Gross Floor Area (m 2 ) Occupant Load Factor (m 2 /pers) Occupant Load Factor (feet 2 /pers) Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Table 5. Data collected from 148 ambulatory health care floors (cont.). 23 Page 89 of 316

90 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Main Health Care Activity Time N Patients-Waiting N Active-Services Ratio Patients / Consultation 1 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 6. Patients-to-consultation ratio for each facility in the sample at different times. 24 Page 90 of 316

91 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Main Health Care Activity Time N Patients-Waiting N Active-Services Ratio Patients / Consultation Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Table 6. Patients-to-consultation ratio for each facility in the sample at different times (cont.). 25 Page 91 of 316

92 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time N Total-Companions N Total-Patients Ratio Companions / Patient 1 0 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 7. Companions-to-patient ratio for each health care facility floor in the sample. 26 Page 92 of 316

93 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time N Total-Companions N Total-Patients Ratio Companions / Patient 36 0 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 7. Companions-to-patient ratio for each health care facility floor in the sample (cont.). 27 Page 93 of 316

94 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time N Total-Companions N Total-Patients Ratio Companions / Patient 71 0 Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Table 7. Companions-to-patient ratio for each health care facility floor in the sample (cont.). 28 Page 94 of 316

95 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time N Total-Companions N Total-Patients Ratio Companions / Patient Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Primary Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Table 7. Companions-to-patient ratio for each health care facility floor in the sample (cont.). 29 Page 95 of 316

96 Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Data Points Code of Health Care Facility Floor Number Main Health Care Activity Time N Total-Companions N Total-Patients Ratio Companions / Patient Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Urgent/Treat Table 7. Companions-to-patient ratio for each health care facility floor in the sample (cont.). 30 Page 96 of 316

97 TECHNICAL NOTES Evaluating Occupant Load Factors for Ambulatory Health Care Facilities Kristin Steranka William E. Koffel, P.E., FSFPE Koffel Associates Inc. March Fire Protection Research Foundation The Fire Protection Research Foundation One Batterymarch Park Quincy, Massachusetts, U.S.A Web: Page 97 of 316

98 Acknowledgements The Fire Protection Research Foundation expresses gratitude to those that assisted with the development and review of the information contained in this report. The Research Foundation appreciates the guidance provided by the Project Technical Panel: Chad Beebe, ASHE Phil Hoge, US Army Core of Engineers David Klein, US Department of Veteran s Affairs William Lindeman, WEL Designs PLC Rachel Miller, ARA Mary Wei, AAAHC Ron Cote, NFPA Staff Liaison Robert Solomon, NFPA Staff Special thanks are expressed to NFPA for funding this project through the annual Code Fund. The authors of this report would like to thank the collaboration of the various ambulatory health care facilities in the Maryland, Pennsylvania, and Virginia areas. However, our agreement with the facilities was that they would not be identified in the report. About the Fire Protection Research Foundation The Fire Protection Research Foundation plans, manages, and communicates research on a broad range of fire safety issues in collaboration with scientists and laboratories around the world. The Foundation is an affiliate of NFPA. About the National Fire Protection Association (NFPA) NFPA is a worldwide leader in fire, electrical, building, and life safety. The mission of the international nonprofit organization founded in 1896 is to reduce the worldwide burden of fire and other hazards on the quality of life by providing and advocating consensus codes and standards, research, training, and education. NFPA develops more than 300 codes and standards to minimize the possibility and effects of fire and other hazards. All NFPA codes and standards can be viewed at no cost at Keywords: ambulatory health care, occupant load, occupant load factor, occupant density 3 Page 98 of 316

99 Abstract NFPA 101 Life Safety Code acts as the main defining Code for life safety in all building occupancies. A fundamental use of this Code requires the application of occupant load factors as a way to determine the number of occupants for which a building or space, and the means of egress therefrom, should be designed. This factor is extremely important when determining the main means of egress from a building, and is crucial to creating the life safety requirements for any building. Though most uses are assigned their own factor, the 100 ft 2 /person (9.3 m 2 /person) that defines business use is also applied to ambulatory health care (AHC) facilities. 1 This broad generalization is being called into question and has led to this research. The data collection and analysis in this report is meant to provide additional information on this topic to the Technical Committee on Health Care Occupancies of NFPA. Background As defined by NFPA 101, AHC occupancies provide medical treatment, anesthesia and other urgent care to four or more occupants who are incapable of self-preservation. AHC occupancy requirements use many of the business occupancy requirements from the LSC as the basis from which the AHC requirements are determined. Business occupancies and AHC occupancies share many of the same types of spaces: offices, conference rooms, waiting spaces, and consultation rooms. However, this is where the similarity ends. AHC occupancies also have areas which are outside the scope of the business occupancy provisions, such as prep areas, operating rooms, and post-anesthesia care units. Due to these differences there has been interest in determining the appropriate occupant load factor for AHC uses, rather than relying on the occupant load factor for business uses. Javier Cuesta, Daniel Alvear, and the GIDAI Group at the University of Cantabria researched this topic in Santander, Spain from November 2013 to February 2014; publishing a research document in March 2014 with NFPA to explain their findings. Their objective was to collect data through site surveys of different AHC facilities and evaluate the occupant loads within them. Overall, 21 health care facilities were surveyed: 18 devoted to primary care, 1 devoted to urgent care and treatment, and 2 devoted to consultation and treatment services, with a total area of approximately 1,180,343 ft 2. Their secondary focus was to design a questionnaire for AHC facilities with the objective of providing a standard way of collecting additional information about an AHC facility s means of evacuation. The priority, however, remained on data collection and determining occupant load factors. 1 The 2015 Edition of NFPA 101 revises this number to 150 ft 2 /person for AHC occupancies but remains as 100 ft 2 /person for business occupancies. 5 Page 99 of 316

100 Objectives The purpose of this research is to capture United States data in order to compare it to the data collected in Spain on this topic. Due to the differences of culture and use of facilities, the collected data from both countries must be analyzed to see if the analysis that was done previously can be universally applied. To replicate Spain s research as much as possible, data was collected through site surveys of various AHC facilities (primary care and urgent care/treatment), the information was analyzed, and occupant load factors were calculated based upon the survey results. Methodology To begin this process, facilities that could be surveyed were identified from client facilities as well as facilities identified by the FPRF Technical Advisory Panel for the project. Facilities considered for the research included standalone facilities and acute care (hospitals) facilities that have a wing or floor devoted to AHC, but excluded those facilities where outpatients and inpatients are treated in the same areas. Ten facilities were initially contacted and responses were received from nine, one of which did not have separate AHC areas. The overall response was positive and helpful both with setting up the surveys and sending floor plans. Only one facility could not send detailed drawings so an average floor area and non-scaled schematic was used to find the occupancy load factor. The final sample consisted of eight facilities: three standalone outpatient surgery centers, two outpatient surgery floors that were part of larger facilities, and three primary care facilities. This combines to be a total of 14 floors and 115,959 ft 2 evaluated. These facilities reach as far north as Pennsylvania and as far south as Virginia, and remain in the mid-atlantic region of the USA. Appendix A shows a snap shot of the average Occupant Load Factors found at each facility with the building AHC average and an average for each area surveyed. Appendix B shows the input data and the solutions of both types of ratios that were solved for: Patients/ Staff and Patients/ Companion. Appendix C gives a condensed version of the survey data, with averages given for the AHC floor area and people surveyed per each time slot surveyed. Appendix D is the raw survey data that includes the breakdown of how many people were in each area surveyed for each time slot, the area of each area, and whether each person acted as patient, companion, or staff. Once the facilities began to be identified, the tables used in Spain were reorganized for use with the USA collection of data. The same basic information was taken, but the forms focused less on extra life safety aspects of the facility so as to keep the main focus on finding the real life occupant load factors. Occupants were split into categories of staff, companion, and patient and were counted about every half hour for the duration of the surveys (between 3 and 4 hours). For each survey the contact was asked when their highest patient loads were and the surveys were planned to correspond with those days and times. This prime time was often about the same for each facility, beginning around 7 am and dropping off around 12 pm, though the day of the week varied. Despite this coordination, the staff at some of the facilities advised us that the patient loads were light for the survey day. 6 Page 100 of 316

101 Prior to conducting the occupant load counts, a walkthrough of the facility was performed. The walk through provided a background of the facility, identified the uses of each area, and introduced the researcher to the staff. After this, the number of occupants in the common areas that were being surveyed was counted, every half hour, for 3 to 4 hours. The common areas that were surveyed in each facility are labeled in Appendix D in their respective tables. The provided building layouts were used to determine the gross floor areas for each of the spaces in which the occupants were counted. To do this the NFPA definition of gross floor area was used to include the inside perimeter of the outside walls of the building under consideration with no deduction for hallways, stairs, closets, thickness of interior walls, columns, elevator and building service shafts, or other features. Though the definition was followed in general, the spaces in the building that were not surveyed, and in which the occupants were not counted, were not included in the floor area. Results To begin the data analysis, each facility was given an ID number from 1-8. This number (i.e. Facility 1) is the name by which that facility is referenced for the rest of the document. General data and detailed data are shown for each individual facility in Appendices C & D respectively. The general data includes total area surveyed and average number of occupants, split into patients, staff, and companions for each time stamp surveyed. The detailed survey goes more in-depth to each time stamp with how the occupants and gross area were split up into different uses, such as patient care, waiting rooms, PACU etc. These tables only include gathered survey data i.e. number of occupants, usage and gross area of each space. For some of the facilities, it was pertinent to separate patients into two categories, capable and incapable, within their general data tables in Appendix C. These categories show the division of patients who are capable of self-evacuation and those who are not. This division was only made for urgent care facilities where the recovery and PACU areas could be surveyed; all patients within these areas were considered incapable of self-evacuation. The primary care facilities did not allow non-patient access to the areas where patients could clearly be stated either capable or incapable so they are listed solely as patients. Appendix A uses the gross area and the counted occupants within each facility to find an average occupancy load factor for each area that was surveyed. These values are averages of the halfhourly counts that were taken in the field. From all of the areas surveyed, 17% were less than 100 ft 2 /person and 83% were greater than 100 ft 2 /person. These individual areas are then averaged to find a total occupancy load factor for each facility. It is important to note that there is one significant outlier, Facility 4, which had an extremely low concentration of occupants. This facility is a standalone emergency department, where patients have to be transferred to an acute care hospital for inpatient treatment. They have a large gross area so the facility can be used as an emergency preparedness facility in the case of a disaster (i.e. they are prepared for a large influx of patients though everyday occupant loads have small concentrations of people). 7 Page 101 of 316

102 All of the facilities occupant load factors were averaged to obtain the overall occupant load factor. This was done two ways. Figure 1 shows the average of all of the surveyed facilities with the standard deviation (S.D.). Figure 2 excludes Facility 4 in its average and S.D. due its extremely low concentration of occupants and outlier effects on the average. Figure 3 shows the overall occupant load factors found in Spain s research. By comparing Figure 2 to Figure 3, it can be seen that US and Spain s values are close together, both showing less concentration of occupants than what is required in the present LSC. USA ft 2 /pers m 2 /pers Mean S.D Figure 1: USA overall occupant load factor including all facilities. USA ft 2 /pers m 2 /pers Mean S.D Figure 2: USA overall occupant load factor excluding outlier. SPAIN ft 2 /pers m 2 /pers Mean S.D Figure 3: Spain overall occupant load factor. Additional comparison was done to find the ratios of patients-to-staff and companions-to-patients for each facility at each time stamp. These values are shown in Appendix B. The number of patients per staff member was found using Formula 1, dividing the number of patients by the number of active staff. RatioPatients/ Staff = N Patients (1) N Staff Formula 2 was used to find the companion-to-patient ratio by dividing the total number of companions by the total number of patients. RatioCompanion/ Patient = N Companions (2) N Patients The overall mean and standard deviation were found for both of the ratios and are shown in Figure 4. To the right of Figure 4 is Figure 5 showing Spain s average ratios from their data. RatioCompanion/Patient RatioPatient / Staff Mean S.D. Mean S.D Figure 4: USA statistical ratio results. RatioCompanion/ Patient RatioPatient / Staff Mean S.D. Mean S.D Figure 5: Spain statistical ratio results. Conclusion Through these surveys, a theme is starting to emerge. Though these spaces are large, the most varying factors are the companions that patients bring with them. For most of these AHC facilities, the number of patients is regulated by some kind of appointment. Facilities plan their number of patients and they plan how many people will be working for them, but they cannot plan for companions. The companions add in the unknown and are hard to predict because of the personal nature of being a companion. Finding a consistent companion-to-patient ratio may help to better predict these numbers for real AHC usage. 8 Page 102 of 316

103 In analyzing the surveyed facilities, 88% showed occupant load factors that were larger than 100 ft 2 / person (9.3 m 2 / person). This seems to support the trend Spain s research points to: normal use of AHC facilities provides more space per person i.e. less concentration of occupants than currently required. 9 Page 103 of 316

104 Appendix A: Average Occupant Load Factor for all Facilities Facility Average Occupant Load Factor ft 2 / pers m 2 /pers Facility 1 A Waiting Room Prep PACU Nurse Room Facility 2 A Waiting Room Prep PACU Offices Facility 3* Waiting Room Front Desk Back Desk Prep PACU Facility 4* Waiting Room Front Desk Back Desk Patient Rooms Facility 5* Facility 6 P Floor Floor Floor Floor Floor Floor Facility 7 P Waiting Room Patient Care Facility 8 P Pharmacy Floor Floor *Free standing urgent/ treatment AHC Facility Primary Care AHC Facility A Urgent/ treatment AHC floor or wing within larger acute care hospital 10 Page 104 of 316

105 Appendix B: Ratios for each facility at each time stamp surveyed B.1: Companion per Patient Ratio Facility Time N Total-Companions N Total-Patients Ratio Companion/Patient 9: : : Facility 1 10: : : : : : : Facility 4 10: : : : : : : Facility 2 10: : : : : : Facility 3 10: : : : : : : : Facility 5 10: : : : : : : Facility 6 9: : : Page 105 of 316

106 Facility Time N Total-Companions N Total-Patients Ratio Companion/Patient 10: : : : Facility 7 9: : : : : : Facility 8 10: : : : B.2: Patients per Staff Ratio Facility Time N Patients-Waiting N Active-Staff Ratio Patients /Staff 9: : : Facility 1 10: : : : : : : Facility 4 10: : : : : : : Facility 2 10: : : : : : Facility 3 10: : : Page 106 of 316

107 Facility Time N Patients-Waiting N Active-Staff Ratio Patients /Staff 11: : : : : Facility 5 10: : : : : : : Facility 6 9: : : : : : : Facility 7 9: : : : : : Facility 8 10: : : : Page 107 of 316

108 Appendix C: General Survey Tables C.1: Facility 1 Building General Information Annapolis, MD Facility Hourly Values Time 9:15 9:45 10:15 10:45 11:15 11:45 12:30 13:00 Gross Floor Area (ft 2 ) Number of Staff Number of Visitors (companions) Number of Patients Number of Capable Patients Number of Incapable Patients C.2: Facility 2 Building General Information Facility Hourly Values York, PA Time 8:30 9:00 9:30 10:00 10:30 11:00 11:30 Gross Floor Area (ft 2 ) Number of Staff Number of Visitors (companions) Number of Patients Number of Capable Patients Page 108 of 316

109 Number of Incapable Patients C.3: Facility 3 Building General Information Gettysburg, PA Facility Hourly Values Time 9:15 9:45 10:15 10:45 11:15 11:45 Gross Floor Area (ft 2 ) Number of Staff Number of Visitors (companions) Number of Patients Number of Capable Patients Number of Incapable Patients C.4: Facility 4 Building General Information Gettysburg, PA Facility Hourly Values Time 9:30 10:00 10:30 11:00 11:30 12:00 Gross Floor Area (ft 2 ) 36,425 36,425 36,425 36,425 36,425 36,425 Number of Staff Number of Visitors (companions) Number of Patients Page 109 of 316

110 Number of Capable Patients Number of Incapable Patients C.5: Facility Building General Information Facility Hourly Values Bel Air, MD Time 8:00 8:30 9:00 9:30 10:00 10:30 11:00 11:30 12:00 Gross Floor Area (ft 2 ) Number of Staff Number of Visitors (companions) Number of Patients C.6: Facility 6 Building General Information Facility Hourly Values Bethesda, MD Time 8:00 8:30 9:00 9:30 10:00 10:30 Gross Floor Area (ft 2 ) 32,796 32,796 32,796 32,796 32,796 32,796 Number of Staff Number of Visitors (companions) Number of Patients Page 110 of 316

111 C.7: Facility 7 Building General Information Fort Belvoire, MD Facility Hourly Values Time 8:00 8:30 9:00 9:30 10:00 10:30 11:00 Gross Floor Area (ft 2 ) 17,532 17,532 17,532 17,532 17,532 17,532 17,532 Number of Staff Number of Visitors (companions) Number of Patients C.8: Facility 8 Building General Information Fort Meade, MD Facility Hourly Values Time 9:00 9:30 10:00 10:30 11:00 11:30 Gross Floor Area (ft 2 ) Number of Staff Number of Visitors (companions) Number of Patients Page 111 of 316

112 Appendix D: Detailed Survey Data D.1: Facility 1 Number of People Gross OLF Main Floor Time Activity Patients Companions Staff Total Area ft 2 /pers m 2 /pers (ft 2 ) Waiting Room Prep 9: PACU Nurse Room Waiting Room Prep 9: PACU Nurse Room Waiting Room Prep 10: PACU Nurse Room Waiting Room Prep 10: PACU Nurse Room Waiting Room Prep 11: PACU Nurse Room Waiting Room Prep 11: PACU Nurse Room Waiting Room Prep 12: PACU Nurse Room Waiting Room 1: Page 112 of 316

113 Number of People Gross OLF Main Floor Time Activity Patients Companions Staff Total Area ft 2 /pers m 2 /pers (ft 2 ) Prep PACU Nurse Room D.2: Facility 2 Number of People Gross OLF Main Floor Time Activity Patients Companions Staff Total Area ft 2 /pers m 2 /pers (ft 2 ) Waiting Room Pre-Op 8: PACU Offices Waiting Room Pre-Op 9: Recovery Offices Waiting Room Pre-Op 9: PACU Offices Waiting Room Pre-Op 10: PACU Offices Waiting Room Pre-Op 10: PACU Offices Waiting Room Pre-Op 11: PACU Offices Waiting Room 11: Page 113 of 316

114 Number of People Gross OLF Main Floor Time Activity Patients Companions Staff Total Area ft 2 /pers m 2 /pers (ft 2 ) Pre-Op PACU Offices D.3: Facility 3 Number of People Gross OLF Main Time Floor Activity Patients Companions Staff Total Area (ft 2 ft ) /pers m 2 /pers Waiting Room Front Desk :15 Back Desk Pre-Op PACU Waiting Room Front Desk :45 Back Desk Pre-Op PACU Waiting Room Front Desk :15 Back Desk Pre-Op PACU Waiting Room Front Desk :45 Back Desk Pre-Op PACU Waiting Room Front Desk 11: Back Desk Pre-Op PACU Waiting Room 11: Front Desk Page 114 of 316

115 Back Desk Pre-Op PACU D.4: Facility 4 Main Activity Time Number of People Patients Companions Staff Total Gross Floor Area (ft 2 ) ft 2 /pers OFL m 2 /pers Waiting Room Front Desk :30 Back Desk Patient Rooms Waiting Room Front Desk :00 Back Desk Patient Rooms Waiting Room Front Desk :30 Back Desk Patient Rooms Waiting Room Front Desk :00 Back Desk Patient Rooms Waiting Room Front Desk :30 Back Desk Patient Rooms Waiting Room Front Desk :00 Back Desk Patient Rooms Page 115 of 316

116 D.5: Facility 5 Main Activity Time Number of People Patients Companions Staff Total Pre-Op Recovery Staff Break :00 Waiting Room Offices Pre-Op Recovery Staff Break :30 Waiting Room Offices Pre-Op Recovery Staff Break :00 Waiting Room Offices Pre-Op Recovery Staff Break :30 Waiting Room Offices Pre-Op Recovery Staff Break :00 Waiting Room Offices Pre-Op Recovery Staff Break :30 Waiting Room Offices Pre-Op Recovery :00 Staff Break Area Gross Floor Area (ft 2 ) Occupant Load Factor ft 2 /pers m 2 /pers 5, , , , , , , Page 116 of 316

117 Main Activity Time Number of People Patients Companions Staff Total Waiting Room Offices Pre-Op Recovery Staff Break Area 11:30 Waiting Room Offices Pre-Op Recovery Staff Break Area 12:00 Waiting Room Offices Gross Floor Area (ft 2 ) Occupant Load Factor ft 2 /pers m 2 /pers 5, , D.6: Facility 6 Main Activity Time Number of People Gross OLF Floor Area Patients Companions Staff Total (ft 2 ) ft 2 /pers m 2 /pers Area A Area B Area C Area D Area E Area F Area G 8: Area H Area I Area J Area K Area L Area M Area A Area B 8: Area C Page 117 of 316

118 Main Activity Time Number of People Gross OLF Floor Area Patients Companions Staff Total (ft 2 ) ft 2 /pers m 2 /pers Area D Area E Area F Area G Area H Area I Area J Area K Area L Area M Area A Area B Area C Area D Area E Area F Area G 9: Area H Area I Area J Area K Area L Area M Area A Area B Area C Area D Area E Area F Area G 9: Area H Area I Area J Area K Area L Area M Area A 10: Area B Page 118 of 316

119 Main Activity Time Number of People Gross OLF Floor Area Patients Companions Staff Total (ft 2 ) ft 2 /pers m 2 /pers Area C Area D Area E Area F Area G Area H Area I Area J Area K Area L Area M Area A Area B Area C Area D Area E Area F Area G 10: Area H Area I Area J Area K Area L Area M Area uses and floor they are on Area A- Physical Therapy (1) Area H: Immunizations/ Allergies (4) Area B- Orthopedics & Podiatry (2) Area I: Pediatric Primary Care (4) Area C- Internal Medicine (2) Area J: Audiology & Speech (5) Area D- Breast Care (3) Area K: Ear/ Nose/ Throat (5) Area E- Surgery Oncology & Gynecological Cancer (3) Area L: DVBIC & Neurology (6) Area F- Dermatology and Rheumatology (3) Area M: Behavioral Health (6) Area G- Pediatrics: Hematology/ Oncology (4) 25 Page 119 of 316

120 D.7: Facility 7 Main Activity Time Occupant Load Number of People Gross Factor Floor Patients Companions Staff Total Area (ft 2 ) ft 2 /pers m 2 /pers Patient Care* Waiting Rm* Patient Care* Waiting Rm* Patient Care* Waiting Rm* Patient Care* Waiting Rm* Patient Care* Waiting Rm* Patient Care* Waiting Rm* Patient Care* Waiting Rm* 8:00 8:30 9:00 9:30 10:00 10:30 11: , , , , , , , *Cardiology Unit Only D.8: Facility 8 Main Activity Time Number of People Gross Floor Area (ft 2 ) Occupant Load Factor Patients Companions Staff Total ft 2 /pers m 2 /pers Pharmacy :00 Floor Page 120 of 316

121 Main Activity Time Number of People Gross Floor Area (ft 2 ) Occupant Load Factor Patients Companions Staff Total ft 2 /pers m 2 /pers Floor Pharmacy Floor 1 9: Floor Pharmacy Floor 1 10: Floor Pharmacy Floor 1 10: Floor Pharmacy Floor 1 11: Floor Pharmacy Floor 1 11: Floor Pharmacy: Main pharmacy right near side entrance to Kimbrough. Floor 1: Refill Pharmacy, Outpatient OR Waiting Room, Muscular Skeletal, & Physical Therapy Floor 2: GI, Hand and Foot, Pain Management, and Pediatrics 27 Page 121 of 316

122 Cote, Ron From: Sent: To: Cc: Subject: Woodruff, Mary Elizabeth Tuesday, March 10, :49 AM Duval, Bob; Cote, Ron Dutton, Nicole FW: Quakers Hill nursing home fire - inquest findings released Of possible interest the report of a 2011 Nursing Home fire has been released. Link below. From: infire list@googlegroups.com [mailto:infire list@googlegroups.com] On Behalf Of Julie Wyner Sent: Monday, March 09, :25 PM To: discussion@alies.org.au; infire Subject: [infire] Quakers Hill nursing home fire inquest findings released Dear colleagues The NSW Coroner yesterday released the report of the inquiry into the 2011 nursing home fire in the Sydney suburb of Quakers Hill, full report can be accessed at n%20and%20reasons%20 %20quakers%20hill%20fire.pdf regards Julie Wyner Librarian FRNSW Library E Julie.Wyner@fire.nsw.gov.au T (02) Library, State Training College, 189 Wyndham St, Alexandria NSW 2015 PO Box 559, Alexandria NSW 1435 FRNSW staff can search the library catalogue via the Library homepage at: This Library is a member of ALIES - Australasian Libraries in the Emergency Sector, and infire - the international network for Fire Information and Reference Exchange. 1 Page 122 of 316

123 NFPA Health Care Corridor Projections Relative to the 6 in. projections into corridors that have 6 ft (1830 mm) or greater width, as permitted by (2), (2) and (2), revise text as follows rather than strictly limiting the projection to being not more 4 in. for compatibility with accessibility requirements: (2)* Projections Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted by one of the following: (a) Noncontinuous projections not more than 4 in. (100 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted. (b) Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall shall be permitted provided that both of the following are met: i. The projecting item is positioned not less than 38 in. (965 mm) above the floor ii. A vertical extension, having the same depth as the projecting item, is provided to within 27 in. (685 mm) of the floor (2)* Projections Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted by one of the following: (a) Noncontinuous projections not more than 4 in. (100 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted. (b) Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall shall be permitted provided that both of the following are met: i. The projecting item is positioned not less than 38 in. (965 mm) above the floor ii. A vertical extension, having the same depth as the projecting item, is provided to within 27 in. (685 mm) of the floor (2)* Where corridor width is at least 6 ft (1830 mm), noncontinuous projections not more than 6 in. (150 mm) from the corridor wall, above the handrail height, shall be permitted by one of the following: (a) Noncontinuous projections not more than 4 in. (100 mm) from the corridor wall, positioned above handrail height, shall be permitted. (b) Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall shall be permitted provided that both of the following are met: i. The projecting item is positioned above handrail height ii. A vertical extension, having the same depth as the projecting item, is provided to within 27 in. (685 mm) of the floor Page 123 of 316

124 Cote, Ron From: Sent: To: Cc: Subject: Cote, Ron Tuesday, April 01, :02 AM 'William Koffel' Solomon, Robert Health care ceilings Thanks Bill. I deliberately stay away from the list serve sites. I will add this paper trail and that from your previous to the agenda folder for SAF-MEA s next meeting. Thanks for documenting the history and suggesting the direction that the code text might take for the next revision cycle. Ron Coté, P.E. Principal Life Safety Engineer NFPA - Quincy, MA USA From: William Koffel [mailto:wkoffel@koffel.com] Sent: Tuesday, April 01, :51 AM To: Cote, Ron Subject: FW: Questionable TJC Finding Ron, If you care to read this, here is the chain resulting from your response to Skip. Again, I think my response is consistent with your response. Bill From: William Koffel Sent: Tuesday, April 1, :41 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: RE: Questionable TJC Finding I have remained silent over the many posts that have occurred, primarily on the public list serve. However, Ron s response actually should start to bring closure to the issue. Ron has answered both questions and the answer does not require an additional level of protection. Let s explore four options: 1. The Code specifically states that the WALL terminates at the ceiling which is addressed in Ron s first paragraph. This is an alternative to a wall that continues to the slab. The typical wall assembly has a hollow core and consists of two layers of gypsum wallboard, one on both sides. In this instance, the ceiling membrane on both sides of the wall serves as an alternative to the two layers on membrane that constitute the typical wall assembly. This is the scenario that was tested in the research tests that support the current code language. 2. The second scenario, which is Skip s second question and is the more typical construction for most hospitals, is a corridor wall that extends slightly above the ceiling membrane instead of stopping at the ceiling membrane. As Ron points out, this is NOT the construction specifically permitted by the Code and technically needs to be addressed by an equivalency. I agree with Ron s assessment but would further argue that the Code language should be revised to specifically permit this and that this construction is probably superior to what is specifically permitted by the Code. 1 Page 124 of 316

125 3. The third scenario is the one that is part of this discussion. The scenario involves the use of the ceiling membrane on one side of the wall and no ceiling membrane on the other side. The response that I proposed is that if there is no ceiling membrane on one side of the corridor wall, the corridor wall needs to extend to the slab above. Actually, I would argue a further detail that only one side of the corridor wall needs to extend to the deck. The membrane commonly found on the other side of the wall is the ceiling of the corridor. This is not requiring a second level of protection; but rather, constructing the wall in the same manner as described in the above two scenarios with two layers of membrane protection. The two layers further discount concerns one may have with a small hole in the ceiling tile (where this whole discussion actually started) even though ASHE has argued in other forums that holes in ceiling tiles generally are not permitted to exist in a health care facility. Again, as Ron pointed out in his response, this scenario is not covered by the text of the Code and needs to be addressed as an equivalency. 4. The fourth scenario, and the one posed in the follow-up question, is a corridor wall that extends at least to the ceiling membrane on the corridor side only and possibly slightly above; but there is no ceiling membrane on the other side. In the previous response, it was noted that if the wall terminates AT the ceiling, clearly the ceiling membrane must be continuous on the other side (see highlighted text). So, let s focus on the scenario where the wall extends inches above the ceiling membrane and there is a ceiling membrane on one side of the wall. How does that final assembly equate to any of the above three scenarios in which there are two layers of membrane substituting for the Code requirement that the wall extend to the deck above? How does that final assembly equate to the assemblies tested that support this Code text in which a ceiling membrane was on both sides of the wall? How does that final assembly equate to the one in which the wall stops at the ceiling and the response below states that the ceiling must be on both sides of the wall even if only from a construction point of view? While one would not normally construct a hospital this way, if one supports this scenario it would also be possible to have a ceiling membrane only on the room side of the wall and the corridor side could be without a ceiling membrane and the corridor wall would not need to extend to the deck above. This would be equivalent to only providing a membrane on the corridor side of the wall. Regarding the last scenario, if the corridor wall is permitted to stop at the ceiling that exists only on the corridor side, it should be noted that sprinkler protection will most likely be required above the ceiling membrane (depending on the location of the sprinklers in the rooms adjacent to the corridor). If there is not at least a single membrane separating the space above the corridor ceiling from the adjacent room, the space above the corridor ceiling is not a concealed space and sprinkler protection is required for that space (per NFPA 13). This alone may be a basis to construct the walls and ceilings as identified in the first three scenarios above. Lastly, in the final response to this issue it should probably be noted that for the most part we are only talking about existing conditions. Most hospitals in the US are required to comply with the International Building Code. The IBC has been interpreted, and the interpretation has been supported by ICC Committee and membership votes on code change proposals and comments, in a manner that lay-in acoustical tile is not considered as meeting a Code requirement for limiting the passage of smoke. While the Annex note in NFPA 101 states otherwise, when the construction needs to meet the IBC and lay-in acoustical tile is used, the corridor walls need to extend to the deck above. Yes, this interpretation is the subject of ongoing code change activity and does not apply to existing conditions but it still exists and will until at least the 2018 Edition of the IBC for new construction and rehabilitation projects. Bill From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Ben Thurston Sent: Monday, March 31, :47 PM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding James, 2 Page 125 of 316

126 Thanks for forwarding this. For some odd reason, the original question is completely missing from the original I received from Skip. Skip, In the case Ron cited, where the corridor wall terminates at the ceiling, it's pretty obvious that the ceiling would have to be continuous on both sides of the corridor wall, just from a construction point of view. But that's not the question here. I think your Question 2, which Ron didn't answer, is closer to what Joe's asking--where a suspended ceiling in the corridor forms part of the separation of the corridor from "all other areas", as permitted by Exception No. 1, and there is not a suspended ceiling in a room adjacent to the corridor, is there a code requirement for the corridor walls to extend to the structure above? Since by definition the partial-height corridor walls and suspended ceiling form the required separation of the corridor from "all other areas", requiring the corridor walls to extend to the structure above would constitute a second level of separation from the corridor; and there's nothing in LSC requiring this second level of separation. If you can ask Ron to answer your Question 2, I'll be interested to hear the answer. Ben Thurston From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Peterkin, James S. Sent: Monday, March 31, :06 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding Ben, It was included in the original . See highlighted section below From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Ben Thurston Sent: Monday, March 31, :01 PM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding Skip, Would you please send the question that Ron responded to? Thanks! Ben Thurston From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Skip Gregory Sent: Monday, March 31, :26 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding 3 Page 126 of 316

127 Ben, I received the below from NFPA as a response to my questions concerning this issue. JAMES GREGORY: No. Provision written for the smoke-resisting ceiling to be continuous to both side sides of corridor wall. Corridor wall then extends upward so as to contact the continuous ceiling. Equivalency can be used to do something other than prescribed if you can convince AHJ. Remember that this prescriptive "requirement" is actually an exemption to a rule that would otherwise require vertical continuity to continue to the deck above. If you have a follow-up question directly related to this inquiry, please reply to this . If you have another question on either a separate topic or different document please return to the document information pages and submit your new question by clicking on the Technical Questions tab. Ron Coté, P.E. Principal Life Safety Engineer National Fire Protection Assn Quincy, MA USA Important Notice: This correspondence is not a Formal Interpretation issued pursuant to NFPA Regulations. Any opinion expressed is the personal opinion of the author and does not necessarily represent the official position of the NFPA or its Technical Committees. In addition, this correspondence is neither intended, nor should it be relied upon, to provide professional consultation or services Create Date: 3/28/2014 Contact: JAMES GREGORY Document Number: 101 Edition: 2000 Section: Section 18/ Subject: Termination of Corridor Walls Question for NFPA: Section 18/ permits the corridor wall to terminate at the ceiling where the ceiling is constructed to limit the transfer of smoke. In this case the corridor wall does not extend to the floor 4 Page 127 of 316

128 or roof above. Question 1: May this ceiling be installed on only one side of the corridor wall? If so, which side, the corridor side or the room side? Question 2: May the ceiling terminate at the wall instead of the wall terminating at the ceiling. The wall would terminate just above the ceiling. [see attached file: servlet.imageserver] Best Regards, Skip Gregory, NCARB Health Facility Consulting, LLC 4128 Zermatt Drive Tallahassee, Florida P F Registration Is Now Open! AHCA SEMINAR/FHEA TRADE SHOW SEPT , 2014 INFORMATION AT: DropBox: On Mar 28, 2014, at 2:30 PM, Ben Thurston wrote: Skip, The intent of the illustration is clearly to show that the combination of a non-rated corridor wall and non-rated drop in ceiling in the corridor combine to resist the passage of smoke into and out of the corridor, which is what 18/ requires. This could just as well have shown the suspended ceiling stopping at the wall, rather than the wall stopping at the suspended ceiling. 5 Page 128 of 316

129 As long as the combination of corridor walls and ceiling resist the passage of smoke into and out of the corridor, there is nothing in LSC remotely suggesting that adjacent areas are required to have suspended ceilings for the purpose of corridor protection, because as noted in the illustration the corridor wall and suspended ceiling provide the necessary protection. The question of whether or not the adjacent room is hazardous is important, because if it is hazardous, it will require either a suspended ceiling or walls continuous to the slab above. This is not for protection of the corridor, because the corridor is already protected by the corridor wall and ceiling, but for protection of all surrounding spaces from smoke that might be generated within the hazardous area. Even if a hazardous area does not open onto a corridor, it still requires this protection; that is, the requirement for a smoke-tight enclosure in a hazardous area is independent of the requirement for corridors have smoke-tight enclosures. If you and Bill are still adamant that all spaces adjacent to a corridor that uses a suspended ceiling as part of its smoke tight enclosure must also have suspended ceilings, then I'll post the question to the SIG to at least get the TJC perspective on this. However, I'd hate to bother that hard working group to respond to a question whose answer seems crystal clear to me. Ben Thurston, PE From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Skip Gregory Sent: Friday, March 28, :40 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding Ben, I think Bill was commenting on the question regarding the corridor partition terminating at the underside of a lay in ceiling and whether or not this ceiling on to be on both sides of the corridor... not whether the room is hazardous. I have always read this section of the code as requiring a ceiling on both sides of a corridor partition that terminates at a lay in ceiling. The handbook has a diagram of this condition and some commentary on section Most AHJs in evaluating a lay in ceiling's ability to resist the passage of smoke will require the ceiling tile to be substantial (i.e. not constructed of that yellow fiberglass material with a thin vinyl covering that weighs something like an ounce per square foot and will tend to fly up and off the grid with any kind of draft) although this is not mentioned in the commentary. The commentary is more concerned with items penetrating the lay-in ceiling not the tile itself. From the Handbook 2008 LSC In new health care occupancies and sprinklered existing health care occupancies, corridor walls need not be fire rated but must be constructed to resist the passage of smoke. Corridor walls in such buildings are permitted to terminate at ceilings, provided that the wall and ceiling resist the passage of smoke. Where suspended ceilings are provided, partitions are permitted to terminate at the suspended ceiling without any additional special protection if the suspended ceiling will resist the passage of smoke. The ability of the ceiling to resist the passage of smoke must be 6 Page 129 of 316

130 carefully evaluated, and guidance is provided in A and A A An architectural, exposed, suspended-grid acoustical tile ceiling with penetrating items, such as sprinkler piping and sprinklers; ducted HVAC supply and returnair diffusers; speakers; and recessed lighting fixtures, is capable of limiting the transfer of smoke. [see attached file: PastedGraphic-1.tiff] Best Regards, Skip Gregory, NCARB Health Facility Consulting, LLC 4128 Zermatt Drive Tallahassee, Florida P F Registration Is Now Open! AHCA SEMINAR/FHEA TRADE SHOW SEPT , 2014 INFORMATION AT: DropBox: On Mar 28, 2014, at 1:17 PM, Ben Thurston wrote: Bill, As I read LSC, in fully sprinklered buildings, which the OP stated this was, it's only in hazardous areas that there must either be a ceiling that resists the passage of smoke or walls that go to the slab (LSC-2000, ). And in general, mechanical rooms are hazardous areas only if they contain boilers or fuel-fired heaters ( (1)). There was nothing in the original post indicating that this was a hazardous area, and unless it is, there's no requirement for an intact suspended ceiling or walls continuous to the slab in the mechanical room. If it does have boilers or fuel-fired heaters, it has to be protected as a hazardous area, and would require an intact suspended ceiling or walls continuous to the slab; and this is essentially what I said in my response on the open site (although apparently this hasn't been posted yet--i'll follow up with Ken). Would you disagree? Ben Thurston, PE 7 Page 130 of 316

131 -----Original Message----- From: ASHE Advocacy On Behalf Of William Koffel Sent: Friday, March 28, :41 AM To: Subject: Re: Questionable TJC Finding The question, as I understood it, was not whether the wall needed a fire resistance rating (some of the responses dealt with hazardous areas); but rather whether the ceiling needed to resist the passage of smoke. My response was that the wall needed to be continuous to the underside of the slab above unless the ceiling is capable of resisting the passage of smoke. If only the corridor ceiling meets the criteria, the mechanical room wall needs to go to the slab (but need not necessarily have a fire-rating) Original Message----- From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of Ben Thurston Sent: Friday, March 28, :52 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding I've already answered this on the open site so my opinion is on record (no, unless the mechanical room has fired equipment). What's the code basis for your opinion? Ben Thurston -----Original Message----- From: ASHE Advocacy [mailto:ashe-advocacy-l@ahals.aha.org] On Behalf Of William Koffel Sent: Friday, March 28, :40 AM To: ASHE-ADVOCACY-L@AHALS.AHA.ORG Subject: FW: Questionable TJC Finding I know that I have an opinion on this subject but I also know that others have different opinions. This may be a good topic for Just Ask ASHE. I will start the discussion by saying yes, the ceiling on both sides of the corridor wall must meet the criteria. Bill William E. Koffel P.E., FSFPE President KOFFEL ASSOCIATES, INC Centre Park Drive / Suite 200 / Columbia, MD direct 8 Page 131 of 316

132 / tel / fax wkoffel@koffel.com Fire Protection Engineers: Expertly Engineering Safety From Fire -----Original Message----- From: American Society for Healthcare Engineering [mailto:asheaha-l@ahals.aha.org] On Behalf Of Gibson, Joe Sent: Friday, March 28, :37 AM To: ASHEAHA-L@AHALS.AHA.ORG Subject: Re: Questionable TJC Finding Slightly off topic, but do both sides of a corridor wall have to have a suspended ceiling in order to be compliant? For instance, where a corridor wall is adjacent to a non rated mechanical room and the mechanical room does not have a suspended ceiling. Does the suspended ceiling on the corridor side alone meet the intent of the code or would the mechanical room side need to have the corridor walls completely sealed to the deck? Joe Gibson Director, Engineering Phone: Fax: U.S. Hwy. 49, Hattiesburg, MS P.O. Box 16389, Hattiesburg, MS Forrest General; Facebook; Twitter; Blog The information contained in this message and any files transmitted with it are property of Forrest General Hospital and may include privileged and confidential information and information otherwise protected by state and federal law. If you are not the intended recipient of this message or an employee or agent responsible for delivery of this message, or if you otherwise believe you have received this message in error, you are hereby notified that any dissemination, retention, distribution, reproduction, copying, or any other use of or any reliance on this communication is strictly prohibited. If you have received this communication in error, please immediately notify the sender and delete this and any attachments from your computer and system. To unsubscribe from the ASHE-ADVOCACY-L list, click the following link: 9 Page 132 of 316

133 NOTICE: This communication and any attachments ("this message") may contain confidential information for the sole use of the intended recipient(s). Any unauthorized use, disclosure, viewing, copying, alteration, dissemination or distribution of, or reliance on this message is strictly prohibited. If you have received this message in error, or you are not an authorized recipient, please notify the sender immediately by replying to this message, delete this message and all copies from your system and destroy any printed copies. To unsubscribe from the ASHE-ADVOCACY-L list, click the following link: To unsubscribe from the ASHE-ADVOCACY-L list, click the following link: 10 Page 133 of 316

134 Cote, Ron From: Sent: To: Subject: William Koffel Tuesday, April 01, :46 AM Cote, Ron FW: Ask ASHE Question #1486 corridor walls and ceiling tiles Ron, A response you provide to Skip Gregory on this issue was recently posted on the ASHE List Serve. I thought you might find the following response to ASHE on the same issue of interest and I believe consistent with your interpretation. In a separate , I will also forward a response I just posted based upon some questions regarding your response to Skip. Bill From: William Koffel Sent: Sunday, March 30, :08 PM To: 'Kenney, Lynn' Subject: RE: Ask ASHE Question #1486 corridor walls and ceiling tiles Lynn, Due to the controversial nature of this issue, as already demonstrated on the ASHE List Serve, I would recommend that the response be circulated to Chad, Jonathan, or both BEFORE it is circulated to the Just Ask ASHE team for comments. Obviously they, as well as I, can change our opinions as comments come in but this is going to be a challenging one to reach consensus. Bill To begin, we will limit the response to requirements in NFPA 101, Life Safety Code. New construction and rehabilitation projects in most hospitals are required to comply with the International Building Code (IBC). While the IBC permits corridor walls to terminate at the underside of a ceiling if the ceiling is capable of resisting the passage of smoke, the interpretation of the IBC as supported by recent ICC membership votes, does not recognize suspended ceiling systems as being capable of resisting the passage of smoke. While this may be the subject of future code change activity, the earliest such code change activity can influence the IBC is the 2018 Edition. It should be noted that the IFC-2015 Edition will allow certain existing suspended ceiling systems as being treated as capable of resisting the passage of smoke. In buildings (smoke compartments for Chapter 19) that are protected throughout by an approved, supervised automatic sprinkler system, both Chapters 18 & 19 of NFPA 101 Life Safety Code permit walls to terminate at ceilings provided the wall/ceiling are capable of limiting the transfer of smoke (18/ ). Annex notes to both chapters say that an architectural, exposed, suspended-grid, acoustical tile ceiling with various penetrations is capable of limiting the transfer of smoke. It should be noted that this is essentially the same up to and including the 2012 Edition of the Life Safety Code. Two things should be noted right off. The Code does not say that the wall can stop at a corridor ceiling or at a room ceiling, it states that the wall can stop at the ceiling. The other item that should be noted is that the wording is really not accurate. In most cases the wall continues up a short distance above the ceiling plane and the ceiling actually affixes to the wall. Both of these observations might be considered to be knit picking but there have been AHJs that prohibit the better installation where the ceiling terminates at the wall verses the wall terminating at the ceiling. Also brought up through this question, there are some that profess that the ceiling only needs to exist on one side of the wall. The ceiling terminating at the wall, and the ceiling being on both sides of the wall are both supported by one of the major research documents that can be used to justify this provision (NBSIR Smoke Movement Through A Suspended Ceiling System). In the fire tests documented in the research report, the wall was built like in most hospitals 1 Page 134 of 316

135 where the wall goes up just above the ceiling plane and the ceilings were attached to the wall. In all tests the ceilings were on both sides of the corridor wall. Although it would take a serious dissertation to totally review all the tests, after reviewing the tests, it can be concluded that the spaces above the ceiling did NOT spread smoke from room to room and in most cases very little smoke was in the interstitial space, due in part to the presence of a ceiling in the fire room. Most of the smoke that did enter the interstitial spaces came from where the frame was attached to the wall. If the wall tile sat on top of the wall, it is clearly evident that the situation would be much worse. One of the weak points of the tests was that there were no ceiling penetrations in the rooms. No light fixtures with the vents, no sprinkler pipe, no speakers, etc. In one test some ceiling tiles were removed from the room of origin and in the high energy fires the ceiling in the room of origin failed. In both cases the ceiling in the other rooms prevented the smoke from entering the other rooms. The major safety factor that the Life Safety Code uses is that these provisions can only be used where there is a supervised, automatic sprinkler system (not part of the tests). Fire modeling sponsored by ASHE in 1987 documented that fast response sprinklers are capable of maintaining tenable conditions at the bed level in a typical patient sleeping room during most reasonably, credible fire scenarios (note: this is an ASHE Technical Document for which I can get the reference is desired). Subsequent full scale fire tests performed by NIST confirmed the results of the computer fire modeling. While some may say that this further negates the need for a ceiling in the room of origin, one could also argue that the primary benefit derived from the corridor wall will be in the fire scenarios in which the sprinkler systems fails to control the fire or those limited scenarios in which tenability is not maintained. As such, the fire tests without sprinklers may provide the basis for the continuity of the wall, the ceiling system, or both. The performance of sprinklers systems in health care occupancies is not well documented since the NFPA data actually includes health care facilities that would be classified as other than a health care occupancy. Following the test protocol that has been used to support the code requirement that corridor walls may terminate at the underside of a ceiling capable of limiting the passage of smoke, requires that ceilings be on both sides of the corridor wall. This provides two weaker membranes to equate to the better membrane (typically two membranes in a health care occupancy) provided by the corridor wall. In cases where a ceiling is either missing or actually undesirable the walls of such room must go up to the floor or roof above. However, that wall only has to resist the passage of smoke (single layer of gypsum board on one side of the studs would be satisfactory). The seals around penetrations and the head-ofwall seal would not have to be rated. However they must be non-combustible. It should also be noted that if a ceiling is not provided in the adjacent room and the wall does not extend to the underside of the floor or roof deck above, it would be reasonable to require sprinklers above and below the ceiling in the corridor. When a Code requires sprinklers to be provided throughout the building, NFPA 13 requires sprinklers everywhere unless a provision in NFPA 13 exempts sprinklers from the location. Currently the only related provision would be to omit sprinklers from certain concealed spaces and absent a wall to the deck or a ceiling in the adjacent rooms, the space above the corridor ceiling is not a concealed space. Based on this, in new construction, corridor walls should be constructed to extend above the ceiling plane with the ceiling grid attached to the wall. Ceilings should extend throughout. Rooms, such as IT walls should continue to the floor or room above. In existing situations walls can terminate at the ceiling as long as the ceiling wall joint resists the passage of smoke, although this arrangement is not as smoke resistant, the Code clearly allows it. Where rooms might not have ceilings (such as IT rooms) it is best to extend the walls up to the floor or roof deck above. However, due to the vagueness of the wording in the Code an argument can be made that it would be acceptable. This would be of a much bigger concern in rooms that are either larger or have a higher fuel load. A few other items must be noted. As noted in the first paragraph, this type of construction might not be allowed by the local building code. Also, missing ceiling tiles are a problem not only due to the discussion above, but missing ceiling tiles most likely are a problem for the sprinkler system as it affects the height of the true ceiling above the sprinkler. They also might affect the fire resistance rating of the structure above depending on if the ceiling is part of a fire resistance rated floor/ceiling or roof/ceiling assembly. Lastly, missing ceiling tiles might be an infection control issue also. 2 Page 135 of 316

136 From: Kenney, Lynn Sent: Friday, March 28, :47 PM To: William Koffel Subject: Ask ASHE Question #1486 corridor walls and ceiling tiles Can you clarify? Corridor walls are allowed to terminate at an acoustical grid ceiling in sprinklered buildings. Do both sides of a corridor wall have to have a suspended ceiling in order to be compliant? For instance, where a corridor wall is adjacent to a non rated mechanical room and the mechanical room does not have a suspended ceiling. Does the suspended ceiling on the corridor side alone meet the intent of the code or would the mechanical room side of the corridor wall need to be sealed to the deck to be compliant? This question was discussed on the ASHE listserve and the responses went both ways. Thank you MW Lynn Kenney Sr. Analyst, Advocacy Team American Society for Healthcare Engineering (ASHE) 155 N. Wacker Drive, Suite 400. Chicago, IL Office (312) Cell (781) Fax - (312) Page 136 of 316

137 Cote, Ron From: Cote, Ron Sent: Monday, September 16, :51 AM To: Cote, Ron Subject: FW: NFPA Technical Question Response [ ref:_00d5077vx._50050nszpi:ref ] For Agenda for SAF-HEA 2018 edition cycle. Revisit NFPA and clarify intent. Is intent just to prevent having to meet the requirements applicable to NEW? Must a new AHC meet Chapter 21 for existing AHC? Ron Coté, P.E. Principal Life Safety Engineer NFPA - Quincy, MA USA From: NFPA Life Safety [mailto:techquesbfpls@nfpa.org] Sent: Monday, September 16, :24 AM To: paul.acre@arkansas.gov Subject: NFPA Technical Question Response [ ref:_00d5077vx._50050nszpi:ref ] 1 Page 137 of 316

138 My response is based on NFPA 101, Life Safety Code, 2000 edition. It is our belief that the intent of Exception No. 3 to was to permit a portion of a hospital or nursing home to be converted to an ambulatory health care occupancy without having to meet the requirements for new ambulatory health care, as would otherwise be required by for changes of occupancy. In accordance with the exception, the building must meet the the requirements of Chapter 21 for existing ambulatory health care and Chapter 19 for existing health care. If the ambulatory health care portion of the facility is going to be classified as anything other than health care, a 2-hour separation must be provided in accordance with Please note the authority having jurisdiction determines compliance with the Code. Gregory Harrington, P.E. Principal Fire Protection Engineer NFPA - Quincy, MA USA Important Notice: This correspondence is not a Formal Interpretation issued pursuant to NFPA Regulations. Any opinion expressed is the personal opinion of the author and does not necessarily represent the official position of the NFPA or its Technical Committees. In addition, this correspondence is neither intended, nor should it be relied upon, to provide professional consultation or services Create Date: 9/5/2013 Contact: Paul Acre Subject: Occupancy Separation Question for NFPA: requires 2-hour Occupancy Separation, however since Changes of Occupancy. Exception No. 3: provides for the change from HCO (Chapt 18/19) to AHCO (Chapt 20/21) ~ shall not be considered a change in occupancy or occupancy 2 Page 138 of 316

139 subclassification : The question is can portions of a Hospital Health Care Occupancy (Chapt 18/19), have portions thereof in it that are only 1-hour (same as would be required for hazardous areas) separated per and therefore follow the Egress provisions of Ambulatory Health Care Occupancies? ref:_00d5077vx._50050nszpi:ref 3 Page 139 of 316

140 Can a missing door latch be permitted via an exemption for a space to be left open to a corridor? I ll try to capture why I believe that a missing door latch should not be addressed via an exemption that allows spaces to be open to the corridor. In NFPA , some code exemptions are worded like the Exception to (2) in that they exempt the user from compliance with the base rule. The language typically takes the form of the requirement of 18.x.x shall not apply Exception No. 1 to is NOT of the above format. The technical committee specifically wrote the exception so as to permit spaces to be OPEN to the corridor. The first exemption written by the committee applied only to waiting spaces as addressed by Exception No. 2. It was done to facilitate function as some uses lend themselves to open spaces. Later, Exception No. 1 was written without limiting the use except that such space cannot be used for patient sleeping, patient treatment, or as a hazardous area (like a storage space). The committee felt the exemption would not be abused in that the facility is run primarily for patient sleeping and patient treatment, so open spaces will not be provided frivolously. Again, the exemption was written to facilitate function as some uses lend themselves to open spaces. In your case, the function does not utilize openness. In fact, the facility operator wants the space NOT to be open to the corridor and has provided walls and doors. A missing door latch does not create an OPEN area as permitted by the exemptions. Page 140 of 316

141 Cote, Ron From: Sent: To: Subject: Cote, Ron Wednesday, December 11, :00 AM Solomon, Robert FW: monitoring exterior valves serving hospital fire protection systems Interesting subject. Maybe HITF should discuss. Ron Coté, P.E. Principal Life Safety Engineer NFPA - Quincy, MA USA From: William Koffel [mailto:wkoffel@koffel.com] Sent: Tuesday, December 10, :49 PM To: Kenney, Lynn Cc: Jim Lathrop; Klaus, Matthew; Cote, Ron; Jen Frecker; Sharon Gilyeat Subject: RE: monitoring exterior valves serving hospital fire protection systems This is an interesting question, actually several questions. First, NFPA 101 requires electrical supervision where the word supervised appears before automatic sprinkler system in the Code. The word supervised is used throughout Chapters 18 and 19 and as such applies to sprinkler systems in new and existing health care occupancies. The word supervised is what triggers the requirements of Paragraph which are more restrictive than NFPA 13 and NFPA 24. The second question is whether Paragraph applies to valves in the system outside of the building. An argument has been made that the private fire service main starts at the base of the riser and that is true. However, the definition of sprinkler system in NFPA 13 reads as follows. Note that the definition indicates that a system includes a water source. As such, the sprinkler system includes the tanks, pumps, and private fire service mains that are the water supply for the sprinkler system * Sprinkler System. A system that consists of an integrated network of piping designed in accordance with fire protection engineering standards that includes a water supply source, a water control valve, a waterflow alarm, and a drain and is commonly activated by heat from a fire, discharging water over the fire area. The portion of the sprinkler system above ground is a network of specifically sized or hydraulically designed piping installed in a building, structure, or area, generally overhead, and to which sprinklers are attached in a systematic pattern. The system is commonly activated by heat from a fire and discharges water over the fire area. Further clarity is provided in A which states that supervision includes water tank levels, temperatures, and pressures. As such, the Annex note clarifies that the supervision includes portions of the sprinkler system outside of the building. A NFPA 72, National Fire Alarm and Signaling Code, provides details of standard practice in sprinkler supervision. Subject to the approval of the authority having jurisdiction, sprinkler supervision is also permitted to be provided by direct connection to municipal fire departments or, in the case of very large establishments, to a private headquarters providing similar functions. NFPA72 covers such matters. System components 1 Page 141 of 316

142 and parameters that are required to be monitored should include, but should not be limited to, control valves, water tank levels and temperatures, tank pressure, and air pressure on dry-pipe valves. In summary, I would conclude that all control valves from the water source (public main, tank, etc.) are included in the requirements of paragraph of NFPA 101. Having said that, if the water supply includes an underground gate valve that requires a special key to operate, electrical supervision should not be required. This exception is not included in NFPA 101 but is included in some other codes (see the IBC). Recognizing that closed or partially closed control valves account for about 66% of the sprinkler system failures, it may be prudent to be conservative in the interpretation of this requirement. I apologize that all references are from the 2012 Edition of NFPA 101 and the 2013 Edition of NFPA 13. These are the editions that I can reference at this time. While there have been some revisions from the 2000 Edition of NFPA 101 and the 1999 Edition of NFPA 13, the intent of these provisions have not changed. In fact, I think some of the language in A is actually in Paragraph in the 2000 Edition of NFPA 101. There is one more issue I noted from the original . I find it interesting that CMS is withholding reimbursement for the first citation of one or more existing control valves when the valves apparently were not identified to be in the closed position. Obviously the NFPA staff copied on this most likely will not comment on this aspect but this in contrary to my experience with CMS surveyors. I wonder how long this has been going on as an unresolved issue or if there are other items in addition to this one K-tag. I have copied some others who may care to comment on the issue. Bill From: Kenney, Lynn [mailto:lkenney@aha.org] Sent: Tuesday, December 10, :06 PM To: William Koffel Subject: FW: monitoring exterior valves serving hospital fire protection systems Your thoughts? Lynn Kenney Sr. Analyst, Advocacy Team American Society for Healthcare Engineering (ASHE) 155 N. Wacker Drive, Suite 400. Chicago, IL Office (312) Cell (781) Fax - (312) From: Beebe, Chad Sent: Tuesday, December 10, :14 PM To: Kenney, Lynn; Flannery, Jonathan Subject: FW: monitoring exterior valves serving hospital fire protection systems See string below I dont think it is an HITF issue but certainly worth a discussion or interpretation. Perhaps we could run this by some of the other SMEs? 2 Page 142 of 316

143 Chad E Beebe, AIA Sent from my Verizon Wireless 4G LTE Smartphone Original message From: Mark Jelinske <MJelinske@catorruma.com> Date: 12/10/2013 8:01 AM (GMT-08:00) To: "Beebe, Chad" <cbeebe@aha.org> Subject: FW: monitoring exterior valves serving hospital fire protection systems Chad, see the string below. This may be an issue top bring up with the HITF. Unfortunately, the NFPA 24 verbiage appears to leave locking vs supervision up to an AHJ, so we probably can't get a black and white interpretation. However, perhaps we can at least get an interpretation that NFPA 101 only REQUIRES "Sprinkler System" valves to be supervised and not "Private Fire Service Main" valves. Mark Jelinske, P.E. Sr. Associate/Mechanical Engineer Cator, Ruma & Associates, Co. Colorado Wyoming 896 Tabor Street, Lakewood, CO P (303) D (303) C (303) Π Please consider the environment before printing this . The information contained in this electronic message should be considered confidential, and is intended solely for the use of the individual or entity to which it is addressed. Copying, dissemination, or disclosure of this information is strictly prohibited without the express permission of the sender. If you are not the intended recipient, please delete this message and notify the sender immediately. Thank you Original Message----- From: American Society for Healthcare Engineering [mailto:asheaha-l@ahals.aha.org] On Behalf Of Ben Thurston Sent: Monday, December 09, :58 PM To: ASHEAHA-L@AHALS.AHA.ORG Subject: Re: monitoring exterior valves serving hospital fire protection systems Mark, I will readily agree that LSC requires sprinkler systems to comply with NFPA 13, and that LSC doesn't reference NFPA 24. But I will also state as a fact, subject of course to correction, that nowhere does LSC limit the requirement for supervision to those control valves installed as required by NFPA 13. NFPA 25 defines "control valve" as "[a] valve that controls the flow of water to a water-based fire protection system". It would seem to me that this definition would include PIVs, whether installed under NFPA 13 or NFPA 24. Further, LSC-2000, requires that "a distinctive supervisory signal shall be provided to indicate a condition that would impair the satisfactory operation of the sprinkler 3 Page 143 of 316

144 system". Would a closed PIV impair the satisfactory operation of a sprinkler system? I would certainly think so. In any event, it matters little whether you and I agree on whether PIVs require supervision. What does matter is that CMS, or at least someone in CMS, appears to think so, and in at least one case has assessed Imminent Jeopardy against a facility without this feature. As such, I would think it would be prudent for facilities to consider installing tamper switches on PIVs that don't already have them. I'm certainly going to recommend this to my health care clients. In general, I would think that a day or two of lost Medicare reimbursement would pay for tamper switches on all PIVs in most facilities. Probably best for us to agree to disagree, and get back to our day jobs. As always, I enjoy the spirited debates that crop up from time to time on the ListServe--I always learn from them! Regards, Benjamin E. Thurston, PE 6141 Laport St. La Mesa, CA BenThurston@ATT.net (619) (home) (619) (mobile) -----Original Message----- From: American Society for Healthcare Engineering [mailto:asheaha-l@ahals.aha.org] On Behalf Of Mark Jelinske Sent: Monday, December 09, :38 AM To: ASHEAHA-L@AHALS.AHA.ORG Subject: Re: monitoring exterior valves serving hospital fire protection systems Throughout NFPA 101 section 9.7 the term "automatic sprinkler system" is used and the references are to NFPA 13. Nowhere does NFPA use the term Private Fire Mains or reference NFPA 24. "Automatic sprinkler systems" are one thing, and "Private Fire Mains" are another thing. NFPA documents are usually pretty good about using the words they really mean, especially when the words are defined in NFPA documents. If they really meant to include "Private Fire Mains" in , they could have easily added the words "and Private Fire Mains", but they didn't. Mark Jelinske, P.E. Sr. Associate/Mechanical Engineer Cator, Ruma & Associates, Co. Colorado Wyoming 896 Tabor Street, Lakewood, CO P (303) D (303) C (303) Π Please consider the environment before printing this . The information contained in this electronic message should be considered confidential, and is intended solely for the use of the individual or entity to which it is addressed. Copying, dissemination, or disclosure of this information is strictly prohibited without the express permission of the sender. If you are not the intended recipient, please delete this message and notify the sender immediately. Thank you Original Message----- From: American Society for Healthcare Engineering [mailto:asheaha-l@ahals.aha.org] On Behalf Of Ben Thurston Sent: Monday, December 09, :10 AM To: ASHEAHA-L@AHALS.AHA.ORG Subject: Re: monitoring exterior valves serving hospital fire protection systems Mark, I'm curious where you're seeing that "NFPA 101 is only asking for NFPA 13 valves to be supervised, not NFPA 24 valves"? LSC- 2000, simply requires electrical supervision on sprinkler control valves, without regard to what standard they're installed under. This section also references NFPA 72; but again, NFPA 72 refers to supervision on control valves, without regard to whether they're 4 Page 144 of 316

145 installed under NFPA 13 or NFPA 24. It seems to me that this is similar to the situation of NFPA 13 vs. LSC--NFPA 24 permits various combinations of electrical supervision, locking and sealing, but among those LSC only permits electrical supervision. Ben Thurston -----Original Message----- From: American Society for Healthcare Engineering On Behalf Of Mark Jelinske Sent: Sunday, December 08, :27 AM To: Subject: Re: monitoring exterior valves serving hospital fire protection systems This is a reasonable view. Private Fire Service Mains are under NFPA 24, and the definition of a Private Fire Service Main is (2002 quoted since that is the easiest cut and paste version I have): 3.3.1* Private Fire Service Main. Private fire service main, as used in this standard, is that pipe and its appurtenances on private property (1) between a source of water and the base of the system riser for water-based fire protection systems, (2) between a source of water and inlets to foam-making systems, (3) between a source of water and the base elbow of private hydrants or monitor nozzles, and (4) used as fire pump suction and discharge piping, (5) beginning at the inlet side of the check valve on a gravity or pressure tank. [13:3.8] The illustration in the Annex notes is clear that NFPA 24 covers from the property line to the connection INSIDE the building. NFPA 24 require valves to be visual indicating type. The preferred method is a PIV, but any indicating valve is acceptable, such as rising stem gate valves. Where allowed by the AHJ, an underground valve with t-wrench operator us also acceptable. It sounds like all valves in the are indeed indicting. NFPA 101 is only asking for NFPA 13 valves to be supervised, not NFPA 24 valves. Therefore the NFPA 101 requirement does not start until inside the building. The only potential concern is that NFPA 24 allows 4 methods of "supervision": 6.6.2* Valves on connections to water supplies, sectional control and isolation valves, and other valves in supply pipes to sprinklers and other fixed water-based fire suppression systems shall be supervised by one of the following methods: (1) Central station, proprietary, or remote station signaling service (2) Local signaling service that causes the sounding of an audible signal at a constantly attended location (3) An approved procedure to ensure that valves are locked in the correct position (4) An approved procedure to ensure that valves are located within fenced enclosures under the control of the owner, sealed in the open position, and inspected weekly Supervision of underground gate valves with roadway boxes shall not be required. This certainly allows valves to be locked or fenced in. But note that wonderful phrase "An approved procedure..." regarding fenced/locked valve options. So who "approves"? I would hope CMS would defer to the local Fire Department. Can you show that the FD "approves" this locking arrangement? Mark Jelinske, P.E. Sr. Associate/Mechanical Engineer Cator, Ruma & Associates, Co. Colorado Wyoming 896 Tabor Street, Lakewood, CO P (303) D (303) C (303) Π Please consider the environment before printing this . The information contained in this electronic message should be considered confidential, and is intended solely for the use of the individual or entity to which it is addressed. Copying, dissemination, or disclosure of this information is strictly prohibited without the express permission of the sender. If you are not the intended recipient, please delete this message and notify the sender immediately. 5 Page 145 of 316

146 Thank you Original Message----- From: American Society for Healthcare Engineering On Behalf Of OSWALD,RICHARD J Sent: Friday, December 06, :47 PM To: ASHEAHA-L@AHALS.AHA.ORG Subject: Re: monitoring exterior valves serving hospital fire protection systems I consider the valves at our backflow preventers as part of the 'private fire service main' and do not consider them to be part of the 'sprinkler system'. The valves and backflow preventers on our campus water mains serve domestic water, fire hydrants and riser connections to standpipes and fire pump suction. We have fire alarm supervision of all valves once the pipe enters the building to connect to the fire pump, standpipes or sprinklers. The valves that are associated with the parallel backflow preventers are chained in the open position. Richard Oswald, CHFM Systems Specialist Woman's Hospital P. O. Box Baton Rouge, LA (225) Original Message----- From: American Society for Healthcare Engineering [mailto:asheaha-l@ahals.aha.org] On Behalf Of Ed Tinsley Sent: Thursday, December 05, :55 PM To: ASHEAHA-L@AHALS.AHA.ORG Subject: monitoring exterior valves serving hospital fire protection systems I have a question regarding the monitoring of exterior valves in the service piping to a hospital fire protection system. Recently CMS issues a K tag and is withholding Medicare reimbursement to a hospital. The basis of the K tag is LSC According to CMS, this language requires all automatic sprinkler system valves to be supervised. My confusion is the 1999 edition of NFPA 13 allows these valves to be supervised by one of 4 methods. One of these is simply locking the valves open. ( ). The valves in question were the valves were the double check backflow preventers in an above grade enclosure and several post indicating control valves. The valves were locked open. Is the CMS interpretation correct? Ed Tinsley ############################ To unsubscribe from the ASHEAHA-L list: write to: mailto:asheaha-l-signoff-request@ahals.aha.org or click the following link: Spam Not spam Forget previous vote 6 Page 146 of 316

147 National Fire Protection Association Report Page 147 of of 618 7/7/2015 8:49 AM Public Input No. 206-NFPA [ Section No ] Ambulatory Health Care Occupancy. An occupancy used to provide services or treatment simultaneously to four or more patients that provides, on an outpatient basis, one or more of the following: (1) treatment for patients that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others; (2) anesthesia that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others; (3) emergency or urgent care for patients who, due to the nature of their injury or illness, are incapable of taking action for self-preservation under emergency conditions without the assistance of others. (SAF-HEA) Statement of Problem and Substantiation for Public Input Problem - Designation as 'urgent' care substantially increases facility construction costs in order to comply with the requirements for an Ambulatory Health Care Occupancy. An 'Urgent Care' Clinic is most often a good and timely substitute for a primary care clinic, depending on access to primary care. Based on the program level of care provided at Urgent Care Clinics, the need for enhanced facility features, e.g., emergency generators, is not necessary. Solution - remove Urgent Care Clinics from New/Existing Ambulatory Health Care Occupancy requirements. Health Care construction and maintenance costs are increasing substantially, and creating enhanced facility requirements unnecessarily, with definition or cause, Note - There is a great deal of confusion among consumers, designers, health care policy makers, etc., regarding the differences between primary, urgent and emergency care. If a patient is truly in need of emergency care, 911 is called or they make it to an Emergency Department. All EMTs know the difference, and by routine, would deliver most any patient to a Emergency Department, contiguous to a hospital or free-standing. If a patient makes their way to a Urgent Care Clinic with chest pains, for example, the patient is triaged and stabilized and 911 is appropriately called. To increase the level of facility care for this one (1) patient is also increasing the cost of health care. Recommend a survey or study of licensed (or, marketed...) Urgent Care Centers regarding patient cases before increasing facility requirements. Submitter Information Verification Submitter Full Name: BRUCE BROOKS Organization: NOELKER AND HULL Street Address: City: State: Zip: Submittal Date: Mon Jun 29 06:58:31 EDT 2015

148 National Fire Protection Association Report Page 148 of of 618 7/7/2015 8:49 AM Public Input No. 16-NFPA [ Section No ] * Door-locking arrangements shall be permitted where patient special needs require specialized protective measures for their safety, provided that all of the following criteria are met: (1) Staff can readily unlock doors at all times in accordance with (2) A total (complete) smoke detection system is provided throughout the locked space in accordance with , or locked doors can be remotely unlocked at an approved, constantly attended location within the locked space. (3) * The building is protected throughout by an approved, supervised automatic sprinkler system in accordance with (4) The locks are electrical locks that fail safely so as to release upon loss of power to the device. (5) The locks release by independent activation of each of the following: (6) Activation of the smoke detection system required by (2) (7) Waterflow in the automatic sprinkler system required by (3) (8) Door locking devices shall be manually reset at the door or within the locked area. Additional Proposed Changes File Name Description Approved 101_PC36.pdf NFPA 101 Public Comment 36 Statement of Problem and Substantiation for Public Input NOTE: The following Public Input appeared as Reject but Hold in Public Comment No. 36 of the A2014 Second Draft Report for NFPA 101 and per the Regs. at This would add a requirement that locking devices (typically by electronic means) be manually reset either at the door or from a location within the locked area. This helps ensure that the doors remain unlocked until staff participates in the relocking process. Many of these locking systems reset as soon as the initiating signal is gone (from the fire alarm panel). In health care facilities the staff should initiate relocking; it should not be done through software programming or hardware configurations. Submitter Information Verification Submitter Full Name: TC ON SAF-HEA Organization: NFPA 101 TC on Health Care Occupancies Street Address: City: State: Zip:

149 National Fire Protection Association Report Page 149 of of 618 7/7/2015 8:49 AM Submittal Date: Fri Feb 06 14:45:51 EST 2015

150 National Fire Protection Association Report Page 150 of of 2 2/5/2015 9:36 AM Public Comment No. 36-NFPA [ Section No ] * Door-locking arrangements shall be permitted where patient special needs require specialized protective measures for their safety, provided that all of the following criteria are met: (1) Staff can readily unlock doors at all times in accordance with (2) A total (complete) smoke detection system is provided throughout the locked space in accordance with , or locked doors can be remotely unlocked at an approved, constantly attended location within the locked space. (3) * The building is protected throughout by an approved, supervised automatic sprinkler system in accordance with (4) The locks are electrical locks that fail safely so as to release upon loss of power to the device. (5) The locks release by independent activation of each of the following: (a) Activation of the smoke detection system required by (2) (b) Waterflow in the automatic sprinkler system required by (3) (6) (6) Door locking devices shall be manually reset at the door or within the locked area. Statement of Problem and Substantiation for Public Comment This would add a requirement that locking devices (typically by electronic means) be manually reset either at the door or from a location within the locked area. This helps ensure that the doors remain unlocked until staff participates in the relocking process. Many of these locking systems reset as soon as the initiating signal is gone (from the fire alarm panel). In health care facilities the staff should initiate relocking; it should not be done through software programming or hardware configurations. Submitter Information Verification Submitter Full Name: Doug Hohbein Organization: Northcentral Fire Code Develop Street Address: City: State: Zip: Submittal Date: Tue Apr 02 14:57:32 EDT 2013 Committee Statement Committee Action: Rejected but held Resolution: The subject was not raised in the First Revision phase and must be held.

151 National Fire Protection Association Report Page 151 of of 2 2/5/2015 9:36 AM Copyright Assignment I, Doug Hohbein, hereby irrevocably grant and assign to the National Fire Protection Association (NFPA) all and full rights in copyright in this Public Comment (including both the Proposed Change and the Statement of Problem and Substantiation). I understand and intend that I acquire no rights, including rights as a joint author, in any publication of the NFPA in which this Public Comment in this or another similar or derivative form is used. I hereby warrant that I am the author of this Public Comment and that I have full power and authority to enter into this copyright assignment. By checking this box I affirm that I am Doug Hohbein, and I agree to be legally bound by the above Copyright Assignment and the terms and conditions contained therein. I understand and intend that, by checking this box, I am creating an electronic signature that will, upon my submission of this form, have the same legal force and effect as a handwritten signature

152 National Fire Protection Association Report Page 152 of of 618 7/7/2015 8:49 AM Public Input No. 76-NFPA [ Section No ] High-rise health care occupancies Stairs that serve a floor of an occupiable story that is greater than 75 ft above the level of fire department vehicle access shall comply with the re-entry provisions of Statement of Problem and Substantiation for Public Input A high-rise building is defined as A building where the floor of an occupiable story is greater than 75 ft (23 m) above the lowest level of fire department vehicle access. However, there may be stairs in a building that is classified as a high-rise building, that serve portions of the building where the top occupied floor is less than 75 ft above the access. Presently, the code allows a non-high-rise building classified as a healthcare occupancy to lock exit stair doors against re-entry provided it is not a high-rise building. If the intent is to allow this for stairs that don t serve the high-rise portion, then the modified language would allow a stair that serves only five floors to be locked against re-entry while still requiring any stair that serves the high-rise portions of the building to meet the re-entry provisions of Chapter 7. As written, the stairs serving the non-high rise portion of the building must comply with the reentry provisions of Chapter 7 and that doesn t appear to be the intent of the code based on the wording in the Life Safety Code Handbook, which states the following: Because the Code prohibits more than four floors between floors that provide a way out of the stairway, stair enclosures serving more than six or seven stories must have more than two unlocked re-entry points. This arrangement provides flexibility in buildings that, perhaps for security reasons, need to prevent re-entry on certain floors, while at the same time ensuring that one can re-enter the building without having to travel up or down too many flights of stairs. Submitter Information Verification Submitter Full Name: PETER LARRIMER Organization: US DEPARTMENT OF VETERANS AFFA Street Address: City: State: Zip: Submittal Date: Thu Apr 23 11:25:59 EDT 2015

153 National Fire Protection Association Report Page 153 of of 618 7/7/2015 8:49 AM Public Input No. 213-NFPA [ Section No ] Horizontal sliding doors Special-purpose horizontal sliding accordian or folding door assemblies in accordance with , that are not automatic-closing shall be limited to a single leaf and shall have a latch or other mechanism that ensures that the doors will not rebound into a partially open position if forcefully closed. Statement of Problem and Substantiation for Public Input The last cycle, reference to was removed from the code in 18/ Presently, 18/ allows two options for horizontal-sliding doors. However, it appears that the user of the code can use the first option and none of the restrictions in the second option would apply effectively negating the need for the second option. I am not sure if this is the fix, but the way the code reads now, facilities can install horizontal sliding doors in the means of egress in accordance with 18/ even when serving a large occupant load (>10) and there are no requirements on how the door is supposed to operate. Submitter Information Verification Submitter Full Name: PETER LARRIMER Organization: US DEPARTMENT OF VETERANS AFFA Street Address: City: State: Zip: Submittal Date: Tue Jun 30 08:42:46 EDT 2015

154 National Fire Protection Association Report Page 154 of of 618 7/7/2015 8:49 AM Public Input No. 448-NFPA [ Section No ] Stairs. Stairs complying with shall be permitted Cameras for security or stairwell monitoring shall be permited where wiring is installed in metal conduit and the penetrations are protected in accordance with Statement of Problem and Substantiation for Public Input Cameras need to be allowed in stairwells per and reference to protection requirements needs to be provided to ensure the installation of cameras to not damage the integrity of the stairwell protection. Submitter Information Verification Submitter Full Name: CHAD BEEBE Organization: ASHE - AHA Street Address: City: State: Zip: Submittal Date: Mon Jul 06 16:22:35 EDT 2015

155 National Fire Protection Association Report Page 155 of of 618 7/7/2015 8:49 AM Public Input No. 338-NFPA [ New Section after ] (9) Stored egress devices or equipment may encroach on the required corridor width by 4.5 inches on one side of the corridor. Statement of Problem and Substantiation for Public Input Health care occupancies use these devices as part of the emergency egress plan. This new paragraph will allow the storage of these devices and equipment close to the area of use. Submitter Information Verification Submitter Full Name: MICHAEL CROWLEY Organization: JENSEN HUGHES Street Address: City: State: Zip: Submittal Date: Sat Jul 04 19:49:03 EDT 2015

156 National Fire Protection Association Report Page 156 of of 618 7/7/2015 8:49 AM Public Input No. 194-NFPA [ Section No ]

157 National Fire Protection Association Report Page 157 of of 618 7/7/2015 8:49 AM *

158 National Fire Protection Association Report Page 158 of of 618 7/7/2015 8:49 AM Aisles, corridors, and ramps required for exit access in a hospital or nursing home shall be not less than 8 ft (2440 mm) in clear and unobstructed width, unless otherwise permitted by one of the following: (1) (2) (3) * Aisles, corridors, and ramps in adjunct areas not intended for the housing, treatment, or use of inpatients shall be not less than 44 in. (1120 mm) in clear and unobstructed width. * Noncontinuous projections not more than 6 in. (150 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted. * Exit access within a room or suite of rooms complying with the requirements of shall be permitted. (4) Projections into the required width shall be permitted for wheeled equipment and evacuation aides, provided that all of the following conditions are met: (5) The wheeled equipment does not reduce the clear unobstructed corridor width to less than 60 in. (1525 mm). (6) The health care occupancy fire safety plan and training program address the relocation of the wheeled equipment during a fire or similar emergency. (7) * The wheeled equipment is limited to the following: (8) (9) (10) Equipment in use and carts in use Medical emergency equipment not in use Patient lift and transport equipment (11)* Where the corridor width is at least 8 ft (2440 mm), projections into the required width shall be permitted for fixed furniture, provided that all of the following conditions are met: (12) (13) The fixed furniture does not reduce the clear unobstructed corridor width to less than 6 ft (1830 mm), except as permitted by (2). (14) (15) The fixed furniture is securely attached to the floor or to the wall. The fixed furniture is located only on one side of the corridor. The fixed furniture is grouped such that each grouping does not exceed an area of 50 ft 2 (4.6 m 2 ). (16) The fixed furniture groupings addressed in (5)(d) are separated from each other by a distance of at least 10 ft (3050 mm). (17)* The fixed furniture is located so as to not obstruct access to building service and fire protection equipment. (18) Corridors throughout the smoke compartment are protected by an electrically supervised automatic smoke detection system in accordance with , or the fixed furniture spaces are arranged and located to allow direct supervision by the facility staff from a nurses station or similar space. (19)* Cross-corridor door openings in corridors with a required minimum width of 8 ft (2440 mm) shall have a clear width of not less than 6 ft 11 in. (2110 mm) for pairs of doors or a clear width of not less than in. (1055 mm) for a single door. (20) Nursing home corridors shall be permitted to be not less than 6 ft (1830 mm) wide in smoke compartments housing not more than 30 patients.

159 National Fire Protection Association Report Page 159 of of 618 7/7/2015 8:49 AM (21) Cross-corridor door openings in corridors with a required minimum width of 6 ft (1830 mm) shall have a clear width of not less than 64 in. (1625 mm) for pairs of doors or a clear width of not less than in. (1055 mm) for a single door. Statement of Problem and Substantiation for Public Input Currently there is no provision for evacuation equipment to be stored either in the stairway or corridor. This would permit evacuation sleds with or without wheels to be stored in the corridor which aide in the unlikely evacuation of patients. since these are used for the same primary purpose of the corridor (i.e. evacuation / relocation / movement of patients) there shouldn't be anything that prohibits them from being located in the corridor. Submitter Information Verification Submitter Full Name: CHAD BEEBE Organization: ASHE - AHA Street Address: City: State: Zip: Submittal Date: Fri Jun 26 00:34:03 EDT 2015

160 National Fire Protection Association Report Page 160 of of 618 7/7/2015 8:49 AM Public Input No. 444-NFPA [ Section No ]

161 National Fire Protection Association Report Page 161 of of 618 7/7/2015 8:49 AM *

162 National Fire Protection Association Report Page 162 of of 618 7/7/2015 8:49 AM Aisles, corridors, and ramps required for exit access in a hospital or nursing home shall be not less than 8 ft (2440 mm) in clear and unobstructed width, unless otherwise permitted by one of the following: (1) (2) (3) * Aisles, corridors, and ramps in adjunct areas not intended for the housing, treatment, or use of inpatients shall be not less than 44 in. (1120 mm) in clear and unobstructed width. * Noncontinuous projections not more than 6 4 in. (150 mm) from the corridor wall, positioned not less than 38 in. (965 mm) above the floor, shall be permitted. * Exit access within a room or suite of rooms complying with the requirements of shall be permitted. (4) Projections into the required width shall be permitted for wheeled equipment, provided that all of the following conditions are met: (5) The wheeled equipment does not reduce the clear unobstructed corridor width to less than 60 in. (1525 mm). (6) The health care occupancy fire safety plan and training program address the relocation of the wheeled equipment during a fire or similar emergency. (7) * The wheeled equipment is limited to the following: (8) (9) (10) Equipment in use and carts in use Medical emergency equipment not in use Patient lift and transport equipment (11)* Where the corridor width is at least 8 ft (2440 mm), projections into the required width shall be permitted for fixed furniture, provided that all of the following conditions are met: (12) (13) The fixed furniture does not reduce the clear unobstructed corridor width to less than 6 ft (1830 mm), except as permitted by (2). (14) (15) The fixed furniture is securely attached to the floor or to the wall. The fixed furniture is located only on one side of the corridor. The fixed furniture is grouped such that each grouping does not exceed an area of 50 ft 2 (4.6 m 2 ). (16) The fixed furniture groupings addressed in (5)(d) are separated from each other by a distance of at least 10 ft (3050 mm). (17)* The fixed furniture is located so as to not obstruct access to building service and fire protection equipment. (18) Corridors throughout the smoke compartment are protected by an electrically supervised automatic smoke detection system in accordance with , or the fixed furniture spaces are arranged and located to allow direct supervision by the facility staff from a nurses station or similar space. (19)* Cross-corridor door openings in corridors with a required minimum width of 8 ft (2440 mm) shall have a clear width of not less than 6 ft 11 in. (2110 mm) for pairs of doors or a clear width of not less than in. (1055 mm) for a single door. (20) Nursing home corridors shall be permitted to be not less than 6 ft (1830 mm) wide in smoke compartments housing not more than 30 patients.

163 National Fire Protection Association Report Page 163 of of 618 7/7/2015 8:49 AM (21) Cross-corridor door openings in corridors with a required minimum width of 6 ft (1830 mm) shall have a clear width of not less than 64 in. (1625 mm) for pairs of doors or a clear width of not less than in. (1055 mm) for a single door. Additional Proposed Changes File Name Description Approved ADA_projections.jpg ADA projection limits Statement of Problem and Substantiation for Public Input For fire and life safety reasons there may not be a need to limit the projections to 4" but to meet ADA requirements hospitals must not exceed 4" projections. This conflict is creating a a problem in a number of situations where ADA issues are being cited after construction. we recommend that NFPA go back to the 4 inch projection limit and include reference in the annex to the ADA requirements. If possible, provide allowance for 6" in facilities or areas of facilities where ADA compliance is not necessary. Submitter Information Verification Submitter Full Name: CHAD BEEBE Organization: ASHE - AHA Street Address: City: State: Zip: Submittal Date: Mon Jul 06 16:01:29 EDT 2015

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165 National Fire Protection Association Report Page 165 of of 618 7/7/2015 8:49 AM Public Input No. 450-NFPA [ Section No ] The minimum clear width for doors in the means of egress from sleeping rooms; diagnostic and treatment areas, such as x-ray, surgery, or physical therapy; and nursery rooms shall be as follows: (1) Hospitals and nursing homes in. (1055 mm 1130mm ) (2) Psychiatric hospitals and limited care facilities 32 in. (810 mm) (3) Nursing Homes - 41 in. (1141 mm) Statement of Problem and Substantiation for Public Input The current standard of 41.5 inches for hospitals and nursing homes has a couple of problems. For one thing, 41.5 inches appears to have been settled upon to allow a standard 3'-8" door. This is not the case, however. With a standard 1.75 inch door and 4.5 inch butt hinges, the clear width for a 3'-8" door is less than 41.5 inches. The intent of the standard is to allow beds to pass through the doors with a small margin of error. Nursing home beds are typically no more than 40 inches wide, so 41 inches will allow use of 3'-8" doors without compromising the intent of the standard. For hospitals, the use of bariatric beds has become much more prevalent and the ability to move the patient in the bed may be critical to the patient's survival in a fire event. The typical bariatric hospital bed can be as large as inches wide and a 4'-0" door with standard butt hinges would have a clear opening of about 45 inches. This proposed change is intended to allow use of 3'-8" doors in nursing homes and 4'-0" doors in hospitals without compromising patient safety. Submitter Information Verification Submitter Full Name: JOHN RICKARD Organization: P3 CONSULTING Street Address: City: State: Zip: Submittal Date: Mon Jul 06 16:57:39 EDT 2015

166 National Fire Protection Association Report Page 166 of of 618 7/7/2015 8:49 AM Public Input No. 218-NFPA [ Section No ] The requirements of shall not apply where otherwise permitted by one of the following: (1) Doors that are located so as not to be subject to use by any health care occupant shall be not less than 32 in. (810 mm) in clear width. (2) Doors in exit stair enclosures shall be not less than 32 in. (810 mm) in clear width. (3) Doors serving newborn nurseries shall be not less than 32 in. (810 mm) in clear width. (4) Where a pair of doors is provided, all of the following criteria shall be met: (5) Not less than one of the doors shall provide not less than a 32 in. (810 mm) clear width opening. (6) A rabbet, bevel, or astragal shall be provided at the meeting edge. (7) The inactive door leaf shall have an automatic flush bolt to provide positive latching. (8) Where telescoping doors is provided, all the following shall be met: (9) Not less then 32 inches clear shall be provided on the 1st telescoping opening (10) Not less then 41 1/2 inches clear shall be provided upon the breakaway Statement of Problem and Substantiation for Public Input I m not sure if it was the intent of the code or not, but many jurisdictions require the clear width into a room via a sliding door be 41 1/2 inches clear via the slide of the 1st panel only. I recently did a project with private PACU bays where we had a 4 panel slider. It, additionally, broke away giving a full clear opening of 7 feet wide. The health agency would not allow it because the 1st of the 4 panels did not provide 41 1/2 inches clear. Even with the 3 panels that slid, we had 41 inches, it required the breakaway to achieve the additional opening width. In order to achieve 41 1/2 inches clear on any sliding door, the opening has to be 9 feet or greater. And the way some agencies read this, he only can have a 2 panel sliding door, one sliding door and one fixed breakaway panel. Sliding glass doors have not, until recently, been able to achieve positive latching as well as smoke tight. Therefore, I don't believe the code has been able to keep up with the advancements of some of the new door operations. Not sure what a,b,c on item 4 is underlined. I did not edit that, I only added "5. a and b" Submitter Information Verification Submitter Full Name: MARVIN HUIE Organization: WHR Architects Street Address:

167 National Fire Protection Association Report Page 167 of of 618 7/7/2015 8:49 AM City: State: Zip: Submittal Date: Tue Jun 30 11:55:13 EDT 2015

168 National Fire Protection Association Report Page 168 of of 618 7/7/2015 8:49 AM Public Input No. 112-NFPA [ Section No ] * Not less than two exits shall be accessible from every part of each smoke compartment, and egress shall be permitted through an adjacent compartment(s), provided that the two required egress paths are arranged so that both do not pass through the same adjacent smoke compartment. Additional Proposed Changes File Name Description Approved NFPA_101_ _Public_Input_Example.docx Example of issue. Statement of Problem and Substantiation for Public Input As written, the code permits rooms to be in one smoke compartment while the only egress path from the room is through the corridor door into the adjacent smoke compartment. See the uploaded sketch showing the Social Worker Consultation Room as an example of this condition. The change will help clarify the intent of the code. See also the existing language used in Consideration should also be given to making this change in Chapter 19, specifically Submitter Information Verification Submitter Full Name: PETER LARRIMER Organization: US DEPARTMENT OF VETERANS AFFA Street Address: City: State: Zip: Submittal Date: Mon Jun 01 16:26:06 EDT 2015

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