FIRE PROTECTION KEY DESIGN CONCEPTS IN HEALTHCARE FACILITIES Scott Twele, Aman Shah Steven Dannaway AIA Healthcare Group
Introductions Presenters Coffman Engineers Scott M. Twele, P.E. Operations Manager, Fire Protection Engineering San Diego Aman Shah, P.E. Senior Engineer, Fire Protection Engineering San Diego Steven Dannaway, P.E. Engineer, Fire Protection Engineering Los Angeles 2
Agenda Applicable Codes, AHJs, Jurisdiction Occupancy Classification Defend-In-Place + Smoke Compartments Means of Egress Suites Vertical Openings Hazardous Areas/Incidental Uses Corridors HVAC Fire Protection Systems Removal of Acute Care Services (OSHPD) Note: Red text = 2016 code change 3
Fire Record 4
Applicable Codes and Jurisdiction California OSHPD CBC 1.10 provides authority OSHPD 1 (Hospitals) OSHPD 2 (Skilled Nursing + Intermediate Care Facilities) OSHPD 4 (Correctional Treatment Centers) Local Jurisdictions Outpatient MOB OSHPD 3 (Licensed clinics + freestanding buildings under Hospital License) Applicable Codes California Building Standards California Building Code (CBC), based on the International Building Code (IBC) CFC, CEC, CMC, CPC, etc. NFPA Standards Referenced by Chapter 35 of the CBC/Chapter 80 of the CFC. NFPA 101 Life Safety Code (CMS + TJC) 5
CMS + NFPA 101 Life Safety Code Enforced by Centers for Medicaid and Medicare Services (CMS) Agencies with Deemed Status conduct evaluations on behalf of CMS ex. The Joint Commission (TJC) CMS official adoption of 2012 editions of NFPA 101 and NFPA 99 Effective 07/05/2016 Surveys use 2012 starting 11/01/2016 What facilities must comply with NFPA 101? Hospitals, Long-term care facilities, Ambulatory Surgery Centers, Hospice inpatient facilities, religious non-medical healthcare institutions, inclusive care of the elderly Defined in CMS Final Ruling on adoption of 2012 NFPA 101 CMS amendments to LSC Design to both CBC and NFPA 101 recommended! 6
Occupancy Classifications CBC did not adopt 2015 IBC change: Group I-2 two separate condition groups. Outpatient Facilities - Define # of patients Incapable of Self-Preservation. Infusion/Chemo/Dialysis often fall under this category. Ambulatory Healthcare (NFPA 101): 4 or more patients incapable Note: CMS amendment to NFPA 101 - Chapter 20 applies to ASC with 1 or more patients Incapable of Self Preservation Other Occupancies Healthcare Facility Occupancy Classifications Use CBC NFPA 101 Inpatient (> 24 hrs) Group I-2 Healthcare Ch. 18 Outpatient > 6 Incapable Group I-2.1 Ambulatory Ch. 20 Outpatient 1 < x < 5 Incapable Group B Ambulatory CBC 422 Ambulatory Ch. 20 Outpatient, 0 incapable Group B Business Ch. 38 Many facilities also contain Group B, Group A, Group S, and/or Group F-1 occupancies 7
Multiple Occupancies and Occupancy Separations Occupancy Separation Group I-2 (discussion applies to I-3 too) 2016 CBC 2013 CBC: Group I-2 = 2-hour separation from all occupancies, 3-hours from F-1 2016 CBC eliminates requirement. Accessory, Non-separated, or Separated Occupancy approaches permitted (careful! NFPA 101 for Healthcare still requires 2-hour!) 2016 CBC adds exception 3: No separation required between Group B, E, R-2 sleeping units and S-2 occupancies accessory to Group I-2, I- 2.1, and I-3 of Type I. 2013 CBC 2016 CBC Table 508.4 footnote added about F- 1 commercial kitchen and I-2 (not Group I-3) reduces to 2-hours. OSHPD typically requires Central Plant type rooms to be classified as Group F-1 (chiller, boiler, etc.) (3-hours) 8
Defend-In-Place: Total Concept 9
Defend-In-Place Concept Compartmentation Smoke barriers, evacuation zones may include one or more smoke compartments Corridor integrity Hazardous rooms/areas Facility Emergency Plan + Staff Training CBC/CFC and NFPA 101 require emergency plans for Group I-2 The best LS strategy will not function properly without proper staff training + emergency plan. Means of Egress/Evacuation Refuge Area to accommodate patients Exits available so relocated occupants are not trapped Fire Protection Systems Suppression (sprinklers) Detection and Zoning of Systems (fire alarm + sprinklers) NFPA 99 requires sprinkler zoning to align with evacuation zones, NFPA 72 in combination with CBC/CFC indirectly require this. 10
Smoke Compartments Group I-2 and Group I-2.1: Stories used for patient sleeping or treatment or other stories with more than 49 occupants, regardless of occupancy/use. Existing Group I- 2.1 exceptions Group B Ambulatory: Aggregate area of one or more of Ambulatory Care Facilities > 10,000 sq. ft. 2016 CBC Change: Added exception 3 to CBC 407.5 that correlates to NFPA 101 exceptions for smoke compartments: New Exceptions Existing Exceptions 11
Smoke Compartment Section Red = smoke barrier Blue = 2-hour fire barrier 12
Smoke Compartments Maximum Area per Smoke Compartment: 22,500 sq. ft. California did not adopt 2015 IBC changes to increase smoke compartment size to 40,000 sq. ft. Remains 22,500 sq. ft., same as NFPA 101. Maximum Smoke Barrier Travel Distance = 200 feet to a smoke barrier door. Refuge area calculation Slight Variation between CBC and NFPA 101. Low hazard areas patient rooms, treatment rooms corridors, waiting areas, etc. Refuge Area Calculations CBC NFPA 101 All Floors 30 sf per bedridden patient + 6 sf for ambulatory care recipients and other occupants Stories w/bedridden patients 30 sf per bedridden patient Stories w/o bedridden patients 6 sf per occupant (total OL) 13
Smoke Compartments Two means of egress required from each smoke compartment. Opposite Swinging Doors at cross-corridor conditions. Exits are not required from each individual compartment but cannot have all exits into same smoke compartment. No dead-end compartments! 14
Smoke Compartments The only exit from a room is not allowed to be directly across a smoke barrier. 15
Means of Egress Even with smoke compartments + defend-in-place, compliant exiting is still required per CBC Chapter 10. 16
Chapter 10 Means of Egress CBC 1008 Means of Egress Illumination Group I-2, exit discharge exterior landings Minimum 1 footcandle upon loss of any single lighting unit during normal conditions. Group I-2 emergency illumination Minimum 0.2 footcandle upon loss of any single lighting unit. Emergency illumination required in new spaces Electrical equipment rooms Fire Command Center Fire Pump Room Generator Rooms Public restrooms with area greater than 300 sq. ft. 17
Means of Egress Egress Width Group I-2 occupancies do not qualify for the reduced egress factor exception of CBC. 0.2 inches/occ. for doors/horizontal components and 0.3 in./occ. for stairways. Egress Component Stairways/Ramps Doors Corridors Minimum Egress Width Requirements Egress Width 44 inches between handrails (I-2/I-2.1) (CA amendment) 44-inch clear width serving bed/gurney occ. (I-2/I-2.1) 32-inch clear width otherwise 96 Inches Group I-2, serving bed or gurney occupants or nonambulatory person 72 inches Group I-2.1 or Group B Ambulatory, serving means of egress for bed or gurney occupants (Ch. 10) 96 inches Group I-2.1 or Group B Ambulatory, corridors serving bed/gurney movement during normal day-to-day operations (OSHPD 3 CBC Chapter 12) 18
Means of Egress Horizontal Exits Group I-2: 2/3 exits via HE Other: 1/2 exits via HE 19
Means of Egress Door Locking NFPA 101 and IBC allow locked egress doors under certain conditions in healthcare occupancies. CBC prohibits locked egress doors in the means of egress SFM amendment Delayed egress Local alarm at Unlocked egress door Restrict Access into Space 2016 CBC Group I-2 occupancies can pass through two doors with delayed egress Relocation vs. Exiting AMC? 20
Means of Egress Other Considerations Daylighting the basement CBC 407.4.1.2 (California amendment) Group I-2 occupancies below grade An exterior exit door is required at the basement level Egress Through Stairways on First Floor (OSHPD Interpretation): The means of egress on a Level of Exit Discharge is not permitted to egress through an exit stairway. A separate path of travel to an exterior egress door is required (not through the stairway). In other than Group I-2 occupancies, 2016 CBC allows means of egress to pass through enclosed elevator lobbies. Prohibited in Group I-2 occupancies. Smoke containment system (smokeguard) is an option. 21
Means of Egress Habitable Rooms CBC 407.4.1 Group I-2 Habitable Rooms require direct access to the corridor or shall be located within a Care Suite. OSHPD CAN 2-407.4.1 clarifies application of requirement Habitable rooms are: Patient Areas: sleeping rooms, patient treatment rooms, staff Staff areas: Nourishment rooms, clean/soiled utility rooms, lounges, locker rooms, work areas, consult rooms, offices, workstations, sleeping rooms, etc. Visitor Areas: Waiting rooms, visitor lounges, etc. Not included: Individual bathrooms, closets, housekeeping rooms/similar spaces Control rooms in radiology/imaging spaces, medication rooms from nursing stations, mixing rooms in pharmacies, small storage rooms, small clean/soiled linen storage rooms where no issuing or sorting rooms, MEP utility rooms OSHPD CAN 2-407.4.1 additional clarifications MRI + Radiology rooms can be defined as care suites good! Egress through Anteroom to corridor is permitted without a suite. 22
Suites Group I-2 and Group I-2.1 Sleeping Non-Sleeping Non-Patient Care (NFPA 101). Sleeping Suite Max Size (CBC 407.4.4.5.1) 5,000 sq. ft. basic 1-hour fire barrier separation 7,500 sq. ft. fully sprinklered from remainder of building, 10,000 sq. ft. fully sprinklered + smoke including adjacent suites. detection throughout suite. OSHPD CAN 2-407.4.1 MRI Non-Sleeping Suite Size (CBC 407.4.4.5.1) and Imaging Suites 10,000 sq. ft. Non-Patient Care Areas, CBC vs. NFPA 101 23
Suites Means of Egress Non-Suite areas cannot egress through suites. CBC amendment the fire-rated corridor requirements do not apply in sprinklered Group I-2 suites. NFPA 101 and IBC do not require firerated corridors in Group I-2/Healthcare occupancies. 24
Suites Means of Egress Suite Egress Requirements Type Two Means of Egress Travel Distance to Suite Boundary Sleeping Greater than 1,000 sf CBC 100 feet (one intervening room) Non-Sleeping Greater than 2,500 sf 50 feet (two intervening rooms) 100 feet (two intervening rooms, fully sprinklered, smoke detection) NFPA 101 100 feet (NFPA 101) 25
Vertical Openings 26
Vertical Openings CBC 404.5 Two-Story Atrium, Group I-2 Smoke control is now required in 2-story atriums in Group I-2. I-2.1? Other occupancies, three stories or more (same) Vertical Opening Options CBC 712, 1019 NFPA 101 8.6 Atrium I-2: Smoke control req. Other: Smoke control >3 stories Two-story Unprotected Opening Prohibited in I-2, I-2.1 Other occupancies, now permitted to contain an open exit access stairway No similar option Atrium Smoke control req. Convenience Opening Permitted in healthcare (I-2) Open egress stairways prohibited Communicating Space Prohibited in healthcare (I-2) Would be allowed by CBC, no specific term/code section Partial Enclosure, Two-Story Opening Exit Access Stairways Prohibited in I-2, I-2.1 Multiple options for other occupancies Exit access stairways only permitted by one of the other options in NFPA 101, 8.6. 27
Vertical Openings Consideration to both NFPA 101 and CBC compliance Separation of floors with fire-rated construction to avoid openings: Walls Vertical Shutters/Horizontal Sliding Doors (Openings) Doors complying with ASTM E 119 (equivalent to wall) Tyco Model WS sprinklers (Alternate Method) Occupancy classification/separation I-2 occupancy more restrictive. Other classification allows for additional options. 28
Hazardous Areas 2016 CBC 29
Hazardous Areas NFPA 101 30
Hazardous Areas Group I-2 and I-2.1: One-hour separation is typical. Other occupancies. sprinkler protection may be acceptable in lieu of 1-hour rating. Where sprinkler protection is permitted in lieu of a 1-hour rating, both codes require smoke resistive construction to separate these rooms. Full height walls Smoke Dampers at air transfer openings. Not req d at duct penetrations. Doors shall be self-closing or automatic closing. No louvers. Undercuts compliant with NFPA 80 (3/4-inch). OSHPD classifies CUP rooms like boiler/chiller rooms as Group F-1 occupancies regardless of CBC Table 509. Occupancy Separation from Group I-2 = 3-hours. 31
Corridors Construction Reqs CBC vs. NFPA 101 vs. IBC Fire partitions vs. smoke-resistive vs. smoke partitions CBC includes exceptions that reduce corridor protection to align with NFPA 101. 1-hour fire partitions FSDs (multiple exceptions) Exceptions: Most doors can be non-rated. Do not require selfclosing or automatic closing. devices Smoke Resistive (no louvers). Positive Latching req. Roller latches prohibited Doors must be self-closing/autoclosing if they swing into the required width of corridor. 32
Corridors CBC 407.3.2 Corridor Glazing Unlimited glazing permitted with 20-minute rated fire-protection glazing in approved frames + 1,296 sq. in. max panel. 2016 CBC 2013 CBC 33
Corridors Obstructions OSHPD has been restrictive about allowing equipment/storage within the corridor. NFPA 101 now includes allowances/criteria for wheeled equipment in the corridor. (equipment/carts in use, furniture, medical carts not in use, patient lift and transport equipment not in use). Conflicts between program/owner reqs and OSHPD enforcement of CBC. Wheelchair alcoves or gurney areas have been required to be separated from the corridor. Example of non-compliant storage arrangement open to corridor. 34
Corridors Spaces Open to Corridor Areas open to the corridor Staff supervision + smoke detection in the corridor + area Waiting areas Nursing Stations Gift Shops Nursing Home/Psychiatric facility allowances 35
HVAC System Fire/Smoke Dampers Fire Barriers: Fire/smoke dampers required at all penetrations (California) Corridors: Fire/smoke dampers required at penetrations. Exception for fully ducted system (minimum thickness + ducts = steel) where duct system does not serve corridor. Use this exception to strategically minimize FSDs Smoke Barriers: IBC Smoke dampers not required at smoke barrier penetrations for fully ducted system in sprinklered building. Not adopted by CBC Exit Enclosures, Exit Passageways: Penetrations of exit components prohibited except those items necessary for exit component (sprinkler, fire alarm, lighting, ventilation, etc.). FSD Actuation Methods: Duct detectors vs. full area smoke detection (five methods in CBC 717. 36
HVAC System Fire/Smoke Dampers
HVAC System Sequence of Operations Early discussion understand Owner requirements for HVAC system operation during a fire event. What areas must HVAC system continue to operate? Is full HVAC shutdown acceptable? Critical Care Areas or Hazardous Exhaust? Allows HVAC design development to achieve objectives without significant cost and complication. 38
Fire Protection Systems Fire Alarm Notification Discuss with Owner and AHJ Public vs. Private Mode Signaling (CA) Audible notification appliances chimes or similar sounding devices in patient areas. (CA) In patient areas, visible notification appliances only may be acceptable. CBC 915 Carbon Monoxide Detection Section relocated from CBC 420 and increased in scope. In certain conditions, CO detection required in Group I-2, I-4, R sleeping/dwelling units and Group E classrooms. 39
Removal of Acute Care Services Based on OSHPD CAN 1-6.1.4.5.1 Existing facilities that do not satisfy SPC compliance can be decommissioned. OSHPD has laid out the process for removal of acute care services. General takeaways Split Jurisdiction is not permitted multiple structures that are part of the same Detached Hospital Building Exterior Wall or Fire Wall Separation And Seismic Separation is required for a building to be defined as a separate Freestanding nonhospital building. Only Free standing non-hospital buildings can be removed from OSHPD jurisdiction and moved to the Local Jurisdiction. Buildings on the same lot cannot be applied to separate buildings that are under OSHPD and local jurisdiction. Smoke Compartments + Egress from Hospital Utilities must originate in hospital and not pass through decommissioned bldg. to access hospital. Utilities can only be shared by bldgs. under OSHPD jurisdiction. Local jurisdiction require separate utilities. Acute care services + patient access 40
Closing Thoughts Healthcare Facilities have a good fire record Credit the development of model codes and standards IBC and LSC for mitigation of the life safety hazards in such facilities. IBC/CBC trending towards NFPA 101 Safety features have been proven to establish a high level of safety in facility. A/E/C responsible for correctly implementing established safety features. Compartmentation, Fire Protection Systems, Means of Egress, Emergency Plan + Staff Training: TOTAL CONCEPT! dannawayse@coffman.com twele@coffman.com shah@coffman.com 41