NFPA Overview and 2000 to 2012 Update. Sharon S. Gilyeat, P.E. - Principal. Koffel Associates, Inc. MD, MA, NC, CT, IN

Similar documents
The Impact the Reference Standards in the 2012 Edition of NFPA 101 have on the Operation of Health Care Facilities: NFPA 80 and 99

4/18/2017. *2012 edition of NFPA 99 has gone through a major overhaul. *This document is now a Code.

27th Annual AHCA Seminar

NFPA 45 NFPA 211 NFPA 1600

NFPA 99 for Facility Managers

Medical Gas Inspections and Maintenance Programs. HESNI Annual Conference NIU Conference Center May 10-11, 2018 Presented by Mathis Carlson

Changes to Environment of Care, Equipment Management, and Life Safety Chapters Related to Life Safety Code Updates

Prepublication New Text Jan 2018 Changes to Environment of Care and Life Safety Chapters

EC EP 14 All other electrical K-920 equipment in patient care vicinity NFPA , Chapter 10

AMENDMENTS TO THE BUILDING AND FIRE CODE FOR THE CITY AND COUNTY OF DENVER

NFPA 101, 2012 EDITION IMPACT ON NEW AND EXISTING HEALTH CARE FACILITIES

Public Safety in the Healthcare Facility

2018 Joint Commission Standards What s New in the EC/LS/UM GASHE Annual March Meeting Lake Blackshear Resort

There are many changes to NFPA 99 from 1993 to 2015, but we want to concentrate on the changes made from 2012 to 2015, and we need to know a little

Compliance w/ the 2012 Life Safety Code

WHAT S NEW IN NFPA

WHAT S NEW IN NFPA

SEMICONDUCTOR FABRICATION FACILITIES

SEMICONDUCTOR FABRICATION FACILITIES

Changes to Environment of Care and Life Safety Chapters Related to Life Safety Code Updates

(h) Pesticide Application.

The Healthcare Environment Update

Changes to Environment of Care and Life Safety Chapters Related to Life Safety Code Updates

Changes to Environment of Care and Life Safety Chapters Related to Life Safety Code Updates

SEMICONDUCTOR FABRICATION FACILITIES

Life Safety Code NFPA 10 NFPA 13 NFPA 25 NFPA 72 NFPA 90A NFPA 110 NFPA 99 THE 2012 EDITION OF THE LIFE SAFETY CODE HOSPITAL EDITION SESSION #7

Changes to the 2018 Joint Commission Comprehensive Accreditation Manual for Hospitals (CAMH)

CHAPTER 7 ALTERATIONS LEVEL

First Aspen Federal Regulation Set: K LSC 2000 Health Existing

Agency for Health Care Administration

Course Outline. Course Introduction Purpose of the course Course Overview Program Outline Instructor Information

IMC Significant Changes Summary Tier I

Key Elements of NFPA 99 (and the other NFPA standards): Perspectives from the Safety Office. April, 2013

NFPA 101 Code Update from 2012 Edition to the 2015 Edition

Which Version(s) of NFPA 99 Apply?

TOPICS IN CODE ENFORCEMENT

SEMICONDUCTOR FABRICATION FACILITIES

PROPOSED CODE CHANGES FOR REVIEW BY THE FIRE CODE ACTION COMMITTEE

ANNEX AMENDMENTS TO THE INTERNATIONAL CODE FOR FIRE SAFETY SYSTEMS (FSS CODE) CHAPTER 1 GENERAL

CARBON DIOXIDE SYSTEMS FOR BEVERAGE DISPENSING PERMIT REQUIREMENTS

2012 International Fire Code Significant Changes. IFC Background. Purpose IBC and 2012 NFPA 101 Significant Means of Egress Changes

Update all extract references to NFPA documents (including NFPA 72) in Chapter 3 and related annex material to the latest editions.

Winnipeg Fire Department Fire Prevention Branch

ICC Update - Laboratory Issues Code Changes / Proposals / Trends of Interest 10/2005

FIRE SAFETY SURVEY REPORT AMBULATORY SURGICAL CENTERS (ASC) & END STAGE RENAL DISEASE (ESRD) MEDICARE

Changes in NFPA

NEC Requirements for Standby Power Systems. New England Building Officials Education Association Annual Conference October 5, 2015

NORTH CAROLINA. Downloaded (l) For each nursing unit, or fraction thereof on each floor, the following shall be provided:

Agency for Health Care Administration

Riverside County Fire Department Office of the Fire Marshal Market St., Ste. 150, Riverside, CA Ph. (951) Fax (951)

Laboratories and Hazardous Materials. Company Overview

Facility Sourcing Practices and Joint Commission Update

FHCA 2014 Annual Conference & Trade Show

2018 IFC Update. Based on the 2018 International Fire Code, (IFC ) Goal. Objectives. Content

2.07 Permit Application Checklist for Diesel Generators, Diesel Fire Pumps, and Fuel Tanks Serving Generators and Fire Pumps (2016)

Are there any policies regarding outlets that contain USB ports?

5.07 Air Replenishment Systems

S a n F r a n c i s c o F i r e D e p a r t m e n t B u r e a u o f F i r e P r e v e n t i o n & I n v e s t i g a t i o n 1 of 8 P a g e

NFPA Edition Review

New DATE OF BLDG. PERMIT OR PLAN APPROVAL: SURVEYOR (SIGNATURE) TITLE OFFICE DATE REVIEW AUTHORITY OFFICIAL (SIGNATURE) TITLE OFFICE DATE

Iowa State Fire Marshal

GASEOUS HYDROGEN SYSTEMS

COURSE SYLLABUS HVAC AND MECHANICAL CONSIDERATIONS FOR PART 3 BUILDINGS CORRESPONDENCE COURSE

NFPA Impacts Training presentation for: AlaSHE Spring 2017 Conference David Stymiest, Senior Consultant, Smith Seckman Reid, Inc.

2. The Group F occupancy has have an a combined occupant load of 500 or more above or below the lowest level of exit discharge.

2008 NYC Fire Code. New Laboratory Standards. Operational & Maintenance Provisions effective July 2008

Black Diamond Fire Department Building Owner s Responsibilities for Fire Safety Equipment

Committee on NFPA 99

Element D Services Electrical ODG010107

IFC Significant Changes from the 2009 to the 2015 Edition Tier 1

Objectives. NFPA Dust Specific Documents. Combustible Dust Process Hazard Safety Overview of NFPA Standards for Combustible Dusts

Osceola County Department of Fire Rescue and Emergency Medical Services

RESOLUTION MSC.292(87) (adopted on 21 May 2010) ADOPTION OF AMENDMENTS TO THE INTERNATIONAL CODE FOR FIRE SAFETY SYSTEMS

Danilo B. Concepcion, CBNT, CCHT-A Operations Manager St. Joseph Hospital Renal Services

Agency for Health Care Administration


The Cannabis Industry: Fire Department Requirements

Agency for Health Care Administration

Statement of Conditions

CHAPTER LOCAL AMENDMENTS TO THE INTERNATIONAL MECHANICAL CODE 2000 EDITION

CMS Announcement 3/27/2017. Adoption of 2012 Life Safety Code Health Care Facilities Code. Kenneth Daily, LNHA

NFPA 80 Overview January 21, 2016

California Fire Code (CFC) Part III contains requirements. Building and Equipment Design Features PART. Chapters 5 through 19

Agency for Health Care Administration

Recommended Amendments to the 2015 International Existing Building Code North Central Texas Council of Governments Region

By Authority Of THE UNITED STATES OF AMERICA Legally Binding Document

New Facilities. Minimum Requirements

Agency for Health Care Administration

Element Z General Design Requirements Existing Facilities Information

INTERNATIONAL STANDARD

First Revision No. 20-NFPA [ Section No ]

Medical Gas Training ASSE 6010 Installer & ASSE 6020 Inspector Courses Available

FIRE SAFETY DURING CONSTRUCTION, ALTERATION AND DEMOLITION

Part I Extraction Process Equipment

British Columbia Building Code 2006 Division B Part 3 Fire Protection, Occupant Safety and Accessibility Section 3.2 Building Fire Safety

Alex Masterton, PE Electrical Engineer Reviewer AHCA Neal Boothe, PE Electrical Engineer/Principal

ORDINANCE NO

Taming the Health Care Building Codes NFPA vs. The International and Chicago Building Codes JENSEN & HALSTEAD LTD.

El Reno Fire Department Fire Alarm Plan Review Worksheet

Transcription:

NFPA 99-2012 Overview and 2000 to 2012 Update Sharon S. Gilyeat, P.E. - Principal Koffel Associates, Inc. MD, MA, NC, CT, IN Koffel Associates W.L.L. Qatar Koffel Associates International United Arab Emirates Expertly Engineering Safety From Fire 1

Background 6 years Federal Fire Protection Engineer and Safety Manager Koffel Associates, Inc. 27 years Director, Southeast Office Develop and teach for CMS Chairs NFPA 105 Lasers and serves on NFPA 99, 45, 101, and 82 technical committees Past State of MD fire commissioner

Introduction and Goal This seminar is focused on the changes to the NFPA 99 Health Care Facilities Code with emphasis on changes since 1999 Not all changes included!

CAUTIONS!! Not all changes to NFPA 99 reflected here Slides do not contain full code text only general intent always go to the code for the full text Exceptions may apply

History of Development 2005 last edition to 2012 Extended to 5 year cycle for rewrite Clean rewrite Performance-based Code vs Standard June 2009 NFPA rejected and send back to editing June 2012 NFPA accepted CMS adopted as part of their 2012 LSC adoption

Chapters Deleted for 2012 All Occupancy chapters Chapter 6 Environmental Systems Chapter 7 Materials Chapter 10 Manufacturers Requirements Chapter 11Laboratories Chapter 21 Freestanding Birthing Centers

Annexes Deleted Annex B Nature of Hazards Annex D Safe Use of High-Frequency Electricity Annex F Flammable Anesthetizing Locations

2012 Annexes Annex A: Explanatory material Keyed to specific code text Non-mandatory Annex B: Explanatory material Keyed to Chapter Non-Mandatory Annex C Sample Adopting Ordinance Annex D: Informational References

New Chapters for 2012 Chapter 4 Fundamentals Establishes Categories based on risk assessment Chapter 7 Information Technology and Communications Systems Chapter 8 Plumbing & Chapter 9 HVAC Chapter 13 Security Management Chapter 15Features of Fire Protection Strike out indicates not adopted by CMS

Chapter 12 Emergency Management Totally rewritten Coordinate with requirements of The Joint Commission Lessons learned from recent disasters Better integration with NFPA 1600 Standard on Disaster/Emergency Management and Business Continuity Programs. NOT ADOPTED BY CMS BUT VERY CLOSE TO CMS REQUIREMENTS

Navigation Editorial Marks Asterisks 99-81 Brackets 99-81 Vertical Lines Not used Bullets Not used NOTE: New NFPA policy on vertical lines and bullets very controversial

NFPA 99-2012 Chapter 1 Administration

Administration 1.1 Scope Totally rewritten with scopes essentially for each chapter 1.2 Purpose Provide minimum requirements for the installation, inspection, testing, maintenance, performance and safe practice for facilities, material, equipment, and appliances.

Application Applies to ALL heath care facilities other than home care Construction and Equipment requirements NEW only Alterations, renovations and modernization meet new An existing system not in compliance SHALL BE PERMITTED to be continued in use, unless the AHJ determines that such use is a DISTINCT hazard to life

Patient Care Rooms Governing body NOT AHJ shall determine Critical care rooms General care rooms Basic care rooms Support rooms Anesthesia locations Wet procedure locations (Further discussion later)

Equivalency Equivalencies approved by the AHJ shall be recognized as being in compliance with the Code AHJ authorized to grant exceptions to this code

NFPA 99-2012 Chapter 3 Definitions

Definition Changes Anesthetizing location Administration of general anesthesia Compact storage Defend in place The operational response to an emergency in a building, in which the initial action does not involve evacuation of the building occupants

Definition Changes General Anesthesia and Levels of Sedation General Anesthesia Deep Sedation/Analgesia Moderate Sedation/Analgesia (Conscious Sedation) Minimal Sedation (Anxlolysis) Medical Support Gas Support Gas no longer used

Definitions Patient Care Room Critical Care Room General Care Room Basic Care Room Support Room

Definitions Wet Procedure Location Annex note

NFPA 99-2012 Chapter 4 Fundamentals

Risk Assessment Building system categories based on the system, not the facility no caregiver intervention Category 1 major injury or death Category 2 minor injury Category 3 no injury but can cause discomfort Category 4 no impact on patient care Risk Assessment Extensive Annex material

Annex Material for Chapter 4 Examples of each Category Discussion of major injury Risk assessment ISO/IEC 31010 Risk Management Risk Assessment Techniques NFPA 551 Guild for the Evaluation of Fire Risk Assessments SEMI S10-0307E Safety Guideline for Risk Assessment and Risk Evaluation

NFPA 99-2012 Chapter 5 Medical Gas and Vacuum Systems

Medical Gas/Medical Support Gas Oxygen Nitrous oxide Medical air Carbon dioxide Helium Nitrogen Instrument Air

Vacuum Systems Medical-surgical vacuum Waste anesthetic gas disposal

Medical Gas and Vacuum Systems Hazards Components Category 1 gas and vacuum systems Category 2 gas and vacuum systems Category 3 gas and vacuum systems

Medical Gas and Vacuum Systems Hazards Fire Explosions Loss of systems Inadvertent cross-connections

Medical Gas and Vacuum Systems 3.32

Category 1 Medical Gas and Vacuum Systems Category 1 Medical Piped Gas and Vacuum Systems. Requirements apply to health care facilities that require Category 1 systems as determined using risk assessment as defined in Chapter 4

New Vs. Existing 5.1.14.4.3 through 5.1.14.4.9, 5.1.13 through 5.1.15 existing 5.1.14.3 and 5.1.14.4.1 new and existing See Tentative Interim Amendment (TIA) TIA 12-4

Medical Gas and Vacuum Systems Sources Gas cylinders Cryogenic liquid containers Bulk cryogenic liquids Medical air compressors Medical/surgical vacuum pumps WAGD producers Instrument air compressors Proportioning systems for medical air USP

Category 1 Gas and Vacuum Systems Sources - Cylinders

Cryogenic Liquid System

Bulk Cryogenic Supply

Compressor

Compressor

Vacuum Pump

Vacuum Pump

Central Supply System - Operations Use of adapter/conversion fittings prohibited Handled in accordance with Chapter 11 Only gas cylinders and accessories are permitted to be stored in central supply room Wooden racks for cylinders permitted

Central Supply Room - Construction Lockable doors or gates If outdoors, noncombustible enclosure, with a minimum of two exits If indoors, noncombustible or limited combustible with 1-hour fire resistance rating (see 2015 for clarification) NFPA 70 for ordinary locations

Central Supply Room - Construction Indirect heating (steam, hot water) Racks, chains or other fasteners to secure all cylinders. Powered by essential electrical system Racks, shelves or supports made of noncombustible or limited combustible materials Electrical devices at or above 5 feet from floor protected from damage

Storage Full or empty, when not connected, shall be stored in locations complying with 5.1.3.3.2 and 5.1.3.3.3 (Construction and Ventilation) Cylinders shall not be stored in enclosures containing motor-driven equipment except instrument air reserve headers in same location with instrument air compressors

Final Line Pressure Regulators Isolation valves and or check valves to isolate each regulator Pressure indicator downstream of each regulator or immediately downstream of isolating valves for the regulators Piped to allow for indipendant operation Sized for 100 percent of the peak calculated demand Constructed of materials deemed suitable by the manufacturer

Category 1 Gas and Vacuum Systems Headers Manifolds Gas Cylinders Cryogenic Liquid Containers Manifolds for Gas Cylinders with Reserve Supply Entire section deleted

Bulk Cryogenic Liquid Systems Totally revised and coordinated with NFPA 55, Compressed Gases and Cryogenic Fluids Code

Category 1 Gas and Vacuum Systems Emergency Oxygen Supply Connection (EOSC) may be required for maintenance or emergencies Minimum of 3 ft clearance around EOSC Alternative is in-building emergency reserve The word any in 5.1.3.5.13 may confuse this

Emergency Oxygen Supply Connection

In-Building Reserve

Category 1 Medical Air Supply Systems Medical air quality Be supplied from cylinders, bulk containers, medical air compressor sources, or be reconstituted from oxygen USP and oil-free, dry Nitrogen NF Meet the requirements of medical air USP Have no detectable liquid hydrocarbons Have less than 25 ppm gaseous hydrocarbons Have equal to or less than 51 mg/m3 of permanent particulates sized 1 micron or larger in the air at normal atmospheric pressure

Medical Air Compressors Location Indoors in a dedicated mechanical equipment area Adequate ventilation Ambient temperature range as recommended by the manufacturer.

Compressor

Category 1 Medical Air Supply Systems After coolers Receivers Dryers Filters All component materials are to be determined by the manufacturer

Compressor Intake Outdoors above roof level Draw from a clean source of air Located 25 ft. from ventilating system exhausts, vents, vacuum and WAGD discharges Minimum distance 20 ft. above ground Minimum of 10 ft from any door, window or other opening

Compressor Intake Intake: Hard-drawn seamless copper ASTM B819, medical gas tube ASTM B88, water tube, type K or L ASTM B280, 280 ACR as permitted for vacuum and WAGD systems. Intake turned down, screened, and noncorroding material

Medical Air Quality - Monitoring Dew point monitored and alarmed when dew point exceeds 2 o C (35 o F) CO alarm activated when CO exceeds 10 ppm Dew point and CO monitors activate alarm if power is lost.

Medical Air Proportioning System Entire new section and numerous changes throughout the code on medical air proportioning systems Reconstituting medical air from Oxygen USP and Nitrogen NF

Category 1 Med-Surg Vacuum Systems Pump Location Indoors in a dedicated mechanical equipment area Adequately ventilated Proper utilities Ambient temperature range per manufacturers recommendation

Medical-Surgical Vacuum Pumps

Medical-Surgical Vacuum Systems Medical-Surgical Vacuum Systems Vacuum pumps (2 or more) Peak calculated demand met with largest pump out of service Piping per vacuum piping except brass, galvanized or black steel as per manufacturer

Vacuum Receivers Materials deemed suitable by the manufacturer ASME Boiler and Pressure Vessel Code 60 PSI and vacuum of 30 in. of Hg Manual drain Capacity based on the technology of the pumps

Medical-Surgical Vacuum Systems Medical-Surgical Vacuum Exhaust Located outdoors At least 10 ft. from any door, window, air intake, or other opening or places of assembly Different level than intake Consider prevailing winds, adjacent buildings, topography and other influences End turned down and screened with a noncorroding material

Instrument Air Supply Systems Usage Instrument air shall be permitted to be used for any medical support purpose and if appropriate to the procedures to be used in laboratories Cannot be interconnected with medical air Cannot be used for any purpose where the air will be intentionally respired by humans

New or Replacement Valves

Zone Valves Wall between the valve and outlet/inlet Serves only outlet/inlets on same story Not located in a room that it controls Operable from standing position Pressure/vacuum indicator required Visible and accessible at all times Not in locked rooms, behind doors, open doors, or hidden

Zone Valves Immediately outside each vital life-support, critical care, and anesthetizing location of moderate sedation, deep sedation or general anesthesia Readily accessible in an emergency Shutting off the gas to one operating room or anesthetizing area will not affect others

Zone Valves ZONE VALVES SHALL BE LABELED IN ACCORDANCE WITH 5.1.11.2

Zone Valve

Zone Valve

Zone Valves Floor plan indicating areas controlled by valve

In-Line Check Valves New or replacement Brass or bronze Brazed extensions In-line serviceability NO threaded connections Threaded purge points on 1/8 in NPT

Alarm Requirements - General Separate visual indicators (except on master) Visual non-cancelable Cancelable audible Means to indicate a lamp or LED failure Visible and audible indication that the communication is disconnected. Labeling

Alarm Requirements General Reinitiation of the audible signal if another alarm condition occurs Power from life safety branch of the EES Wiring used for communications is protected Communication devices that do not use wire supervised such that failure will initiate alarm LABELING KEPT UP TO DATE!! Alarm switches/sensors removable

Alarm Requirements Master Alarm Monitors source supply, reserve source (if any) and pressure in main lines of medical gas and vacuum piping system Two master alarm panels required (on-site maintenance office and continuously staffed location) A centralized computer system can be substituted for one of the master alarm panels

Master Alarm Panel Master alarm panel in a facility engineering office

Alarm Requirements Master Alarm Master alarm panels required to communicate directly to the alarm-initiating device they monitor Each of the two mandatory alarms must be wired independently to the initiating devices

Alarm Requirements Area Alarms Location: 1)Anesthetizing locations where moderate sedation, deep sedation, or general anesthesia 2)Critical Care areas

Alarm Requirements Area Alarm Area alarm sensor location Vital life support or critical care area: On patient (use side) of zone valve box assembly Anesthetizing area (moderate sedation, deep sedation or general anesthesia): Either on source side or patient (use side) of zone valve box assembly

Alarm Requirements Local Alarm Monitors air compressors, medical/surgical vacuum pump systems, WAGD systems, instrument air, and proportioning systems One signal located on the control panel for the machinery being monitored, or within monitoring device or on separate panel One signal connected to master alarm panel 11 different items to be monitored

Flexible Joints Metallic flexible joints permitted where required for expansion, seismic, thermal expansion or vibration and: Bronze, copper or stainless steel Cleaned at factory for oxygen service 300 psi and 1000 o F Brazing extensions Supported as required for their weight

Installer Qualifications Installation shall be made by qualified, competent technicians who are experienced in making such installations, including all personnel who actually install the pipe Must meet ANSI/ASSE Standard 6010, Professional Qualification Standard for Medical Gas and Vacuum System Installers

Installer Qualifications Installers shall not use their certification to oversee installation by noncertified personnel

Installer Performed Tests The 24-hour standing pressure test of positive pressure systems and vacuum systems shall be witnessed by AHJ or designee. Form indicating that this test was performed and witnessed shall be provided to the verifier prior to verifier testing

Category 1 Operation and Management Special precautions Piping not used for grounding Medical-Surgical Vacuum and WAGD not used for nonmedical applications Maintenance (new section) General Facilities shall develop and document periodic maintenance programs for these systems and subcomponents

Maintenance Programs Inventory all sources, control valves, alarms, manufactured assemblies and I/O Inspection Schedules scheduled inspections shall be established through risk assessment, manufacturers recommendations and requirements of AHJ

Maintenance Programs Inspection Procedures inspection procedures and test methods established through risk assessment Maintenance schedules - scheduled maintenance shall be established through risk assessment, manufacturers recommendations and requirements of AHJ

Maintenance Programs Qualifications persons maintaining such systems shall be qualified any of the following: Training and certification through the facility ASSE 6040 Professional Qualification Standard for Medical Gas Maintenance Personnel ASSE 6030 Professional Qualification Standard for Medical Gas Systems Verifiers

Inspection and Testing Operations Medical air sources Room temperature Room ventilation Shaft seal condition Filter condition Presence of hydrocarbons Water quality if so equipped Intake location Air purity Dew point Carbon monoxide monitor calibration

Inspection and Testing Operations Vacuum source - WAGD Exhaust location Instrument air source Filter condition Manifold sources Ventilation Enclosure labeling

Inspection and Testing Operations Bulk cryogenic liquid sources per NFPA 55 Final line regulator delivery pressure Valves labels Alarms lamp and audio operation Master, area, local signal operation Station I/O Flow, labeling, latching/delatching/ leaks

Category 3 Gas and Vacuum Systems Many similarities with Category 1 but in general less stringent. Existing 5.3.12.2 and 5.3.13.4 New & existing 5.3.1.1, 5.3.2, 5.3.12.1 & 5.3.13.3 See TIA 12-4 Shall NOT serve more than two adjoining single treatment facilities

Category 3 Oxygen and Nitrous Oxide Source storage Total of all gases more than 3000 ft 3 (5000 ft 3 if in DOT 4L cryogenic liquid container) per Category 1 Smaller quantities per Category 3

NFPA 99-2012 Chapter 6 Electrical Systems

Electrical Systems Moved after gas systems Electrical hazards Electrical distribution system Type 1, 2 and 3 electrical system

Electrical Systems New versus existing

Electrical Hazards Fire and explosion Electrical shock Thermal energy Interruption of power

Distribution Follow NFPA 70 - NEC Critical care areas shall be served by circuits from a critical branch served from a single automatic transfer switch AND A minimum of one circuit by normal power or by a second critical branch automatic transfer switch.

Critical Care Areas

Critical Care Areas

Distribution Access to overcurrent protective devices Only authorized shall have access to those serving Category 1 or Category 2 rooms Shall not be permitted in public access spaces Isolated power panels in critical care areas shall be permitted in those areas.

Distribution Receptacles Patient bed general care (category 2)- 4 8 Patient bed critical care (category 1) 6 14 Operating rooms (category 1) - 36 Bathrooms-none Special areas (psychiatric, pediatric, etc) none Pediatric shall have listed tamper resistant or a listed tamper resistant cover (new and existing)

Receptacles

Quiet Grounds Now referred to as isolated grounds

Wet Procedure Locations Special protection against electrical shock Inherently limits ground fault current without interrupting power (IP) or Interrupts power when ground fault current exceeds 6 ma Operating rooms shall be considered wet procedure locations unless risk assessment determines otherwise

Wet Procedure Locations Where power interruption under first fault condition is tolerable, the use of a ground-fault circuit interrupter (GFCI) shall be permitted as the protective means that monitors the actual ground-fault current and interrupts the power when that current exceeds 6 ma.

Categories Category 1 rooms shall be served only by Type 1 EES Category 2 rooms shall be served by Type 1 or Type 2 EES A Type 1 EES shall be permitted to serve Category 2 rooms in the same facility Basic care rooms shall not be required to be served by EES

Unit Lighting Battery-Powered Lighting Units Shall be provided in deep sedation and general anesthesia areas Sufficient to terminate procedures Wired to general lighting branch circuit 1 ½ hour duration Tested monthly for 30 seconds and annually for 30 minutes

Receptacle Testing

Maintenance and Testing Hospital grade at patient bed locations and where deep sedation or general anesthesia is administered at initial installation, replacement or servicing Additional testing at patient care areas performed at intervals defined by documented performance data Non-hospital grade at patient bed locations and where deep sedation or general anesthesia is administered within 12 months

Essential Electrical System

Essential Electrical System

Type 1 Essential Electrical System Dual sources of normal power shall be considered (not necessary) Minimum two independent sources of power: normal and one or more alternate sources

Generator

Selective Coordination Overcurrent protective devices serving the EES shall selectively coordinate for the period of time that a fault s duration extends beyond 0.1 seconds Not required as follows: Between transformer primary and secondary where only one or one set of devices exist on the secondary Between devices of the same amp rating in series

Type 1 Essential Electrical System Branches Life Safety Branch Critical Branch Equipment Division shall occur at transfer switches when more than one transfer switch is required.

Type 1 Essential Electrical System Number of transfer switches shall be based on reliability, design and load Each branch shall have one or more transfer switches One transfer switch shall be permitted to serve one or more branches in a facility with a continuous load on the switch of 150 kva (120 kw) or less

Life Safety Branch Elevator lighting, control, communications Automatic doors for egress Fire alarm auxiliary functions Alarm & alerting non-fire(life safety or critical) Generator accessories NO other functions

Critical Branch

Type 1 Essential Electrical System Critical Branch Blood, bone and tissue banks Telephone equipment Task Illumination and selected receptacles and power in certain areas Additional task illumination, receptacles, and select power circuits needed for effective facility operations, including single-phase fractional horsepower motors.

Type 2 Essential Electrical System Emergency Systems Critical Systems Life Safety Branch Equipment Branch One or more transfer switches, single transfer switch permitted under same conditions as Type 1

Type 2 Essential Electrical System Equipment Branch Non-delayed-automatic Generator accessories Delayed-automatic connection Task illumination (some areas) HVAC airborne infectious isolation rooms Sump pumps Smoke control systems and stair pressurization Kitchen hood exhaust if required during a fire

NFPA 99-2012 Chapter 7 IT and Communication Systems

Information Technology and Communication Systems NOT ADOPTED BY CMS Still an ANSI Standard Brand new chapter still some coordination issues Acronyms: Entrance Facility (EF or TEF) Telecommunications Equipment Room (TER) Telecommunications Room (TR) Outside Plant (OSP) Infrastructure

NFPA 99-2012 Chapter 8 Plumbing Chapter 9 HVAC

Chapter 8 Plumbing New Chapter NOT REFERENCED BY CMS No risk categories Primarily references to plumbing code Some limited information on Grease interceptors Gray waste and clear waste water

Chapter 9 - HVAC New Chapter

HVAC - General Comply with ASHRAE 170 Laboratories - NFPA 45 Energy conservation ASHRAE 90.1 or local code Commissioned per ASHRAE 90.1, ASHRAE Guidelines 0 or 1

HVAC - General Piping per applicable plumbing code Ductwork NFPA 90A or applicable mechanical code

Medical Gas Storage & Transfilling All gases other than medical gases ventilation per NFPA 55 Outdoor storage/installations of medical gases and cryogenic fluids Ventilation per NFPA 55 Chapter 11 medical gases no requirements Transfilling ventilation per NFPA 55

Medical Gas Storage & Transfilling Indoor storage or manifold areas; storage or manifold buildings, for medical gases and cryogenic fluids shall be provided with natural or mechanical exhaust ventilation

Natural Ventilation Two nonclosable louvered openings, each 155cm 2 /35 L (24 in 2 /1000 ft 3 ) of the fluid (liquid or gas) stored, but not less than 465 cm 2 (72 in 2 ) One within 300 mm (1 ft) of the floor, and one within 300 mm (1 ft) of the ceiling Ensure cross ventilation Direct to outside without ductwork Mechanical if natural cannot be met

Mechanical Ventilation Mechanical exhaust continuous negative pressure unless approved by the AHJ I L/sec per 300 L (1 cfm per 5 ft 3 ) of fluid, > 24 L/sec (50 cfm) < 235 L/sec (500 cfm) Exhaust inlets within 30 mm (1 ft) of floor Powered by the EES Dedicated exhaust not required but not connected to spaces with flammables OR combustibles

Mechanical Ventilation Duct material noncombustible Make-up air (one of the following) From outside or adjacent space with no flammable or combustible materials via noncombustible ductwork From corridors under corridor door up to 24 L/sec (50 cfm) or 15% of the room exhaust per NFPA 90A Ok from building ventilation system

Mechanical Ventilation Waste Gas WAGD or by an active or passive scavenging system. Medical Plume Evacuation (such as from lasers) Direct to the outside, or HEPA and direct connection to return or exhaust duct Chemical or thermal sterilization and return to the space

EPS Room HVAC NFPA 110 Extracted from NFPA 110 Maintaining engine water jacket temperature Ventilation for cooling room Ventilation for cooling engine Ventilation for combustion

NFPA 99-2012 Chapter 10 Electrical Equipment Chapter 11 Gas Equipment

Patient Care Vicinity Chapter 3 3.3.139 A space within a location intended for the examination and treatment of patients, extending 1.8 m (6 ft) beyond the normal location of the bed, chair, table, treadmill or other device that supports the patient during examination and treatment and extending vertically to 2.3 m (7 ft 6 in) above the floor.

Electrical Equipment Testing Requirements Fixed and Portable Physical integrity new annex note Resistance Leakage current tests Fixed equipment Touch current portable equipment Leakage current tests portable equipment

Chapter 11- Gas Equipment Storage of gases and cylinders Performance criteria and testing Administration

Gas Cylinders

Gas Equipment Storage of cylinders (non-flammable gases) More than 3000 ft 3, use Level 1 storage requirements

Gas Equipment Storage of cylinders (non-flammable gases) More than 300 ft 3 but less than 3000 ft 3 Outdoors or secured enclosed interior space of noncombustible or limited combustible construction Secured Can t mix oxidizing gases with flammable liquids, gases or vapors Separate oxidizing gases from combustible materials

Gas Equipment Separation Minimum of 20 ft Minimum of 5 ft if AS Fire rated cabinet Several other limitations from Chapter 5

Gas Equipment Storage of cylinders (non-flammable gases) Less than 300 ft 3 Patient care area not larger than 22,500 ft 2, individual cylinders not required to be in enclosures Precautions in handling apply Cylinders in use do not count Cylinders available for IMMEDIATE use are not in storage

Gas Equipment Performance Criteria and Testing Alterations and repairs require testing Administration Eliminate ignition sources Control flammable substances Service equipment Control transfilling of cylinders and containers Signage

Gas Equipment Operation and Management of Cylinders Administration Special precautions for handling Special precautions for making connections Special precautions for safety mechanisms Special precautions for storage

Gas Equipment Liquid oxygen equipment New section

NFPA 99-2012 Chapter 12 Emergency Management Chapter 13 Security

Chapter 12 -Emergency Management Total rewrite of the chapter Coordination with The Joint Commission Coordination with NFPA 1600 Standard on Disaster/Emergency Management and Business Continuity Programs NFPA 1620 Recommended Practice for Pre- Incident Planning Extensive annex notes

Chapter 13 Security Management New Chapter Facility shall have a security management plan Security vulnerability analysis (SVA) Responsible person Over 30 item listed in the responsibilities!!!

Security Management NOT adopted by CMS Still an ANSI document best practice. Almost laid out as a check list Extensive good annex notes Excellent commentary in NFPA 99 Handbook

NFPA 99-2012 Chapter 14 Hyperbaric Chambers

Hyperbaric Chambers

Hyperbaric Chambers Three classes of chambers Class A Human, multiple occupancy Class B Human, single occupancy Class C Animal no human occupancy Construction and equipment Room containing the chamber shall be AS Piping requirements Totally new requirements

Changes for 2012 Time to evacuate the chamber Restriction on Lithium and lithium-ion batteries Chamber gas supply monitoring Use of class I and II lasers Fire protection equipment inside hypobaric chambers

NFPA 99-2012 Chapter 15 Fire Protection Features

Fire Protection Features New Chapter Heavily based on NFPA 101 Numerous extracts from NFPA 101

Fire Protection Features Sprinklers New Closet Exception Hospitals only Patient room closets Under 6 sq ft

Fire Alarm Systems Fire Protection Features

Fire Protection Features Manual extinguishing equipment Portable fire extinguishers Standpipes Compact storage Maintenance and testing Operating rooms

Health Care Facilities Handbook Thank You!

Future Questions. Join our LinkedIn Discussion Groups Life Safety Code People can join the group and submit their questions or People can email linkedin@koffel.com and submit anonymously Smoke Management Proposed Changes to the IBC Ask the Expert FAQ.Koffel.com Expertly Engineering Safety From Fire 367

Questions? Sharon S. Gilyeat, P.E. sgilyeat@koffel.com Koffel Associates, Inc. 2015 Ayrsley Town Blvd. / Suite 202 / Charlotte, NC 28273 tel 704-280-8365 Corporate Office/410-750-2246/ fax 410-750-2588 Follow us on LinkedIn www.koffel.com Expertly Engineering Safety From Fire 368