NFPA 99-2012 Impacts Training presentation for: AlaSHE Spring 2017 Conference David Stymiest, Senior Consultant, Smith Seckman Reid, Inc. Content Disclaimer - Content Disclaimer: These slides are only meant to be cue points, which were expounded upon verbally by the original presenter and are not meant to be comprehensive statements of requirements or best practices, nor represent all the content of the presentation. Thus, care should be exercised in interpreting content based solely on the content of these slides. - The handouts do not contain photographs or copyrighted material. What is covered? (ASHE explanation) - 42 CFR Part 482 Conditions of Participation for Hospitals - A hospital is an institution primarily engaged in providing, by or under the supervision of physicians, inpatient diagnostic and therapeutic services or rehabilitation services. Under the Medicare provider-based rules, one hospital may have multiple inpatient campuses and outpatient locations. It is not permissible to certify only part of a participating hospital. Psychiatric hospitals that participate in Medicare as a distinct part psychiatric hospital are not required to participate in their entirety. However, the following are not considered parts of the hospital and are not to be included in the evaluation of the hospital's compliance: - Components appropriately certified as other kinds of providers or suppliers, that is, a distinct part skilled nursing facility and/or distinct part nursing facility, home health agency, rural health clinic, or hospice; excluded residential, custodial, and non-service units not meeting certain definitions in the Social Security Act; and, - Physician offices located in space owned by the hospital but not functioning as hospital outpatient services departments - SOURCE: http://www.ashe.org/news/cms-requirements-for-health-care-facilitiesprovider-types-and-final-rule-application NFPA 99-2012 Health Care Facilities Code - ANSI-adopted Health Care Facilities Code: written to be incorporated into law as a stand-alone document. - NFPA 99-2012 [223 page pdf] - Navigating the NFPA 99-2012 Handbook [651 page pdf] New risk-based framework - The risk to the patient does not change for a given procedure. If the procedure is performed in a doctor s office versus a hospital, the risk remains the same. Therefore NFPA 99 eliminated the occupancy chapters and has gone to a risk-based approach. New Chapter 4 outlines the parameters of this approach. The Code now reflects the risk to the patient in defined categories of risk. - From the NFPA 99-2012 introduction Page 1
REMOVED from NFPA 99 All of the Occupancy Chapters - Requirements are based on the impact to the patient, regardless of the type of occupancy. Laboratory requirements (now refer to NFPA 45) Manufacturers' requirements on electrical equipment now per IEC 60601-1, etc. Annexes B, D, & E were deleted. (They were technology no longer in use.) Annex B Nature of Hazards Annex D Safe Use of High-Frequency Electricity Annex E Flammable Anesthetizing Locations NFPA 99-2012 Chapters (No occupancy chapters) 1. Administration 2. Referenced Publications 3. Definitions 4. Fundamentals Extremely short 5. Gas and Vacuum Systems 6. Electrical Systems 7. Information Technology & Communications Systems 8. Plumbing: Added via TIA 9. Heating, Ventilation and Air Conditioning (HVAC): Added via TIA 10. Electrical Equipment 11. Gas Equipment 12. Emergency Management [DNV invokes Chap. 12 in hospitals] 13. Security Management [DNV invokes Chap. 13 in hospitals] 14. Hyperbaric Facilities 15. Features of Fire Protection NFPA 99-2012 TIAs adopted by CMS - Added Chapter 9 HVAC systems - Modified 6.6.3.1: Removes alternate source requirement for Type 3 CB - Clarified New vs. Existing in Ch. 5 Gas & Vacuum systems - Deleted 10.2.3.6(5): Removed extra RPT leakage current testing - Modified 11.5.1.1 Clarified (limited) ignition sources in resp. care areas NFPA 99-2012 Handbook contents NFPA 99-2012 Chapter Contents 1. Administration - Scope, Purpose, Application, Equivalency, Units, Code Adoption Requirements 2. Referenced Publications - General, NFPA, Other, References for Extracts in Mandatory Sections 3. Definitions - General, NFPA Official Definitions, General Definitions, BICSI (Building Industry Consulting Services International) Definitions 4. Fundamentals (less than ½ Pg) - Building System Categories, Risk Assessment, Application Page 2
5. Gas and Vacuum Systems (48 pgs) - Category 1, Category 2, Category 3 6. Electrical Systems (14 pgs) - Applicability, Nature of Hazards, Electrical System, Type 1 EES, Type 2 EES, Type 3 EES 7. IT & Communications Systems for HCF (4 pgs) - Applicability, Category 1, Category 2, Category 3 - Training available: Geoffrey King (GKing@ssr-inc.com) 8. Plumbing (1 pg) Added via TIA - Applicability, System Category Criteria, General Requirements 9. HVAC (2 pgs) Added via TIA - Applicability, System Category Criteria, General 10. Electrical Equipment (6 pgs) - Applicability, Performance Criteria and Testing for Patient-Care Related Electrical Appliances and Equipment, Testing Requirements Fixed and Portable, Nonpatient Electrical Appliances and Equipment, Administration 11. Gas Equipment (5 pgs) - Applicability, Cylinder and Container Storage, Cylinder and Container Storage Requirements, Performance Criteria and Testing, Administration, Operation and Management of Cylinders, Liquid Oxygen Entrapment 12. Emergency Management (4 pgs) DNV PE.6 SR.2 - Scope, Responsibilities, Matrix Categories, General, Category 1 and Category 2 Requirements 13. Security Management (2 pgs) DNV PE.4 SR.2 - Scope, Security Vulnerability Assessment (SVA), Responsible Person, Security-Sensitive Areas, Access and Egress Security Measures, Media Control, Crowd Control, Security Equipment, Employment Practices, Security Operations, Program Evaluation 14. Hyperbaric Facilities (11 pgs) - Scope, Construction and Equipment, Administration & Maintenance 15. Features of Fire Protection (3 pgs) - Applicability, Construction and Compartmentation, Special Hazard Protection for Flammable Liquids and Gases, Laboratories, Utilities, Rubbish Chutes Incinerators and Laundry Chutes, Fire Detection Alarm and Communications Systems, Automatic Sprinklers and Other Extinguishing Equipment, Manual Extinguishing Equipment, Compact Storage, Compact Mobile Storage, Maintenance and Testing, Fire Loss Prevention in OR s Annex A Explanatory Material (50 pages) Annex B Additional Explanatory Notes (17 pages) Annex C Sample Ordinance Adopting NFPA 99 Annex D Informational References Index Page 3
CMS K-tags in Part II HCF Code (NFPA 99) - K900 HC Facilities Other - K901 Fundamentals Building Systems Categories - K931 Hyperbaric Facilities - K932 Features of Fire Protection Other - K933 Features of Fire Protection Fire Loss Prevention in ORs - K902 Gas and Vacuum Piped Systems Other - K903 Gas and Vacuum Piped Systems Categories - K904 Gas and Vacuum Piped Systems Warning Systems - K905 Gas and Vacuum Piped Systems Central Supply System Identification and Labeling - K906 Gas and Vacuum Piped Systems Central Supply System Operations - K907 Gas and Vacuum Piped Systems Maintenance Program - K908 Gas and Vacuum Piped Systems Inspection and Testing Operations - K909 Gas and Vacuum Piped Systems Information and Warning Signs - K910 Gas and Vacuum Piped Systems Modifications - K911 Electrical Systems Other - K912 Electrical Systems Receptacles - K913 Electrical Systems Wet Procedure Locations - K914 Electrical Systems Maintenance and Testing - K915 Electrical Systems EES Categories - K916 Electrical Systems EES Alarm Annunciator - K917 Electrical Systems EES Receptacles - K918 Electrical Systems EES Maintenance and Testing - K919 Electrical Equipment Other - K920 Electrical Equipment Power Cords and Extension Cords - K921 Electrical Equipment Testing and Maintenance Requirements - K922 Gas Equipment Other - K923 Gas Equipment Cylinder and Container Storage - K924 Gas Equipment Testing and Maintenance Requirements - K925 Gas Equipment Respiratory Therapy Sources of Ignition - K926 Gas Equipment Qualifications and Training of Personnel - K927 Gas Equipment Transfilling Cylinders - K928 Gas Equipment Labeling Equipment and Cylinders - K929 Gas Equipment Precautions for Handling Oxygen Cylinders and Manifolds - K930 Gas Equipment Liquid Oxygen Equipment New risk-based framework - The risk to the patient does not change for a given procedure. If the procedure is performed in a doctor s office versus a hospital, the risk remains the same. Therefore NFPA 99 eliminated the occupancy chapters and has gone to a risk-based approach. Page 4
New Chapter 4 outlines the parameters of this approach. The Code now reflects the risk to the patient in defined categories of risk. - From the NFPA 99-2012 introduction NFPA 99-2012 Some of the major changes - "Fundamentals" chap. 4: risk based on type of care provided - Category 1: equipment failure likely to cause major injury or death of patients or caregivers - Category 2: equipment failure likely to cause minor injury (not serious or at risk of life) to patients or caregivers - Category 3: equipment failure not likely to cause injury to patients or caregivers; can cause patient discomfort - Category 4: equipment failure would have no impact on patient care - Categories determined by following and documenting a defined risk assessment procedure. - Select systems or processes that are required for that risk category. Major injury examples from Ch.4 Annex (invokes Category 1) - Amputation - Loss of sight of an eye (even temporary) - Burn to eye or any penetrating injury to eye - Electric shock / electric burns: unconsciousness requiring resuscitation or 24 hours hospitalization - Hypothermia, heat induced illness: unconsciousness requiring resuscitation or 24 hours hospitalization - Loss of consciousness caused by asphyxia or lack of oxygen or exposure to a biological agent or harmful substance - Absorption of any substance by inhalation, skin, or ingestion causing loss of consciousness or acute illness requiring medical treatment - Acute illness requiring medical treatment where there is reason to believe the exposure was to biological agents, its toxins, or infected materials - Some system/equip. examples from Ch 4 Annex Category 1 - OR EP, ICU MedGas, Ventilator-assisted procedure in medical office OR suite, Cardiac cath equipment Category 2 - Pt room task or procedure lighting, Pt care area potable water Category 3 - Heating in the south; humidity control in non-operating areas, dental drills, motorized bed adjustments, cooling tower makeup water in NW Category 4 - Gray water lawn sprinklers, seasonal lighting, PA, Pneumatic tube, vacuum system in research lab How NFPA 99-2012 will work - Determine the worst case procedure or process Page 5
- Use a documented process to select risk category ISO/IEC 31010: Risk Management Risk Assessment Techniques NFPA 551: Guide for the Evaluation of Fire Risk Assessments SEMI S10-0307E: Safety Guideline for Risk Assessment and Risk Evaluation Process Other formal process - Select the systems or procedures prescribed by that level of risk Except for Hyperbaric Facilities where Ch. 14 applies (Hyperbaric Facility requirements are not Risk-Based) - Additional FP specialties in Ch. 15 Application of NFPA 99-2012 - All HC facilities that treat humans other than home care - Construction & equipment requirements for new only except as modified in chapters - Only altered or renovated or modernized portion of system or component - If above modifies performance of a system, it must be modified - Existing system permitted to continue unless AHJ determines distinct hazard to life - LSC Chapter 43 Building Rehabilitation Applicability to existing systems? Ch.5: Gas/Vacuum - 5.1.1.4 An existing system that is not in strict compliance with the provisions of this code shall be permitted to be continued in use as long as the authority having jurisdiction has determined that such use does not constitute a distinct hazard to life. - 5.1.1.5 Subsection 5.1.2 through 5.1.12.3.14.5 and 5.1.14.4.2 shall apply to new health care facilities or facilities making changes that alter the piping. - 5.1.1.6 Paragraph 5.1.14.4.3 through 5.1.14.4.9 and 5.1.13 through 5.1.15 shall apply to existing health care facilities. - 5.1.1.7 Paragraph 5.1.14.3 and 5.1.14.4.1 shall apply to new and existing health care facilities. Partial example of significant changes listed in Supplement 5 NFPA Medical Gas & Vacuum Systems Installation Handbook - Starting 2012, NFPA 99C no longer a stand-alone document. - 2012 Medical Gas and Vacuum Systems Installation Handbook is intended by NFPA to be a complete tool for specialized knowledge about Category 1-3. - MedGas/Vac rules w/ expert insight, explanations, visuals - Comprehensive resource to help users understand 99-2012 - Combines all relevant MedGas/Vac info in Ch 1-5 w/ photos, illustrations, comments written by experts for clarity on intent - Supplements cover qualifications for personnel and general brazing procedures, cleaning for O2 service and preparing joints for brazing, and installation testing and documentation. Testing of Articulating Medical Booms - 18 month (or as determined by risk assessment) testing of articulating medical booms in OR Page 6
- Details are in 5.1.14.2.3.2 Manufactured Assemblies Employing Flexible Connection(s) Between the User Terminal and the Piping System. - Changes reflect concerns over reports of fires in articulating booms, which appear to be correlated to leaks in the gas lines. Since these units employ hoses internally, and the hoses can wear against the sides, the bearing housings, and one another, they need to be inspected frequently and replaced whenever wear is evident. from 99 Handbook Some other changes Prohibits use of plug-in connections to piped oxygen systems - Such as ozone sterilizers 5.1.3.5.12* Bulk Cryogenic Liquid Systems. - Most text removed, refers to NFPA 55 instead - Testing for Cryogenic Systems - Tested for proper function; purity; alarm sensors; operation of control sensors - 5.1.3.3.2* Outdoor central supply systems locations Fencing to have 2 entry/exits 5.1.14.2 Maintenance of MedGas... [CAT.1] - 5.1.14.2.2.5 Qualifications. Persons maintaining these systems shall be qualified to perform these operations. Appropriate qualification shall be demonstrated by any of the following: Training and certification through the health care facility by which such persons are employed to work with specific equipment as installed in that facility Credentialing to the requirements of ASSE 6040, Professional Qualification Standard for Medical Gas Maintenance Personnel Credentialing to the requirements of ASSE 6030, Professional Qualification Standard for Medical Gas Systems Verifiers MedGas maintenance - Facility shall develop and document PM - Program shall include an inventory of: All source subsystems, control valves, alarms, manufactured assemblies, and outlets - Inspection schedule established through a risk assessment - Inspection procedure established by Org - PM schedule established through a risk assessment Mandatory MedGas testing frequencies - MedGas testing frequencies partial examples 5.1.14.2.2.2* Inspection Schedules. Scheduled inspections for equipment and procedures shall be established through the risk assessment of the facility and developed with consideration of the original equipment manufacturer recommendations and other recommendations as required by the authority having jurisdiction. A.5.1.14.2.2.2 In addition to the minimum inspection and testing in 5.1.14, facilities should consider annually inspecting equipment and procedures and correcting any deficiencies. Page 7
5.1.14.2.2.4 Maintenance Schedules. Scheduled maintenance for equipment and procedures shall be established through the risk assessment of the facility and developed with consideration of the original equipment manufacturer recommendations and other recommendations as required by the authority having jurisdiction. B.5.2 Retesting and Maintenance of Nonflammable Medical Piped Gas Systems (Level 1 Systems). B.5.2.1 [5.1.3.5.10] These systems should be checked daily to ensure that proper pressure is maintained and that the changeover signal has not malfunctioned. Periodic retesting of the routine changeover signal is not necessary, as it will normally be activated on a regular basis. B.5.2.2 [5.1.3.5.12] These systems should be checked daily to ensure that proper pressure is maintained and that the changeover signal has not malfunctioned. Periodic retesting of the routine changeover signal is not required. Annual retesting of the operation of the reserve and activation of the reserve-in-use signal should be performed. B.5.2.3 [5.1.3.5.12] If the system has an actuating switch and signal to monitor the contents of the reserve, it should be retested annually. - 5.1.14.4.4 Central supply systems for nonflammable medical gases shall conform to the following: They shall be inspected annually. - 5.1.14.4.5 A periodic testing procedure for nonflammable medical gas and vacuum and related alarm systems shall be implemented. - 5.1.14.4.7 Procedures, as specified, shall be established for the following: Maintenance program for the medical air compressor supply system in accordance with the manufacturer s recommendations Facility testing and calibration procedure that ensures carbon monoxide monitors are calibrated at least annually or more often if recommended by the manufacturer - 5.1.15* Category 1 Maintenance. Facilities shall have a routine maintenance program for their piped medical gas and vacuum systems. - A.5.1.15 Medical gas and vacuum systems should be surveyed at least annually for the items that follow and deficient items corrected. Survey of medical air and instrument air sources should include, but not be limited to, the following: 2012 Monograph on Medical Gas Cylinder and Bulk Tank Storage - BASED ON NFPA 99-2012 - Definitions - General Storage Requirements - Cylinder storage < 300 CF - Cylinder storage 300 3,000 CF Page 8
- Cylinder storage > 3,000 CF - Signage requirements - Requirements for transfilling liquid O2 - Outdoor bulk tank storage Scope for Electrical Systems Chapter 6 Certain areas are not covered directly by NFPA 99: (Ref: 70, 101, 72, 20, 37 instead) Applicability to existing systems? Ch. 6: Electrical - 6.1.1 This chapter shall apply to new health care facilities as specified in Section 1.3. - 6.1.2 The following paragraphs of this chapter shall apply to new and existing health care facilities: (1) 6.3.2.2.4.2 GFCIs must be listed (2) 6.3.2.2.6.1 Types of receptacles (3) 6.3.2.2.6.2(F) Designated General Care Pediatric Locations: tamper resistant (4) 6.3.2.2.8.5(B)(2), (3), and (4) Receptacle ITM (5) 6.3.2.2.8.7 Wet Procedure Location ORs need IPS or GFCIs (6) 6.3.4 Electrical system ITM (7) 6.4.1.1.17.5 BAS may not take place of EPSS annunciator (8) 6.4.2.2.6.2(C) LS/CB receptacles readily identifiable (9) 6.4.2.2.6.3 Lighting switches OK when lighting not 101-required (10) 6.4.4 Type 1 EES Administration including ITM (11) 6.5.4 Type 2 EES Administration including ITM (12) 6.6.2.2.3. 2 LS/CB receptacles readily identifiable (13) 6.6.3.1 Type 3 EES LS/CB within 10 sec for 90 min (14) 6.6.4 Type 3 EES Administration including ITM - 6.1.3 Paragraph 6.3.2.2.2.3 shall apply only to existing facilities. No separate grounding conductor may be OK if. Partial example of significant changes listed in Supplement 5 ORs are Wet Procedure Locations by default Ch. 6 Electrical Systems - 6.3.2.2.11 Battery-Powered Lighting Units. - 6.3.2.2.11.1 One or more battery-powered lighting units shall be provided within locations where deep sedation and general anesthesia is administered. - 6.3.2.2.11.2 The lighting level of each unit shall be sufficient to terminate procedures intended to be performed within the operating room. - 6.3.2.2.11.3 The sensor for units shall be wired to the branch circuit(s) serving general lighting within the room. - 6.3.2.2.11.4 Units shall be capable of providing lighting for 1 ½ hours. - 6.3.2.2.11.5 Units shall be tested monthly for 30 seconds, and annually for 30 minutes. Post 1983 changes: EES branch separation - Post-1983 changes will trigger Page 9
- NFPA 99-2012 compliant EES: existing - All 3 EES branches - LS & CB independent of all other wiring & equipment - NFPA 99-2012: 6.4.2.2; 6.4.2.2.6. - These requirements were for NEW back in 1983, so any changes since then could have trigger those requirements. Ch.7 IT & Communication Systems - NOT adopted by CMS - Includes Nurse Call as one communication system - Review it anyway many best practices and areas for consideration - Category 1, Category 2, Category 3 - Infrastructure; Distribution; Spaces; Pathways - Equipment CH. 8 Plumbing Systems - NOT adopted by CMS; Very short - Mainly says to follow local plumbing codes - Risk category sample table similar to HVAC - 8.1 Applicability 8.1.1 This chapter shall apply to construction of new health care facilities, except as noted in 8.1.2 and 8.1.3. 8.1.2 This chapter shall also apply to the altered, renovated, or modernized portions of existing systems or individual components. 8.1.3 Existing construction or equipment shall be permitted to be continued in use when such use does not constitute a distinct hazard to life. - Sample Plumbing System Risk Category Table Ch. 9 HVAC Systems - New chapter; Very short - Mostly references out to ASHRAE 170-9.3.3 requires commissioning per ASHRAE 90.1 - Invokes NFPA 90A, NFPA 55 - Extracted text from NFPA 110 for EPS areas - TABLE A.9.3.7.5.1: Typical Medical Gas Cylinders Volume and Weight of Available Contents Applicability to existing systems? Ch. 9: HVAC - 9.1 Applicability 9.1.1 This chapter shall apply to construction of new health care facilities, except as noted in 9.1.2 and 9.1.3. 9.1.2 This chapter shall also apply to the altered, renovated, or modernized portions of existing systems or individual components. 9.1.3 Existing construction or equipment shall be permitted to be continued in use when such use does not constitute a distinct hazard to life. Sample HVAC System Risk Category Table Page 10
Electrical Equipment Chapter 10-10.1 Applicability 10.1.1 This chapter shall apply to the performance, maintenance, and testing of electrical equipment in health care facilities, as specified in Section 1.3. 10.1.2 Experimental or research apparatus built to order or under development shall be used under qualified supervision and shall have a degree of safety that is equivalent to that described herein or that has been deemed acceptable by the facility. - Performance Criteria and Testing for Patient-Care Related Electrical Appliances and Equipment, Testing Requirements Fixed and Portable, Nonpatient Electrical Appliances and Equipment, Administration - 10.2.3.6 Multiple Outlet Connection [RPTs] - 10.2.4 Adapters and Extension Cords - 10.4.2 Portable Equipment in Patient Care Room - 10.5.2.7 Appliances Not Provided by the Facility - 10.5.3 Servicing and Maintenance of Equipment - 10.5.4.1 Electrical Equipment in Oxygen-Enriched Atmospheres - 10.5.8 Qualification and Training of Personnel Gas Equipment - Chapter 11-11.1 Applicability - 11.1.1* This chapter shall apply to the use, at normal atmospheric pressure, of all of the following: Nonflammable medical gases Vapors and aerosols Equipment required for the administration of 11.1.1(1) and (2) - Cylinder and Container Storage - Cylinder and Container Storage Requirements - Performance Criteria and Testing - Administration; policies - 11.5.1.1 Elimination of Sources of Ignition. - 11.5.2.1 Qualification and Training of Personnel - 11.5.3 Use (Including Information and Warning Signs). - Operation and Management of Cylinders - Liquid Oxygen Entrapment Emergency Management Chapter 12-12.1.2 Applicability. This chapter shall be applicable to any health care facility that is intended to provide medical care during an emergency or maintain services for patients during a disaster and for the protection of visitors and staff. - Based on NFPA 1600 & TJC s EM Chapter - Comprehensive - Scope, Responsibilities, Matrix Categories, General, Category 1 and Category 2 Requirements Security Management Chapter 13 Page 11
- Scope, Security Vulnerability Assessment (SVA), Responsible Person, Security-Sensitive Areas, Access and Egress Security Measures, Media Control, Crowd Control, Security Equipment, Employment Practices, Security Operations, Program Evaluation - Comprehensive Hyperbaric Facilities Chapter 14-14.1.1 Applicability. 14.1.1.1 This chapter shall apply to new facilities. 14.1.1.2 Portions of this chapter shall apply to existing facilities. (See 1.1.12.) 14.1.1.3 This chapter shall also apply to the altered, renovated, or modernized portion of an existing system or individual component. 14.1.1.4 Existing construction or equipment shall be permitted to be continued in use when such use does not constitute a distinct hazard to life. - Scope - 14.1.2.2* Occupancy. Hyperbaric chambers shall be classified according to the following criteria: Class A Human, multiple occupancy Class B Human, single occupancy Class C Animal, no human occupancy - Construction & Equipment - Administration & Maintenance - Very special spaces many unique requirements Features of Fire Protection Chapter 15 - Applicability, Construction and Compartmentation, Special Hazard Protection for Flammable Liquids and Gases, Laboratories, Utilities, Rubbish Chutes Incinerators and Laundry Chutes, Fire Detection Alarm and Communications Systems, Automatic Sprinklers and Other Extinguishing Equipment, Manual Extinguishing Equipment, Compact Storage, Compact Mobile Storage, Maintenance and Testing, - Fire Loss Prevention in OR s - Extracts from and/or references NFPA 101, 10, 13, 25, 30, 45, 54, 58, 70, 72, 82, 90A, 110, 111, ASME A17.1, ASME A17.3 Fire Loss Prevention in ORs - 15.13.1, Hazard Assessment - Includes hazards associated with the properties of electricity, hazards associated with the operation of surgical equipment, and hazards associated with the nature of the environment. - Includes periodic reviews of surgical operations and procedures that include any changes in materials, operations, or personnel - 15.13.2, Fire Prevention Procedures - 15.13.3, Germicides and Antiseptics - Pre-Op Time-Out - Safety policies & procedures - Emergency procedures - Orientation and training - Continuing safety education and supervision Page 12
- Monthly reviews - Fire exit drills 2.4 References for NFPA 99-2012 Mandatory Extracts - NFPA 13, Standard for the Installation of Sprinkler Systems, 2010 edition. - NFPA 30, Flammable and Combustible Liquids Code, 2012 edition. - NFPA 45, Standard on Fire Protection for Laboratories Using Chemicals, 2011 edition. - NFPA 55, Compressed Gases and Cryogenic Fluids Code, 2010 edition. - NFPA 70, National Electrical Code, 2011 edition. - NFPA 90A, Standard for the Installation of Air-Conditioning and Ventilating Systems, 2012 edition. - NFPA 99B, Standard for Hypobaric Facilities, 2010 edition. - NFPA 101, Life Safety Code, 2012 edition. - NFPA 110, Standard for Emergency and Standby Power Systems, 2010 edition. - NFPA 1670, Standard on Operations and Training for Technical Search and Rescue Incidents, 2009 edition. - NFPA 5000, Building Construction and Safety Code, 2012 edition. NFPA 99-2012 references over 80 newer publications. [including some important ones below]: - NFPA 99-2012: updated NFPA publications - NFPA 10-2010 - NFPA 13-2010 C/R - NFPA 25-2011 - NFPA 45-2011 - NFPA 70-2011 C/R - NFPA 72-2010 - NFPA 110-2010 Ref. by 101; not 99 - NFPA 17A-2009 - NFPA 80-2010 - NFPA 96-2011 - NFPA 105-2010 NFPA 99-2012: other updated publications NFPA 99-2012: other updated publications Some newer referenced standards 1 [SEE DETAILS BELOW] Some newer referenced standards 2 [SEE DETAILS BELOW] Some other newer referenced standards 3 [SEE DETAILS BELOW] NFPA 55-2010 (was 1998) Major ITM Changes - Compressed Gases and Cryogenic Fluids Code - Revised 2003, 2005, 2010 Page 13
- Incorporated NFPA 50, 50A, 50B - Separation distances & threshold storage requirements - Incorporated NFPA 99 bulk O2 systems - Incorporated NFPA 560 - Added gas generation systems - Added insulated liquid CO2 systems NFPA 10-2010 (was 1998) Major ITM Changes - Portable FEs Revised in 2002, 2006, 2010 - Securely installed on bracket or hanger provided by mfr or listed; or cabinet or wall recess - Manufacturer s strap-type bracket for protection in certain cases - Instructions located on front and clearly visible - Electronic monitoring now permitted (check with AHJs though) - Remove non-rechargeable FEs 12 yrs after mfr - Electronic monitoring permitted in lieu of physical monthly inspections. Monthly inspection procedures simplified somewhat. Investigate new technology. - Halon FE limited: only where necessary to extinguish fire without damaging equipment - Maintenance/recharging only by certified persons (by factory, by AHJ, or by org acceptable to AHJ) - Special reqmts for hoses on wheeled equipment NFPA 25-2011 (was 1998) Major ITM changes - Water-based FP Systems ITM. Revised in 2002, 2008, 2011 - Identify all shut-off valve locations no guidance in NFPA 25 - New sign requirements at system control risers supplying antifreeze loop, dry system, pre-action system or aux system control valve. - Quarterly main drain test downstream of backflow preventer some cases - Standpipe hose valves (not FD Connections) inspected quarterly - Annual valve test @ standpipe systems w/2.5 hose valves - 3 yr valve test @ standpipe systems w/1.5 hose valves - 5 year wet standpipe water-flow tests - 5 year dry standpipe hydrostatic pressure tests - Test a sample or replace: Dry sprinklers (10 yrs); All sprinklers (75 yrs) - Repairs: qualified individuals. Performance-based ITM if AHJ approves - Categorical waivers monthly churn test for motor-driven FPs; semi-annual testing of vane & pressure-type waterflow switches - Caution: More changes than these. NFPA 13-2010 (was 1999) - Installation of Sprinkler Systems - Few impacts on ITM NFPA 13 is an installation code new construction & renovations see most impact through building codes - Revised in 2002, 2007, 2010 - Many changes affecting new designs - Be careful with renovations Page 14
NFPA 20-2010 (was 2000) Major ITM Changes - Installation of Stationary Pumps for FP - Revised in 2003, 2007, 2010 - Acceptance test criteria added for replacement of critical path components of a fire pump installation - Component replacement testing tables NFPA 30-2012 - Flammable & Combustible Liquids Code - Revised in 2003, 2008, 2012 - Special operating requirements for certain aboveground tanks - Prohibits permanent connections between fire water and process water - New requirement for aboveground storage tank ITM - FP changes for inside storage areas - Several new requirements on tanks - Several new Annex recommendations NFPA 17A-2009 (was 1998) Major ITM changes - Wet Chemical Extinguishing Systems - Updated in 2002, 2009 (ITM) - Electronic monitoring for monthly pressure gauge readings (check with AHJs though) - ITM only by certified/tested persons (by mfr or by org acceptable to AHJ) - When ITM identifies defective part that could cause an impairment or failure, system must be tagged as "noncompliant with owner's rep & AHJ notified - Record retention at least 1 year after last required ITM - Fixed fusible metal alloy elements replaced at least semiannually from the date of installation or more frequently as needed (was annual) NFPA 96-2011 (was 1998) Major ITM changes - Ventilation Control and FP of Commercial Cooking Operations - Updated in 2001, 2004, 2008, 2011 - Cleaning & maint of exhaust systems; +[D] - Certified persons only: IT of listed hoods - Class K FE within 30 ft - Written impairment notifications - No spray pattern obstructions - Remove abandoned pipe/conduit from hoods, plenums, exhaust ducts & seal all penetrations NFPA 45-2011 (was 1996) Major ITM changes - FP for Labs Using Chemicals - Revised in 2000, 2004, 2011 - Separation requirements, gases, lab ventilation & hoods, face velocity, VAV - Extinguishing systems, quantities, bio safety cabinets, outside cylinder storage - Major modifications, height restrictions, FRR, HazMat quantities, ACH changes to align with other documents, explosion hazards, time-sensitive chemicals. Page 15
- All laboratory requirements were moved from NFPA 99-2012 to NFPA 45-2011. NFPA 90A-2012 (was 1999) Major ITM changes - Installation of AC & Ventilating Systems - Revised in 2002, 2009, 2012 - Remove accessible abandoned materials in concealed & plenum spaces - Permitted materials in plenum spaces - Moved fire dampers to 80 - Moved smoke dampers to 105 - Better alignment with 70, 80, 105 NFPA 37-2010 (was 1998) Major ITM changes - Installation and Use of Stationary Combustion Engines and Gas Turbines - Revised in 2002, 2006, 2010 - Spill prevention & containment changes - Interior engine rooms; detached structures - Safeties, allowable combustion air filters - Other miscellaneous changes NFPA 70-2011 (was 1999) - National Electrical Code - Few impacts on ITM NEC is an installation code new construction & renovations see most impact through building codes - Revised in 2002, 2005, 2008, 2011 - Specific loads on branches - Battery-powered lights in ATS locations - Tougher arc flash hazard markings (70E) - Wet procedure location - Patient care vicinity - Overcurrent protection & selectivity NFPA 72-2010 (was 1999) Major ITM changes - National Fire Alarm & Signaling Code - Now includes emergency communication systems - Voice intelligibility testing Completed at initial acceptance or reacceptance, after any building or system modifications - Inspection paperwork now 10 pages (was 4 pages) a lot more information must be entered; require compliance from your contractors - Testing & inspection requirements for Mass Notification Systems (MNS) - Documentation: FA software current revisions & compatibility - Changed requirements for ITM of gas detectors, circuits, pathways - Replace combination smoke/co alarms @ 10 years or EOLife signal - New requirements for commissioning, acceptance & annual testing of interior emergency radio comm systems - New requirements for mass notification systems (MNS) Will AHJs require reactive compliance? Page 16
NFPA 110-2010 (was 1999) Major ITM changes - Revised in 2002, 2005, 2010. Should also see 2013 fuel oil. - Loading % and time frames; monthly & annual test durations, combining tests - Testing after repairs - Installation acceptance test rewritten - Maintenance requirements - Optional standby systems excluded - Ch. 8 applies to new & existing systems - Seismic risk area: Class X = 96 hours - Temperatures - Allow parts, tools, manuals for PM/repair in gen rm -?s w/ fuel tests approved by ASTM standards - E-mail presenter for more 110 changes details NFPA 241-2009 (was 1999) Major ITM changes - Safeguarding Construction, Alteration, and Demolition Operations - Revised 2004, 2009-2-hour fire watch following torch-applied roofing operations - Changes for exterior trash chutes - New sprinklers on line ASAPracticable - With some exceptions, 1 hr temp construction barriers to separate occupied egress areas from higher hazard C/R/demo areas ASHE Step 1: Review LSC Ch.19, EXISTING ASHE Step 2: Compare 2000 vs. 2012 LSC ASHE Step 3: Review NFPA 99-2012 ASHE Step 4: Review ASHRAE 170 ( 08, 13) ASHE Step 5: Plan your compliance strategy ASHE e-learning Course: NFPA 99 in HCFs - NFPA 99: Health Care Facilities Code e-learning provides minimum health care facility requirements covering a broad spectrum of applications. The 2012 edition contains the most extensive changes since the inception of NFPA 99, including the change from a standard to a code and the shift to a risk-based approach. This course examines each topic area covered by the 2012 edition of NFPA 99. - Other codes and standards are also referenced by NFPA 99. Where pertinent, these other codes and standards will be examined during this e-learning course to provide a more complete understanding of NFPA 99 and how it is applied to health care facilities. - 1.5 CEUs (equivalent to 16.0 contact hours) - http://www.ashe.org/education/nfpa99_elearning/index.shtml Thank You! David Stymiest, P.E., CHFM, CHSP, FASHE - (P.E. in LA, MS, MA) Page 17
- Senior Consultant Smith Seckman Reid, Inc. - www.ssr-inc.com Compliance News archives and sign-up are available at: http://www.ssr-inc.com/blog/ Page 18