FHCA 2014 Annual Conference & Trade Show CE Session #5 Preparing for the Upcoming Code Changes Don t Look Back Tuesday, July 8 8:15 to 9:15 a.m. Canary 3 Operations/Quality Improvement Upon completion of this presentation, the learner will be able to: explain the Life Safety Code being enforced in by and also the Florida Building Code in existence; identify preventive measures to ensure good emergency planning for the safety and security of a long term care physical plant; and develop methods of communication with life safety surveyors in response to known trends of citations. Seminar Description: The Life Safety Code is anticipated to be adopted by in 2014. Some facilities may think they will not be influenced by the enforcement of the new Code provisions. This session will stress the areas that will be implemented across all facilities, including the grandfathered-in long term care facilities. is planning a more intensive look behind at facilities physical plant and security planning in case a disaster occurs. Other examples will be provided to ensure providers are up to date and prepared for the life safety surveyors coming from the local, state and federal levels. Presenter Bio(s): Max Hauth is president/owner of Hauth Health Care Consultants, Inc. He holds nursing home administrator licenses in Indiana, Illinois and Florida, and is a Florida-certified residential contractor. With 35+ years in health care administration, he has a strong working knowledge of the requirements of the health care delivery system. Max has been active developing new health care facilities, renovations and additions, and in helping facilities achieve code compliance with various states and. He has participated in developing State Building Codes and NFPA Codes and Standards. He gives presentations at NFPA, state associations, and community forums. His informative monthly articles for FHCA s newsletter have helped Florida s health care facilities remaining code compliant. An active member of NFPA since 1979, and a member of the Executive Board since 1988, Max had served on a number of the Health Section s committees. He is also on the American Health Care Association s Life Safety Physical Plant Committee and several Florida Health Care Association committees.
Life Safety Code Florida s State Fire Marshall To Adopt Life Safety Code NFPA 101 & NFPA 99 Health Care Facilities January 1, 2015 To Adopt Life Safety Code NFPA 101 & Health Care Facilities NFPA 99 Agenda Global Changes Core Chapters Chapters 1 11 Health Care Specific Changes Chapters 18 & 19 Building Rehabilitation Chapter 43 (New) 1. Repair 2. Renovation 3. Modification 4. Reconstruction 5. Change of use or occupancy classification 6. Addition (59A 4 AHCA OPC Plan Reviews required) 2.1(3) Existing installations shall be permitted to be continued in use provided lack of conformity with referenced documents does not present a serious hazard to the occupants. 1
Hauth Health Care 2516 Jonila Avenue Consultants, Inc. Lakeland, FL 33803 Phone 863-688-0863 EMHauth@aol.com Review of Proposed Regulations 42 CFR Parts 403, 416, 418, 460, 482, 483 and 485 Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities Health Care (Ch. 18 & 19) Minor renovations & modernizations Corridor projections 2000 LSC LSC Proposed Must comply with new construction Maximum 3½ in. projections permitted at or below handrail height (38 in.). Subsequently modified by in S&C letters. Suites Maximum 5,000 sf for patient sleeping suites and 10,000 sf for non-patient sleeping suites. Subsequent categorical waiver for LSC. Chapter 43, Building Rehabilitation allows for degrees of compliance based on the work category such as the extent of work. Permits non-continuous projections of not more than 6 in. Maximum 7,500 sf for patient sleeping suites with a) quick-response sprinklers or b) standard-response sprinklers and smoke detection through the smoke compartment; and 10,000 sf for nonpatient sleeping suites and patient sleeping suites with quickresponse sprinklers throughout and direct visual supervision and complete smoke detection. proposes that alterations to existing buildings must comply with Chapter 43. proposes that projections must not exceed the maximum 4- in. requirement of the 2010 ADA. Reduces costs for minor construction projects. ADA compliance has been required prior to the proposed adoption of the LSC. Improves facility staffing flexibility and reduces costs by reducing number of suites. Q:\0601-000\BSC\Rosenbaum E\TABLE_Proposed Regs.docx FIRE SCIENCE & ENGINEERING PROPOSED REGS IN0000000.063 PAGE 2 Health Care (Ch. 18 & 19) Recycling Maximum capacity of 32 gallons for recycling clean waste containers where containers are not located in protected hazardous areas. Roller latches Existing roller latches permitted where demonstrated to keep door closed against a force of 5 lbf. deleted this Sprinklers in existing highrises 2000 LSC LSC Proposed Reserved (no provision) Maximum capacity of 96 gallons for recycling clean waste containers or patient records where containers are not located in protected hazardous areas. Where acceptable to the AHJ, existing roller latches permitted where demonstrated to keep door closed against a force of 5 lbf and corridor doors are in a fully sprinklered building. Sprinkler protection is required throughout the building within 12 years of the adoption of the LSC (except where a jurisdiction already adopted the 2009 LSC in which case installation must be within 9 years). Roller latches will remain as prohibited by. adopt provision, but would like to solicit public comments regarding the phase-in period of 12 years. Larger containers allow for less frequent emptying thus reducing housekeeping costs. No major impact as these were not previously not permitted. believes this requirement would affect mainly hospitals. 2
PROPOSED REGS IN0000000.063 PAGE 3 Health Care (Ch. 18 & 19) Door locking Door locking is permitted where the clinical needs of the patients require specialized security measures for their safety and that keys are carried by staff and/or staff can readily unlock doors all times. 2000 LSC LSC Proposed Door locking is permitted where the clinical needs of the patients require specialized security measures or where patients pose a security threat provided that staff can readily unlock doors all times [ 18.2.2.2.5.1] (applicable to dementia units, psych, forensic). Door locking is permitted where patient special needs (e.g., pediatric patients) require specialized protective measures for their safety provided that a) staff can readily unlock doors at all times, b) total (complete) smoke detection throughout locked space or doors can be remotely unlocked, c) sprinklered building, d) doors fail safe upon loss of power, e) door locks release on fire alarm or sprinkler waterflow detection. Improve security of facilities with specialized needs and improve patient safety. Alcohol-based hand rubs (ABHRs) Gels permitted. Aerosols also permitted in addition to gels. Automatic dispensers permitted. Clarifies placement of dispensers above, next to and below ignition sources. Allows for more hand hygiene dispenser options. PROPOSED REGS IN0000000.063 PAGE 4 Health Care (Ch. 18 & 19) Sprinkler system outage Anesthetizing locations 2000 LSC LSC Proposed 1998 NFPA 25 requires evacuation of a building or instituting a fire watch when a sprinkler system is out of service for more than 4 hours. 1999 NFPA 99 requires smoke control ventilation in anesthetizing locations such as operating rooms [ 5-4.1.3]. Corridors Storage is permitted in alcoves not exceeding 50 sf open to corridors. In use items such as linen carts, crash carts are permitted. Cooking facilities Kitchens are not permitted to be open to corridors. 2011 NFPA 25 requires evacuation of a building or instituting a fire watch when a sprinkler system is out of service for more than 10 hours in a 24- hour period. NFPA 99 deletes smoke control requirement. In addition to 2000 LSC provisions, allows for storage of wheeled medical equipment (emergency equipment, patient lift and transportation) in corridors, and fixed furniture. Allows for cooking facilities to be open to corridors where food is prepared for not more than 30 individuals based on compliance protection criteria in 18.3.2.5.3/ 19.3.2.5.3 retain 4 hour requirement. retain smoke control ventilation requirement in 1999 NFPA 99. No change is anticipated as will keep an existing requirement. No change is anticipated as will keep an existing requirement. Equipment allows for more timely patient care. Furniture provides resting points and a more home-like setting. Provides a more homelike setting. 3
PROPOSED REGS IN0000000.063 PAGE 5 Health Care (Ch. 18 & 19) Furnishings and decorations 2000 LSC LSC Proposed Prohibits combustible decorations unless they are flame-retardant or of limited quantities that do not present a hazard of fire development or spread. Expands 2000 provisions. Allows combustible décor provided that the items are flame-retardant or treated with approved fire-retardant coatings. Provides a more homelike setting. Fireplaces Permitted in Allows direct-vent gas Allows for 18.5.2.2, Ex. fireplaces to be without more options 2/ 19.5.2.2, Ex. 1-hour FRR. Solid fuel- for locating 2 in areas other burning fireplaces must fireplaces. than patient be separated by 1-hour sleeping areas FRR. where fireplace is separated by Outside windows and doors 1-hour FRR. Every patient sleeping room must have an outside window or outside door. The sill height must not exceed 36 in. except in special nursing units (60 in. AFF) and limited care (44 in.). This requirement has been deleted. retain 2000 requirement for outside windows or doors except for newborn nurseries and rooms intended for occupancy less than 24 hours, and atrium windows. Window sill height in special nursing care areas must not exceed 60 in. AFF. No change is anticipated as will keep existing requirements applicable to long-term care. PROPOSED REGS IN0000000.063 PAGE 6 Residential Board & Care (Ch. 32 & 33) Sprinklers 32.2.3.5.3.2 requires sprinklers in all habitable areas and closets for slow and impractical evacuation (NFPA 13D) and for impractical evacuation (NFPA 13R). 2000 LSC LSC Proposed All habitable areas, closets, roofed porches, balconies and decks must have sprinklers (NFPA 13D and NFPA 13R). strongly encourages all existing facilities to be sprinklered in all habitable areas as for new construction. Attics in Small 1999 Editions cites the Facilities of NFPA 13D 32.2.3.5.7/ 333.2.3.5.7 fatal 2009 and 13R do not is a new provision Wells, NY fire require requiring sprinklers in as support for sprinklers in attics that are used for this attics. living purposes, storage requirement. or housing of fuel fired equipment. Reliability of No provision New provision requires means of escape Smoke alarms in New Large Facilities 32.3.3.4.7 requires a smoke alarm in each sleeping room. designated means of escape to be continuously maintained free of all obstructions and impediments to full instant use in the case of a fire or emergency. requires smoke alarms in every sleeping room, outside every sleeping area in the immediate vicinity of the bedrooms, and on all levels within a resident unit. is soliciting public comments about whether these requirements should also apply to existing facilities. Administrative and operational impact should be minimal as the new code reflects standard acceptable practice. A significant cost would be incurred if smoke alarms must be provided in these other areas in addition to the sleeping rooms in existing facilities. 4
PROPOSED REGS IN0000000.063 PAGE 7 Residential Board & Care (Ch. 32 & 33) 2000 LSC LSC Proposed Staff No provision adds provisions for staff to be on duty and in the facility at all times when residents requiring evacuation assistance are present. Accesscontrolled egress doors in large facilities Hazardous areas in existing facilities Emergency forces notification in existing large facilities Exception 2 of 32.3.2.2.2(3) and 33.3.2.2.2(3) permits accesscontrolled egress doors in accordance with 7.2.1.6.2. 33.3.3.2.2 does not specify a requirement for smoke partitions. 33.3.3.4.6 requires provisions for the immediate notification of the public fire department by either telephone or other means or to a private fire brigade in case of a fire. keeps this 33.3.3.2.3 requires smoke partitions for hazardous area separation in facilities having impractical evacuation. 33.3.3.4.6.1 retains the 2000 33.3.3.4.6 provision where the existing fire alarm system does not provide for automatic emergency forces notification. 33.3.3.4.6.2 requires that where a new fire alarm system is installed or the existing fire alarm system is replaced, emergency forces notification in accordance with 9.6.4 is required. This increases safety for residents who are not capable of independently exiting the building. No substantive change. This should be a minor upgrade in most cases. This provision would only apply when the fire alarm system is replaced or a new system is installed. The additional cost would be minor given current technology. Chapters Deleted for 1012 All Occupancy chapters Chapter 6 Environmental Systems Chapter 7 Materials Chapter 10 Manufacturers Requirement Chapter 11 Laboratories Deleted Annexes Annex B Nature 0f Hazards Annex D Safe use of High Frequency Electricity Annex F Flammable Anesthetizing Locations 5
New Chapters for Chapter 4 Fundamentals Established Categories based on risk assessments Chapter 7 Information Technology and Communications Section Chapter 8 Plumbing & Chapter 9 HVAC Chapter 13 Security Chapter 15 Features of Fire Protection Chapter 12 Emergency Management Totally rewritten Coordinate with requirements of the Joint Commission Lessons learned from recent disasters Better integration with NFPA 1600 Standards on Disaster/Emergency Management and Business Continuity Programs. Annexes (New) Annex A: Explanatory material Keyed to specific code text Non mandatory Annex B: Explanatory material Keyed to Chapter Non Mandatory Annex C: Sample Adopting Ordnance Annex D: Informational References PROPOSED REGS IN0000000.063 PAGE 8 NFPA 99 1999 NFPA 99 NFPA 99 Proposed Chapter 4 - Fundamentals Chapter 9 HVAC New risk-based methodology for application of requirements. Four categories are specified with Category 1 being the highest risk where failure of equipment or system is likely to cause death or major injury. Section 4.2 requires that each facility define its risk assessment methodology, implement the methodology and document the results. New chapter requires HVAC systems to comply with 2008 ASHRAE 170. Chapter 9 does not apply to existing HVAC systems but would apply to altered, renovated or modernized systems. Commissioning 9.3.3 requires HVAC commissioning to follow ASHRAE Guideline 0, 1.1 or other publically viewed documents acceptable to the AHJ. Chapter 15 Features of Fire Protection Chapter 15 covers performance, maintenance, and testing of FP equipment. The provisions apply to both new and existing facilities. Highlight is Fire Loss Prevention in Operating Rooms. proposes not to require the use of any particular risk assessment procedure. will only allow ASHRAE Guideline 0 and 1.1. 6
PROPOSED REGS IN0000000.063 PAGE 9 Other Notes: LTC Facilities retain 483.70(a)(7)(i), (ii), (iii), (A) and (B) for installation, inspection, testing & maintenance (ITM) of battery operated single station smoke alarms. remove the phase-in period (to March 13, 2006) of 483.70(a)(ii)(4) for compliance with emergency lighting as all facilities must be in compliance. retain 483.70(a)(6) referencing NFPA 13, however, they did not revise the edition from 1999 to 2010 which may be an error or omission. To order code books call NFPA at 1-800-344-3555. 7
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