Nursing Homes: Fire Safety Requirements Make No Sense

Legislation | August 28, 2017 | by Jennifer Hilliard

Even though nursing homes are required to be fully sprinklered, the Centers for Medicare and Medicaid Services (CMS) has directed that buildings must also have fireproofed structural steel members. To comply, nursing homes will have to spend millions of dollars to retrofit the physical structure, tear it down and rebuild or close.

The Centers for Medicare and Medicaid Services (CMS) has adopted the 2012 Life Safety Code (LSC) by regulation published at 81 Fed. Reg. 26872 (May 4, 2016).   The 2012 LSC contains certain “Extinguishment Safety” requirements.  One such requirement mandates that facilities have fireproofed structural steel members. 

Previously, facilities without fireproofed structural steel members nevertheless were permitted under the 2001 Fire Safety Evaluation System (FSES) to demonstrate compliance with the extinguishment safety requirements if they were otherwise were equipped with sprinklers and detectors.  However, on December 16, 2016 in Survey and Certification Letter No. S&C 17-15-LSC (S&C 17-15-LSC), CMS notified providers that it had adopted the 2013 FSES, which does not permit facilities to obtain a waiver of the extinguishment safety requirements if the building is equipped with sprinklers and detectors. 

As a result, facilities without fireproofed structural steel members will fail their life safety inspection. To remedy the deficiencies, CMS has told facilities that they must fireproof the structural steel members, construct an entirely new building or close the building altogether.  Neither of the first two options is economically viable as the necessary changes would cost millions per facility. The third option, at the very least, would disrupt the care provided to our most frail and vulnerable seniors, and more likely would actually deprive those seniors of care given the nationwide scope of the problem.  Experts estimate that 500-600 nursing facilities nationwide would be forced to close, with thousands of jobs lost and resident lives disrupted. 

S&C 17-15-LSC affords providers a time-limited waiver of up to five (5) years to correct any deficiencies resulting from unfireproofed structural steel members and to come into compliance with the prescriptive requirements of the 2012 LSC. Such a waiver, however, is wholly inadequate given the likelihood that 500-600 hundred nursing homes nationwide will likely be forced to close. These consequences simply are unreasonable and could not possibly be what the agency expected.

Related Statute/Regulation:

42 CFR Parts 403, 416, 418, 460, 482, 483, and 485

Proposed Solution:

Provide existing nursing facilities that are equipped with sprinklers and detectors a permanent waiver of the requirement for fireproofed structural steel members as required by the 2012 LSC and all future versions of the Life Safety Code.