Healthcare facilities of all kinds need to be aware of recent changes to the National Fire Protection Association (NFPA) 99 Healthcare Facilities Code 2018, specifically Section 16.9 which contains new requirements for fire extinguishers. There are also important changes to the corridor projection allowances in NFPA 101 Life Safety Code 2018 that can affect healthcare facilities.
The 2018 editions of both NFPA 99 and NFPA 101 became effective on September 6, 2017. And, both sets of regulations apply to all types of healthcare facilities including:
- Medical and psychiatric hospitals
- Outpatient surgical centers
- Behavioral healthcare facilities
- Inpatient hospices
- Intermediate care facilities for people with intellectual disabilities
- Long term care facilities
- Assisted living facilities and senior living facilities
- Rehabilitation centers
This post summarizes the changes in 2018 editions of NFPA 99 and NFPA 101. While not an exhaustive review of all changes in these codes, the information provided here will help you identify potential issues with the fire extinguishers you use in your facility.
NOTE: Centers for Medicare & Medicaid Services (CMS) is currently following the 2012 editions of both NFPA 99 and NFPA 101. While the changes listed below may not currently be adopted by CMS and required of healthcare facilities, they more than likely will be at later date when CMS adopts them.
Changes to NFPA 99 Healthcare Facilities Code
NFPA 99 Healthcare Facilities Code has long required that fire extinguishers be installed in accordance with the requirements in NFPA 10 Standards for Portable Fire Extinguishers. However, prior to the 2018 edition of NFPA 99, specific requirements regarding the types of fire extinguishers to be used in healthcare facilities did not exist. NFPA 99 Chapter 16 now provides detailed information regarding the types of fire extinguishers required for specific areas within the healthcare facility.
The need for these new, more specific requirements was driven by concerns regarding the different environments within a healthcare facility and the fact that a certain type of fire extinguisher that is effective in one type of environment may not be in another.
The 2018 edition of NFPA 99 now requires specific extinguisher types for different settings within a healthcare facility:
- For rooms in which magnetic resonance imaging (MRI) is conducted, only nonferrous (also called "non-magnetic") type extinguishers should be used. This is because MRI scanners use magnets 140 times stronger than the Earth's magnetic field -- easily strong enough to make a steel fire extinguisher fly across a room with lethal force.
- Class K fire extinguishers are the only kind that should be used in facility kitchens. This is now specified in the Code because while most people are familiar with "ABC" fire extinguishers, they may not realize that these types of extinguishers are not designed to put out fires involving combustible cooking media such as fats, greases, and oils.
- Dry chemical fire extinguishers are not to be used in operating rooms. Instead, operating rooms should be equipped with clean agent or water mist-type fire extinguishers. If using clean agent extinguishers, they should have a Class A rating. The issue with dry chemical fire extinguishers is the potential for contamination. If a fire breaks out during a surgery, there is a risk of accidentally spraying dry powder into an open cavity of a patient.
- From the transfer of electronic health records to systems that facilitate video-conferencing between doctors, healthcare facilities rely heavily on telecommunications to provide good patient care. Clean agent fire extinguishers are the only appropriate type of extinguisher for telecommunications equipment rooms and their entrances because dry-chemical and water-mist can damage the sensitive electronic equipment.
Changes to NFPA 101 Life Safety Code
Another important change that healthcare providers should be aware of are new and more specific requirements pertaining to corridor projection allowances in healthcare facilities. In the 2018 edition of NFPA 101, the requirements in Chapters 18 and 19 for corridor projections have been modified to correlate with accessibility standards under the American with Disabilities Act (ADA).
The 2010 Americans with Disabilities Act (ADA) Standards for Accessible Design includes requirements necessary to accommodate people with vision impairments. Among these are requirements for wall-mounted objects, including fire extinguishers.
Those who are blind or have low vision often travel closely along walls to help guide them as they move throughout a building. Given this, anything mounted on a wall can pose a potential hazard, particularly if it is above the "cane sweep" of 27 inches from the floor and below 80 inches. To protect people with impaired vision from these hazards, the ADA requires the protrusion of wall-mounted objects to four inches between 27 and 80 inches from the floor.
Previous editions of the NFPA 101 Life Safety Code, which applies to all buildings, allowed greater corridor projections than those allowed by the ADA. This difference created an inconsistency between ADA and NFPA standards, which was eliminated with the recent updates to Chapters 18 and 19 of the Life Safety Code.
Now, both sets of standards require that wall-mounted equipment, including fire extinguishers, protrude no more than four inches from the wall. These changes can create compliance issues for facilities that have fire extinguishers that are too large to meet the new requirements.
Fire extinguishers greater than four inches in diameter will not meet the new requirements unless they are mounted in recessed cabinets. Facilities that store their extinguishers in partially recessed cabinets may also find themselves out of compliance if the cabinet frames and doors – including the door handles – extend beyond four inches.
Non-Compliance Can Be Fatal for Healthcare Facilities
While the NFPA 101 Life Safety Code applies to all types of buildings that people occupy, the potential cost of noncompliance are perhaps the greatest with healthcare facilities. This is because Centers for Medicare and Medicaid (CMS) requires compliance with the ADA. And, where corridor safety is concerned, if a facility is out of compliance with NFPA 101, it is also out of compliance with the ADA.
In nursing homes, fines for fire extinguishers that protrude beyond the maximum four inches allowed can range from $150 to $10,050 a day until the situation is remedied. Other types of healthcare facilities are commonly given 45 days to comply. But, if they don't, they face the possibility of having their CMS provider agreement terminated.
The ability to serve Medicare and Medicaid patients is the life blood of many healthcare facilities, particularly for nursing homes. For these facilities, having their CMS provider agreement terminated could put them out of business.
Clearly, noncompliance is not an option for any healthcare facility. Koorsen Fire & Security is a national leader in helping healthcare facilities avoid costly and potentially devastating compliance issues. We have the expertise to maintain compliance with The Joint Commission, Healthcare Facilities Accreditation Program (HFAP), and other accreditation organizations (AO).
Koorsen’s Fire & Security experts can review your existing installations to identify any fire extinguishers that do not meet the new requirements and any new areas in your facility that now require them. If any issues are identified, Koorsen will help you find the most cost-effective solution to achieve full compliance.
Contact Koorsen today at 1-888-456-8038.
