CMS Issues New Rule to Protect Medicare and Medicaid Patients from Fire, Smoke and Panic

Susan Jones | May 3, 2016 | 11:13am EDT
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( - The Centers for Medicare & Medicaid Services has issued new regulations to protect its beneficiaries from fire, smoke and panic.

The final rule announced on Tuesday applies to health care providers and suppliers -- hospitals, long-term care facilities, hospice units, surgical centers, and all other facilities that treat Medicare and Medicaid patients.

"CMS strives to promote health and safety for all patients, family and staff in every provider and supplier setting. Fire safety requirements are an important part of this effort," the announcement said.

The final rule adopts updated provisions set forth in the National Fire Protection Association’s 2012 Life Safety Code. The LSC is a compilation of fire safety requirements for new and existing buildings, and it is updated every three years. (Currently, CMS is relying on the 2000 Life Safety Code.)

Some of the main requirements laid out in the final rule include:

-- Health care facilities located in buildings that are taller than 75 feet are required to install automatic sprinkler systems within 12 years after the rule’s effective date.

-- Health care facilities are required to either have someone watch for fire or else evacuate the building if their sprinkler system is out of service for more than ten hours.

-- The provisions offer long-term care facilities greater flexibility in what they can place in corridors. Currently, they cannot include benches or other seating because of fire code requirements that limit potential barriers to firefighters. Long-term care facilities soon will be able to include more home-like items such as fixed seating in the corridor for resting.

-- Fireplaces will be permitted in smoke compartments (protected areas) without a one-hour fire wall rating, which makes a facility more home-like for residents. (Fireplaces may not be located inside patients' rooms.)

-- Cooking facilities now may have an opening to the hallway corridor. This will permit residents of inpatient facilities such as nursing homes to make food for themselves or others if they choose to, and, if the patient does decide to make food, staff is able to supervise the patient.

-- For ambulatory surgical centers, all doors to hazardous areas must be self-closing or must close automatically. Additionally, alcohol-based hand cleaning dispensers now may be placed in corridors to allow for easier access.

-- Most patient sleeping rooms must have either an outside door or an outside window with an allowable sill height not to exceed 36 inches.

“This final rule meets health care facilities’ desire to modernize their environments while also ensuring the necessary steps to provide patients and staff with the appropriate level of safety,” said Kate Goodrich, director of CMS's Center for Clinical Standards and Quality. “Health care facilities can now be more home-like while ensuring that the most modern fire protection practices are in place.”

CMS estimates the overall economic impact for the rule to be $18 million in the first year of implementation; $12 million, annually, for years two and three of implementation, and $6 million, annually, for years 4-12 of implementation. 

"We estimate that this rulemaking is not “economically significant” as measured by the $100 million threshold, and hence not a major rule under the Congressional Review Act," the regulation says.

Health care providers affected by the new rule must comply with all regulations within 60 days of the rule's May 4, 2016 publication date, unless otherwise specified in the final rule.

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