Fire EMS, Fire Prevention & Protection

CMS To Require Certain Nursing Homes To Install Smoke Detectors

Baltimore, MD – Nursing homes that do not have sprinkler systems or hard-wired smoke detectors will have to install battery-operated ones in patient rooms and public areas according to an announcement made today by the Centers for Medicare & Medicaid Services (CMS).

“This is an important rule that could save many lives by making real improvements in nursing home safety,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “Nursing home residents are an especially vulnerable population and we need to take every step possible to protect them.”

CMS took this unprecedented action after two tragic nursing home fires in Connecticut and Tennessee in 2003. Neither home had smoke detectors in the patient rooms where the fires originated. The agency worked closely with the National Fire Protection Association to develop ways to get effective fire protection into all facilities.

A review of the two incidents by the Government Accountability Office (GAO) asserted that smoke detectors could have resulted in quicker staff response that may have led to a better outcome.

This action is expected to considerably improve the safety of residents living in over 4,000 nursing homes that do not have sprinkler systems. Newly constructed nursing facilities are required to be fully covered by a sprinkler system, while older homes built of noncombustible materials like concrete block are not. Homes will be given a year in which to comply with the new requirement.

The interim final rule also includes a provision that will allow nursing homes, hospitals, ambulatory surgical centers and other health care facilities to install dispensers of alcohol-based hand sanitizers in exit corridors that meet certain conditions. This had not been allowed previously because of concerns that the alcohol rubs may serve as an accelerant in the event of a fire and block access to exits. Studies on this concern, however, have shown that if certain conditions are met, that fire hazard is greatly reduced while there can be a significant benefit in reducing hospital-acquired infections.

Alcohol-based hand rubs are more effective at destroying bacteria than ordinary soaps and water. This is critically important in a health care setting. The Centers for Disease Control estimates that two million patients a year get hospital-based infections and that 90,000 of those patients die. Hospital-based infections can often be traced to a lack of hand washing by health care personnel with direct patient contact.

Some precautions facilities must take include making sure the dispensers are not near a heat or ignition source, that they are at least four feet apart and that they are placed in corridors at least six feet wide.

The full interim final rule was published in the March 25 Federal Register.