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National Long-term Care Life Safety Task Force

Pioneer Network Submits Proposals to the NFPA on Behalf of the National Long-term Care Life Safety Task Force

UPDATE: Pioneer Network Announces Life Safety Code Changes Approved, 9/16/11 

As a follow up to the 2008 CMS/Pioneer Network Creating Home in the Nursing Home Symposium on Culture Change and the Environmental Requirements, the Pioneer Network, with funding from the Hulda B. and Maurice L. Rothschild Foundation, convened a National Long-term Care Life Safety Task Force. The primary focus of the Task Force was to review the 2009 Edition of NFPA 101 Life Safety Code® and recommend changes for NFPA to consider for the 2012 Edition that would remove unintended barriers and support creation of home in the nursing home. 

The National Long-term Care Life Safety Task Force is comprised of organization and individual members including:

Organizations
American Association of Homes for the Aging (represented by Evvie Munley)
American Health Care Association (represented by Tom Jaeger)
American Institute of Architects Design for Aging Community (represented by Martin Cohen)
Association of Health Facilities Survey Agencies (represented by Polly Weaver)
Centers for Medicare & Medicaid Services (represented by Jim Merrill and Karen Schoeneman)
Eden Alternative (represented by Jim Hammond)
NCCNHR: The National Consumer Voice for Quality Long-Term Care (represented by Sarah Wells and Lori Smetanka)
Pioneer Network (represented by Bonnie Kantor)
Society for the Advancement of Gerontological Environments (represented by Amy Carpenter)
The GREEN HOUSE® Project (represented by Robert Jenkens)
U.S. Department of Veterans Affairs Geriatrics and Extended Care (represented by Christa Hojlo) 

Individuals
Glenn Blacklock, Action Pact
Carmen Bowman, Edu-Catering
Margaret Calkins, IDEAS, Inc.
Amy Carpenter, Wallace Roberts and Todd
Kim Clayton, NHA
Beverly Cowdrick, Carolinas Health Systems
Lois Cutler, University of Minnesota
Vernon Feather, SFCS, Inc.
Heidi Gil, Planetree Continuing Care
Skip Gregory, Florida Agency for Health Care Administration
Lorraine Hiatt, Planning, Research and Design for Aging
Debra Levin, Center for Health Design
Steve Lindsey, Garden Spot Village
Rob Mayer, Hulda B. and Maurice L. Rothschild Foundation
Gaius Nelson, Nelson-Tremain Partnership
LaVrene Norton, Action Pact, Inc.
Jude Rabig, Rabig Consulting
Colleen Reeves, California Department of Public Health Licensing and Certification
Steve Shields, Meadowlark Hills
Gary Steiner, Perkins Eastman
Fred Worley, Texas Department of Aging and Disability

The Task Force divided itself up into three Work Groups to draft proposals to be considered by the full Task Force. After Task Force review, revisions were made and a vote was taken, five proposals were submitted to NFPA on July 31, 2009. The following is a summary of the proposals including some of the benefits to residents if the changes are made to the Life Safety Code®.

Summary of National Life Safety Task Force Proposals to the National Fire Protection Association for the 2012 Edition of NFPA 101: Life Safety Code® 

Sections 18.3.2.5 and 19.3.2.5

What the proposal does:

  • Allows for the use of residential cooking equipment for nursing homes with 24 or fewer residents or where a nursing home is separated into smaller units by a one hour rated fire/smoke barrier, each with its own kitchen, with 24 or fewer residents.
  • The requirements for the use of residential appliances include the use of a kitchen hood with grease removal capability and it must provide enough air flow for its purpose. The cooktop or range must also be protected per UL 300A which is a residential suppression system. Therefore, a Type I commercial hood would not be required but could be utilized if desired by the provider.
  • Allows residential scale and character kitchens, whether they use residential or commercial appliances, that serve 24 or fewer residents to be open to the common areas and corridors of a nursing home or portion of a nursing home.
  • Requires a deactivation switch for cooking equipment that is locked and only accessible to staff to prevent unauthorized use of the cooking appliance without staff supervision and a fire extinguisher in each kitchen area.

Benefit to residents include:

  • The residential scale and character kitchen resembles the kitchen that residents had in their own homes, thus making them feel at home. The kitchen is usually the most utilized room in one's home both to prepare meals and to eat and as a gathering place so an open residential looking kitchen is an important way to "create home" for residents. The food is able to be prepared in full view (and smell) of residents, staff and visitors resulting in an increased appetite and interest in this important aspect of everyday life. Some residents, depending on cognition and physical frailty level, may be able to participate in food preparation activities with the staff.

Sections 18.2.3.5, 19.2.3.4, A. 18.2.3.5 and A. 19.2.3.4 

What the proposal does:

  • Where the corridor width is at least 8 feet, permits areas along the corridor to contain "functional furniture" that is freestanding and easily moveable by one person in an emergency evacuation. "Functional furniture" is defined as a chair, bench or grouping of chairs that are specifically placed along the length of the corridor at strategic intervals to allow residents to sit and rest during the course of ambulating through the corridor. This revision does not permit surplus furniture or equipment to be stored in the corridor. The furniture must be sturdy enough to enable a person to transfer safely in and out of it.

Benefit to residents include: Promotes a resident's ability to maintain her/his highest practicable level of functioning and maintain independence as it affords a resident to walk a distance, rest, and then continue to their destination without using a wheelchair and it may also prevent falls as well as help to foster social opportunities and create a more homelike environment.

Section 7.1.10.2.2 

What the proposal does:

  • The proposed language includes that: "where the authority having jurisdiction finds the required path of travel to be obstructed by furniture or other moveable objects not otherwise permitted by this code, the authority shall be permitted to require corrective action that will result in an unobstructed path of egress." The proposed language leaves absolute authority with the AHJ, but allows the "operator" the chance to develop solutions that are appropriate from a life safety standpoint, from a care standpoint and from a quality of life standpoint. The "not otherwise permitted by this code" language refers to the proposed revisions to Sections 18.3.2.5 and 19.2.3.4 which will allow movable "functional furniture" in corridors as long as they are not within the required egress width or are easily moveable by one person in the event of an emergency. 

Benefit to residents include:  Supports the proposed revisions to Sections 18.3.2.5 and 19.2.3.4 thus the benefit to residents of those revisions apply to this proposal as well.

Sections 18.7.5.6 and 19.7.5.6

What the proposal does:

  • Increases the percentage of wall and door areas to which decorations such as photographs, paintings and other art can be attached from 20% to 50% inside resident sleeping rooms having a capacity not exceeding 4 persons in a building that is protected throughout by an approved automatic sprinkler system. This is the same allowance given to day care centers and schools.
  • Requires that decorations on non-fire rated doors not include or cover the part of the door that interfaces with the frame and not visually obscure the door.

Benefit to residents include:

  • Increases the size or number of decorations a resident can have on the wall and the door of her or his bedroom in order to further personalize the room and maintain connections with family and community.

Sections 18.5.2 and 19.5.2 

  • Currently a fireplace is defined as "an item having a fire box, a hearth and a chimney." This includes all of the gas log fireplaces that are actually heaters with gas fired logs and not "real" fireplaces. This proposal clarifies that a gas heating device designed to look like a fireplace is still a heating device and not a solid fuel fireplace so it can be permitted inside the sleeping room areas.

Benefit to residents include:

  • Allow for a gas heated device designed to look like a fireplace to be in resident bedrooms providing a "homey" feel to the room.

The submission of these proposals is only the first step in NFPA's 2-year process to adopt a new edition of the Life Safety Code®. Task Force members and anyone else will have a lot of opportunity to comment on the proposals and provide input for consideration by the NFPA Technical Committee. Once finalized, the NFPA membership must vote to approve the inclusion of the proposed revisions and additions in the 2012 Edition of NFPA 101 Life Safety® Code.

Pioneer Network believes that updating Life Safety Code® provisions to recognize the changes in long term care delivery models, yet keeping these occupancies safe for the residents and staff by creating home in the nursing home, is a worthy and compelling initiative. In every part of our country, providers, large and small, are making physical environment changes in newly designed buildings as well as within existing buildings, renovating existing buildings into attached households with a full service kitchen, living room, dining room and private bedrooms or building Green Houses® and other similar detached small house models with a kitchen, large family-style dining table, a hearth area (an open living area with a fireplace) and private rooms. Both these adaptations and the proposed changes that the Task Force is suggesting are firmly grounded in OBRA '87 and will have an overwhelmingly positive impact on current and future generations of elders who need residential skilled nursing care.

Click here to download "Enhancing Quality of Life for Elders Safely: A Background Report from the
National Long-term Care Life Safety Task Force."