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Fire Protection Guidelines for Nursing Homes

May 1, 2004
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Interview with James M. Shannon, President and CEO, NFPA

Fire protection guidelines for nursing homes The deaths of some two dozen elderly residents in recent Tennessee and Connecticut nursing home fires galvanized attention on an ongoing issue: fire protection in nonsprinklered long-term care facilities. Some older facilities constructed prior to 1991 have not been required to install sprinkler systems. While such installation would seem to be an obvious solution to fire protection concerns, in an era when many facilities are strapped for sufficient funding to cover day-to-day operations, an investment in retrofit is not always an option. Recently James M. Shannon, president and CEO of the National Fire Protection Association (NFPA), offered suggestions on how facilities might think practically about enhancing fire protection in an exclusive interview with Nursing Homes/Long Term Care Management.

What have we learned from previous nursing home fires?

Shannon: We have learned the value of automatic sprinkler systems. Beginning with the 1991 edition of NFPA 101, all new nursing homes have been required to have automatic sprinklers. Our code has also had some pretty strict criteria for the inventory of existing nursing homes, including circumstances when they would have to be retroactively protected with automatic sprinklers. While no final reports have been issued on the nursing home fires from last year and this, NFPA has taken the somewhat extraordinary position of calling for sprinklers in our nation's stock of existing nursing homes. Our NFPA Technical Committee on Healthcare Occupancies is also looking at this issue. Our regulation of the furnishings and contents and our criteria for staff response are still important measures, but when we have multiple fatalities in these facilities in such a short period of time as we had recently, it is time to do more. And we believe that doing more will include broader retroactive requirements for automatic sprinklers.

Why were many older nursing homes built without sprinkler systems?

Shannon: Just like many facilities built before the 1980s, applied combinations of fire-resistive construction and materials were used as the preferred method of construction in nursing homes. Automatic sprinklers became more widely used and accepted in the 1970s, as their positive impact on life safety and property conservation were more widely understood. Up until this time, we had a notion of "fireproof" buildings, meaning that the building materials themselves were not likely to burn. But these structures still had furnishings, interior finishes, and other combustible contents that did burn. Fire-resistive construction materials don't help out much with the combustible contents problem-but automatic sprinklers do.

How difficult or costly is it to add sprinklers?

Shannon: Putting in a system when the building is new is much easier. Installing the systems retroactively may impose some difficulty, but it is not an impossible task by any means. The costs for system installations are pretty wide-ranging. Costs for new construction may be in the range of $2 to 4 per square foot, while retrofit costs may be $3 to 5 per square foot. In some cases, the cost may be higher if a reliable, adequate water supply is not on-site.

Are there cost-effective ways of doing these installations?

Shannon: It is probably easiest to retroactively install the sprinklers during a major rehabilitation of the facility. While it might be preferable to install the entire system at once, most authorities having jurisdiction are usually flexible and may allow or encourage the system to be installed during a series of phases.

Are there cases in which installing sprinkler systems might not be possible?

Shannon: I can't imagine a scenario where it isn't possible. We have seen sprinklers retroactively installed in nursing homes and in hospitals, office buildings, hotels, high-rise buildings, the Library of Congress, and the White House. It can be challenging but it is not impossible.

When shopping around for a sprinkler system, what should a facility keep in mind?

Shannon: NFPA 13, Standard for the Installation of Sprinkler Systems, provides the design and installation criteria for these systems. NFPA 13 is used exclusively as the design standard for a system that would be installed in a nursing home. As long as the system is designed, reviewed, and approved to meet the criteria in NFPA 13, the facility can be assured of getting a reliable system.

Once it is installed, the nursing home operator must then ensure that the system is properly maintained. NFPA 25, Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems, can be consulted to determine the appropriate plan, frequency, and protocol for keeping the system functional.

Does sprinklers' quality vary significantly?

Shannon: The quality of these devices is excellent. We have had quick-response sprinklers since about 1984, and these are one of the types mandated for use in nursing homes by NFPA 101. In NFPA's annual report on sprinkler performance in fires, we state that we have no record of a multiple-fatality fire occurring in a fully sprinkler-protected building. Of course, there are caveats to this, such as no flash fire or explosion occurred, and that the system was functional at the time of the event.