CMS is updating its fire safety guidelines for the first time in 13 years with several new standards on automatic sprinkler systems. The new safety rules also allow for aerosol alcohol-based hand rub dispensers.

With a few exceptions, the rule adopts the 2012 editions of the Life Safety Code (LSC) and Health Care Facilities Code of the National Fire Protection Association. The current regulations are based on the 2000 edition of those same codes, which CMS adopted in 2003. The new rule argues having CMS adhering to old standards while fire codes have since been updated several times was “problematic” for facilities.

“A healthcare facility that is constructed or renovated in 2015 would likely be required by its state and local authorities to comply with a more recent edition of the LSC, while also being required to comply with the 2000 edition of the LSC in order to meet the Medicare and applicable Medicaid regulatory requirements,” the rule said. “Requiring compliance with two different editions of the LSC at the same time can create unnecessary conflicts, duplications and inconsistencies that increase construction and compliance costs without any fire safety or patient care benefits.”

One example of how updating the standard may simplify building code compliance is new provisions on alcohol-based hand rub dispensers. While the 2000 standards currently used by CMS only allows gel-based dispensers, the 2012 code includes provisions allowing aerosol-based dispensers. Those will now be allowed in healthcare facilities, as long as they’ve been tested and are located away from any ignition source.

The most notable provision of the new rule is the requirement deals with automatic sprinkler systems. In all buildings taller than 75 feet—typically seven or eight stories—healthcare facilities must have sprinklers throughout, though not immediately.

“Those facilities that are not already required to do so will have 12 years following publication of this final rule, which adopts the 2012 LSC, to install sprinklers in high-rise buildings,” the rule said.

In other provisions involving sprinklers, new and existing facilities will have to install sprinklers in attic spaces if those areas are used for “living purposes, storage or housing of fuel fired equipment.” The new rule also deals with out of service systems, requiring a facility to either evacuate or appoint a fire watch if sprinklers aren’t working for more than 10 hours in a 24-hour period.

A CMS press release summarized other requirements in the rule, including:

• The provisions offer long-term care (LTC) facilities greater flexibility in what they can place in corridors. Currently, they cannot include benches or other seating areas because of fire code requirements limiting potential barriers to firefighters. Moving forward, LTC facilities will be able to include more home-like items such as fixed seating in the corridor for resting and certain decorations in patient rooms (such as pictures and other items of home décor);
• Fireplaces will be permitted in smoke compartments without a one hour fire wall rating, which makes a facility more home-like for residents;
• Cooking facilities now may have an opening to the hallway corridor;
• Facilities with windowless anesthetizing locations are required to have an air supply and exhaust system that automatically vents smoke and products of combustion, prevents recirculation of smoke originating within the surgical suite, and prevents the circulation of smoke entering the system intake.

The final rule will be published May 4, giving facilities 60 days to comply with the new regulations, unless an exception is specified in the rule.