Feds to require sprinklers in nursing homes

WASHINGTON--As those in the fire industry have been anticipating for more than a year, the Centers for Medicare and Medicaid Services (CMS) on Oct. 27 proposed a new regulation that would require nursing homes to install sprinkler systems if they wish to continue to serve Medicare and Medicaid beneficiaries. CMS is a division of the U.S. Department of Health and Human Services that administers federal funds to nursing homes. The proposed rule is in a public comment period until Dec. 26, 2006, said Mary Kahn, CMS spokesperson. The next step is a review of comments, after which the rule may be amended before it is implemented. The timeline for finalization of the rule differs "depending on whether we get five comments or 5,000 comments and sometimes we do get that many," Kahn said. This proposed rule, however, "comes as a surprise to no one," Kahn said. Because the nursing home and fire industries were well aware that CMS would be proposing this rule, Kahn surmised that there would not be a lengthy review period. In March 2005, CMS took an "interim step" toward this announcement, when it began requiring all nursing homes that did not have sprinklers to install battery-operated smoke alarms in all patient rooms and public areas. In October of 2005, Robert Solomon, assistant vice president of building and life safety codes for the National Fire Protection Association told Security Systems News that CMS was contemplating such a regulation (see "Experts say: 'U.S. Sprinkler Mandate by 2007'" in the October 2005 issue of Security Systems News). Contacted after the CMS announcement, Solomon said, "My sense is that there will be two issues, the phase-in period ... and financing for smaller facilities that don't have a corporate parent." The phase-in period will dictate how long nursing homes have to comply after the regulation becomes finalized. "Whether it's two or 10 years, that will be a big discussion point," Solomon predicted. CMS has already adopted NFPA sprinkler codes and sprinklers are required in all new nursing homes and in any nursing home that undergoes significant renovations. Older nursing homes have not previously been required by CMS to have sprinklers. Somewhere between 3,000 and 4,000 nursing homes will be affected by this regulation, although most of those homes have "partial sprinkler systems in place. The number of nursing homes with no sprinklers at all is miniscule," Kahn said. CMS estimates that there are 18,000 nursing homes in the United States. Close to 100 percent serve Medicaid or Medicare beneficiaries or both. "We're very happy that CMS made this move," said Jim Dalton, director of public fire protection for the National Fire Sprinkler Association. Dalton said that NFSA executive vice president Russ Fleming will be submitting comments to CMS. NFSA will likely recommend that CMS institutes a 180-day time frame for non-complying nursing homes to file their plans for bringing their facilities into compliance.