Feds May Mandate Sprinkler Systems in Older Nursing Homes


The federal government is considering a directive that would require about 3,500 older homes to install sprinkler systems, according to a recent report in USA Today.

A rule proposed by the Centers for Medicare and Medicaid Services would end an exemption in existing law that mandates sprinklers for new nursing homes but not older facilities, according to the report. The exemption has left about one in five facilities nationwide without full sprinkler coverage, federal data show.

The newspaper says patient advocacy groups and fire officials, including the National Association of State Fire Marshals, have increased their calls for a universal sprinkler requirement since 2003, when 31 patients died in two fires at nursing homes without sprinklers in Hartford, Conn., and Nashville, Tenn. Since then, at least a dozen other patients have died in nursing home fires around the country, according to a USA Today analysis of federal statistics.

In an investigation last year, the newspaper reported that about 2,300 fires are reported in nursing homes annually. Of the 18 worst nursing home fires since 1970, every one happened in a facility that lacked sprinklers in patient rooms and corridors, USA Today found. Those fires killed more than 200 patients.

“Sprinkler systems are integral to increasing fire safety in nursing homes,” Leslie Norwalk, acting administrator for the Centers for Medicare and Medicaid Services, told the newspaper.

Medicare and Medicaid pay $70billion annually for nursing home care. The proposed rule would cover all nursing homes that participate in the programs, or nearly 90 percent of facilities.

As proposed, the rule could take effect as early as 2008, and it would be phased in so older nursing homes would have three to 10 years to comply. The centers will take public comment on the phase-in period before finalizing the rule.

Janet Wells, policy director for the National Citizens’ Coalition for Nursing Home Reform, welcomed the rule but told the newspaper, “It should have been done 30 years ago.”

Wells said congressional studies first recognized the risks of not having sprinklers in nursing homes in the mid-1970s.

“The (USA Today) stories really exposed the problem to a wider audience and put a lot of pressure on (regulators),” she said.

Wells and others told the newspaper that previous efforts to require sprinklers have derailed out of concern for bankrupting older, less-profitable nursing homes. Congress has considered bills to help facilities pay those costs, which can top $200,000 for a typical nursing home. None passed.

Norwalk says that the 2003 fires highlighted the risks at nursing homes without sprinklers. And she hailed recent “collaboration” between the industry, fire safety groups and patient advocates in helping put a regulation in place.

Bruce Yarwood, president of the American Health Care Association, a nursing home trade group, supported the rule and said the phase-in is critical to making it work.

“We’re pleased,” Yarwood told the newspaper. “Fire prevention remains a top priority for our members.”

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