Life safety in skilled nursing facilities that provide care and compassion to some of our nation’s most vulnerable residents is in part based on the presence of sophisticated fire protection and life safety systems within the built environment.
These systems are highly regulated by multiple authorities having jurisdiction, including federal, state and local agencies. Everyone from licensing agencies like CMS to the local fire department has an obligation to help ensure that these systems are properly inspected, tested and maintained in accordance with all regulations.
While extensive oversight is in place to help ensure the reliability of these systems, there still are times when mechanical and electrical systems are vulnerable. Fire protection systems like wet sprinkler systems, for example, can be exposed to environmental conditions, including freezing temperatures, that can impair operation.
Every SNF is constructed with features within the built environment designed to promote life safety, including certain elements of the means of egress, like the specific regulatory requirements for hallways and stairwells. In addition to passive features of fire and life safety, there are other safety systems that rely on technology and electrical power to help ensure a safe and secure environment of care. When these systems are compromised, life safety is at risk.
A devastating fire in a Tennessee long-term care facility in late 2022 ignited while a Fire Watch was in place in the building due to unexpected frigid temperatures that caused the fire sprinkler system to freeze, subsequently rendering the system inoperable. The facility initiated a Fire Watch, but a fast-moving fire during the period of time that the fire sprinkler system was inoperable occurred, and a resident was killed. While a Fire Watch procedure is designed to monitor a building for smoke and fire conditions when fire protection systems are inoperable, it was not enough to prevent a tragic loss in this particular situation.
Long-term care providers should train staff to understand the significance of fire protection systems and the vulnerabilities that exist when they are out of service. Informed decisions need to be made when a system goes out of service to determine if a Fire Watch is appropriate or if a building should be evacuated when fire protection systems are compromised. When one of these critical systems goes down due to a mechanical or electrical malfunction, facilities should activate their Emergency Operations Plan (EOP) and establish an Incident Management Team (IMT) to effectively manage the situation just like any other emergency incident or disaster.
Many skilled nursing facilities, especially those that provide behavioral care or have a secure memory unit, are equipped with electronic safety systems including door alarms, wander management solutions and delayed egress locks to help safeguard residents. These systems are designed to keep residents safe and secure under normal conditions as well as provide them with an unimpeded path out of the building when emergency evacuation is required.
There are times when these systems are compromised, representing a significant life safety vulnerability. For example, when the building’s fire alarm system activates, or a power failure occurs, some of these systems will disengage to allow safe egress during an emergency. Of course, conducting fire drills, as well as scheduled and unscheduled power disruptions, can also disengage some of these systems.
Once again, it is essential to train your staff to understand the security and elopement risks that exist when these systems are disengaged, either during a real-world emergency or drill. Appropriate measures need to be in place to reset or re-arm these critical systems as quickly and efficiently as possible to reduce the risk of elopement or unauthorized entry into a facility.
Fire and life safety compliance does not happen in a long-term care facility by accident. Ensuring a safe and secure environment of care requires the integration of fire protection and life safety systems into the built environment to help safeguard stakeholders, including residents, staff and visitors. All facility staff members should be trained on a regular basis to fully understand the consequences when fire protection or life safety systems are compromised and know what measures are needed to restore these systems in the quickest possible manner to reduce the potential for an adverse incident.
Stan Szpytek is the president of the national consulting firm Fire and Life Safety, Inc. based in Mesa, Arizona. He is a consultant for the American Assisted Living Association (AALNA) and is the Life Safety/Disaster Planning Consultant for the Arizona Health Care Association, California Association of Health Facilities (CAHF) and Utah Health Care Association. Szpytek is a former deputy fire chief and fire marshal with more than 40 years of experience in life safety compliance and emergency preparedness. For more information, visit www.FLSafety.org or e-mail Szpytek at [email protected].
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
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