Michael Chotiner

In recent years, The Joint Commission (formerly known as JCAHO) has cited deficiencies in emergency standby power systems among the top 10 issues for its healthcare accreditation program. Emergency power systems generally consist of one or more generators, switches and circuits that take over automatically when the primary power source fails.

Along with other organizations, including the Centers for Medicare & Medicaid Services and regulatory agencies in every state, the Joint Commission sets standards for the “environment of care” in hospitals, nursing homes and long-term care facilities. Additionally, almost all organizations concerned with healthcare environments rely on standards set by the National Fire Prevention Association’s Life Safety Code (NFPA 101) and Healthcare Facilities Code (NFPA 99), which are revised on a three-year cycle. Most observers anticipate that the Joint Commission and CMS will adopt the latest NFPA codes within 2016. The new code versions contain substantial changes in emergency power system management for healthcare facilities.

While facility managers who aren’t also engineers probably won’t get much from poring over the new code versions, understanding why the changes are being enacted and to what specific areas they apply should help inform oversight of new testing and maintenance procedures.

What emergency power systems must support

In the overall range of healthcare services, emergency power systems are required to be configured and scaled for support of critical areas such as operating rooms, obstetrical delivery rooms, nurseries and urgent care areas. Emergency power must also be available for critical life-support systems, including ventilators, medical air compressors and vacuum systems. Standby power is also required for communications systems, elevators, egress lighting and refrigeration.

It’s important to note a major change in the NFPA approach. Specific emergency power requirements used to be based on how a facility was classified — hospital, nursing home, medical office, etc. In the new schema, requirements are based on the services the facility provides. If surgery isn’t performed on-site at your facility, you probably don’t have to meet the more stringent requirements. On the other hand, if you foresee a need to refrigerate medications and run HVAC systems during an extended blackout, you need the capacity to supply emergency power.

Lessons learned from recent experience

Code requirements once assumed that power outages tend to be localized, infrequent and short in duration. But in the aftermath of events such as the 1989 San Francisco earthquake, the 2003 blackouts affecting the Northeast, the 2005 hurricanes affecting Florida, Louisiana and Mississippi and the effects of other increasingly frequent and severe weather events, assumptions have changed. In affected areas, emergency power systems that didn’t fail were overtaxed. Many failed when needed most, due to inadequate design and/or maintenance.

Generators were housed in the basements of facilities in flood zones. Startup batteries were weak and nobody knew. Some generators wouldn’t start because their fuel was contaminated; others ran out of fuel before the primary power could be restored. The new rules reflect a new assessment of today’s risks and realities.

Some things you and your maintenance supervisor need to know

  • NFPA 101(00), Sec., requires that emergency generators be installed, tested and maintained in accordance with NFPA 110, Standard for Emergency and Standby Power Systems.

  • The latest Life Safety Code references the 2010 editions of NFPA 110 and NFPA 111 rather than the 1999 editions, as did the previous version.

  • Facilities that are equipped with or in which patients require life support systems (e.g., nursing homes with residents on ventilators) must also meet the maintenance and testing provisions for the 2010 edition of NFPA 99, Standard for Healthcare Facilities.

  • Weekly inspections of generators and monthly testing under load are required to meet federal certification standards and, in some states, licensure requirements. [See NFPA 110(99) for inspection and test specifics.] Transfer switches must also be tested monthly.

  • Three- and four-year test procedures have subtle but important changes meant to address ambiguities in the former standard. Changes in test procedures include requirements for testing after repairs and/or replacement of system components, including battery replacement.

  • Healthcare facilities in areas subject to earthquakes are now required to keep a minimum of 96 hours of fuel on hand at all times. Fuel quality must be checked routinely.

Routine maintenance, inspection and testing of the emergency power systems must be overseen by an adequately trained individual. Evidence of training should be kept in the designated employee’s personnel file. A qualified contractor may be used to oversee performance of all or part of these services. A written record of inspections, tests, operation and repairs must be maintained for review by the fire inspector on request.

This account of the changes in requirements for emergency power systems is by no means comprehensive. Consider it a heads-up regarding a maintenance issue that many facility managers simply neglect. Consult your local building authority or a qualified engineer to make sure that every part of your facility’s emergency power system and your program meet the new standards.

Former construction manager Michael Chotiner knows his way around emergency power systems. His advice includes new codes and how to install generators and load centers that can sustain a building’s needs during power outages. Click here to see The Home Depot’s selection of load centers.