Opinion: The Big Picture -- Tragedies waiting to happen
Few businesses are as heavily regulated as nursing homes. And many of the current rules waste the paper they require. That noted, a universal sprinkler mandate is long overdue.It is simply unfathomable that in 2006 we would have one nursing home without a sprinkler system, never mind one in five. After all, this is a profession that exists to care for people unable to take care of themselves. I understand that retrofitting sprinklers is a costly proposition. But let's get real.
Would we accept an argument from airlines that they must use unsafe jet fuel because the good stuff costs more? Or would we agree that carmakers don't need to put brakes in every fifth vehicle because of the related hassle factors? Yet there's no outcry when we have more than 3,000 nursing homes operating without sprinkler systems. Would you put a loved one in such a place? Talk about accidents waiting to happen.
Actually, accidents already have happened. Remember 2003, when 31 residents died in two fires at sprinkler-free nursing homes in Tennessee and Connecticut?
Currently, federal rules require only that newly constructed nursing homes or those undergoing major renovations contain sprinkler systems. While states are free to up the ante, only a quarter now mandate sprinklers.
But under a measure CMS unveiled just before press time, the 3,500 or so nursing homes currently without sprinklers would need to put them in place. Additional installation expenses could cost the nursing community about $700 million. The proposed rule would be phased in so older nursing homes would have three to 10 years to comply.
Provider groups praised the proposed measure, which considers costs and other hardships involved. The regulation recognizes that an "appropriate phase-in timeframe for the installation of an automatic sprinkler system" is needed, according to Bruce Yarwood, president of the American Health Care Association.
Consumer groups have called for a quicker phase-in, so timeframes could become a major sticking point as the proposal advances. What's not in doubt is sprinklers help save lives.
The government notes that there are 10.8 deaths per 1,000 fires in facilities without sprinkler systems. The rate for facilities with sprinklers is 1.9. Moreover, there has never been a multiple-death fire in a nursing home with an automatic sprinkler system, according to CMS.
"Automatic sprinkler systems are integral to increasing safety in nursing homes, and we look forward to their installation in all of the nursing homes across the country," said Leslie V. Norwalk, acting administrator for CMS.
That day won't get here soon enough.
John O'Connor is vice president, McKnight's Long-Term Care News.