Nursing Homes & Sprinklers

[NJFFSA16]

Should all nursing homes be required to install sprinkler systems?

KANSAS CITY, Mo. (AP) - Advocates of automatic sprinklers for
nursing and group homes pointed to Monday's deadly blaze at an
Anderson group home as a grim reminder of why the systems should be
standard equipment in long-term care facilities.
Ten people died and at least 18 were sent to hospitals early
Monday after a fire broke out at the Anderson Guest House, a care
home for the elderly and mentally ill. The home had smoke alarms
but no sprinklers.
"You can't prevent fires from happening at all times," said
Susan Feeney, a spokeswoman for the American Health Care
Association, a trade group representing nursing homes. "However,
having automatic sprinkler systems and other fire safety devices
can save lives, which is critically important for very vulnerable
patient populations, including the frail, elderly and disabled."
It's unclear how Monday's victims died, either by burns or smoke
inhalation, or whether they were adequately warned by smoke alarms.
In Missouri, only certain types of long-term care facilities are
required to have comprehensive sprinkler systems and only in
certain circumstances, such as those that house residents on a
second floor. The one-story Anderson Guest House was built before
1980 and was not required to have sprinklers.
"We'll definitely be looking to see what the investigation
finds and looking at what changes might be needed and then
certainly we'll see whether any of our current regulations were
violated," said Nanci Gonder, a spokeswoman for the Department of
Health and Senior Services. "The investigation should yield
information about what happened, maybe about how the response
happened. We'll be looking at all of that."
About 80 percent of nursing homes have comprehensive automatic
sprinkler systems, according to a January survey of American Health
Care Association members. Gonder said the survey did not include
group homes, which often face less-stringent requirements by the
states that license them.
The association began pushing for mandatory sprinklers for all
nursing homes after deadly blazes in facilities in Connecticut in
Tennessee.
In February 2003, a patient suffering from dementia and multiple
sclerosis set fire to her bed and burned down the Greenwood Health
Center in Hartford, Conn., killing 16 residents. Six months later,
in September 2003, a fire killed 15 patients in Nashville, Tenn.
Neither nursing home had an automatic sprinkler system.
Recently, the federal agency that oversees the safety of nursing
homes issued a proposed regulation calling for all nursing
facilities to have comprehensive sprinkler systems. The agency has
asked for comments about how much time an estimated 2,500 older
facilities without sprinklers should have to comply with its
proposed rule.
Currently, federal regulations require that newly constructed
nursing homes or those undergoing major renovations to include
sprinkler systems. But states are free to enact more-stringent
requirements. Fourteen now require nursing homes to have sprinkler
systems to operate, according to the American Health Care
Association.
"It is most certain this will happen," Feeney said of the
regulation.
But Feeney noted the proposed regulation would not affect group
homes, which are not subject to the same federal oversight.
Still, she said the deadly Missouri blaze could lead to a push
for individual states to toughen their fire-safety requirements
governing group homes.
Evvie Munley, senior policy analyst for the American Association
of Homes and Services for the Aging, said her group has long
supported comprehensive sprinkler systems for nursing homes as long
as the facilities are given adequate money and time to meet the
requirement. She noted some owners may choose to build new
facilities rather than retrofit older buildings.
And she said there could be support for requiring other types of
long-term care facilities to add sprinkler systems.
"I think no one is going to oppose the idea of sprinklers for
long-term care facilities with vulnerable populations, but the same
considerations would apply - resources and a phase in to allow
people to contract for this and acquire it," Munley said. "No one
would oppose sprinklering for facilities with vulnerable
populations."

(Copyright 2006 by The Associated Press. All Rights Reserved.)

Smoke alarms are not enough. The elderly can not react quickly enough to evacuate a building. Their physical limitations can prevent them from a successful escape. Surely, sprinkler systems would save lives. Your opinions?

[RFDACM02]

An obvious no-brainer. Any building that houses elderly, infirm or persons otherwise unable to exit rapidly should be fully sprinklered.

[LaFireEducator]

This is an issue that the fire service really needs to push. The fact that we allow facilities like this to exist without sprinklers is a national disgrace. Unfortunatly, I have seen fire chiefs use unsprinklered facilities as a justification for more apparatus amd manpower, while, they have made no efforts to push for mandatory un-grandfathered sprinkler ordiances in thier communties. This issue, and sprinkler ordiances in general, often get the typical blasea fire department response that prevention in general often gets.

[DeputyChiefGonzo]

It is a no brainer... but remember, when it comes to installations of sprinkler systems, the bean counters are the ones who will be out in force crying how "expensive" it is. The nursing home industry is huge, and they have a huge lobby pushing for higher payments from Medicare and insurance than for fire safety.

Of course, the entertainiment industry doesn't do us any favors by
misrepresenting the way a sprinkler system operates...

[randsc]

...in the full knowledge that nuance is not rewarded on this forum, between acute-care nursing homes and much smaller sheltered care or group homes.

It is easy to mock the expense arguments, but the fact is that for small (<20 bed) facilities, the sprinkler requirement is a deal-breaker. Most of these small homes are run by small business people or non-profits, and have little clout. In fact, the stand in opposition to the acute-care nursing home lobby, which would like everyone over 70 in an acute-care environment whether they need that level of care or not.

Forcing small, community-based facilities out of business is bad public policy. Here in New Hampshire, these facilities literally take people off the street. I have a friend in the business, and he has literally admitted people out of homeless shelters, or out of ERs after they were scooped from the gutter. Also here in New Hampshire, the state has gotten very agressive (frankly more aggresive than they have the right to be under existing legislation and administrative rules) about forcing any life safety issue they think might possibly be helpful. As a result, the number of sheltered-care beds has declined by 40% in 10 years. So what happened to these people? They are either in acute-care nursing homes, and great cost to the state and great cost to their own well-being, or they are back on the street.

I am a big believer that mandates from government should never be unfunded. If you require sprinklers, you need to be sure the rates the state pays for these people's care covers that cost. Sadly, this is not currently the case anywhere in New England.

All a long way of saying, "No, it's not a no-brainer".

[SBrooks]

I'm in line with randsc.

Ideally, a nonsprinklered nursing home would go out of business.

Unfunded government mandates keep businesses and employment down.

That being said, the medicare / medicaid & other state & federal laws should be changed such that, among other things, sprinklers are required to recieve reimbursement.

[DeputyChiefGonzo]

The cost of installing a sprinkler system is miniscule compared the the dollar figure of the wrongful death lawsuits that will come about from a fire in a nursing home that leads to patient deaths.

The cost of design and installation can be financed.

Here in Massachusetts, sprinklers are required to be retrofitted to restaurants and nightclubs that seat over X amount of people ( don't have the exact number in front of me at this time). There was a grace period to allow for the owners of said properties to have the systems installed. Some have dragged their feet and are now crying to the media that it's too expensive, will disrupt their business, etc. etc. etc.

[randsc]

The cost of installing a sprinkler system is miniscule compared the the dollar figure of the wrongful death lawsuits that will come about from a fire in a nursing home that leads to patient deaths.

The cost of design and installation can be financed.

Here is Massachusetts, sprinklers are required to be retrofitted to restaurants and nightclubs that seat over X amount of people ( don't havr the exact number in front of me at this time). There was a grace period to allow for the owners of said properties to havre the systems installed. Some have dragged their feet and are now crying to the media that it's too expensive, will disrupt their business, etc. etc. etc.

With all due respect, you're wrong. That "miniscule" cost is puching providers out of business every day. Banks like to see an adequate cash flow before they finance anything. You want to require sprinklers for everything, fine. But if you do, the reimbursement rates MUST rise.

[Diane E]

You need to help push the issue:

HR 1131 Fire Sprinkler Incentive Act -- will never make the floor for a vote this year because it's too costly (can you put a cost on a life?), 165 cosponsors.

HR 4491 -- Nursing Home Fire Safety Act of 2005 -- 23 cosponsors! This legislation would require the Secretary of Health and Human Services to establish programs of direct loans and grants for retrofitting nursing facilities with automatic fire sprinkler systems. Gives priority to grant applications that demonstrate a need or hardship.

Both measures have companion bills in the Senate and both will have to be re-introduced in the 110th Congress in January. HR 1131 will need a strong Republican backer since Rep. Curt Weldon lost.

[nmfire]

You need a 3rd option for "Glad we have no nursing homes in my district"

[randsc]

Something like the Nursing Home Fire Safety Act is what is required if a large (not "miniscule") cost is to be imposed on providers.

I do think there is a arguement to be made that this is a state rather the federal responsibility, but that is a whole other thread.

[res54cuecaptain]

Yes, and DONT FORGET THE ATTIC!!!!!!

http://kdka.com/topstories/local_story_309192331.html
http://cms.firehouse.com/content/art...4&sectionId=45

Nov 5, 2006 11:43 pm US/Eastern

Senior Citizen Complex Goes Up In Flames
Slideshow: Fire Guts Senior-Citizen Complex
(KDKA) CABOT They're calling it one of the biggest fires in Butler County in years - startling even veteran firefighters.

At about 11:30am Concordia Haven independent living apartments erupted in flames.

Flames consumed the facility's roof in minutes.

Officials say the wind helped spread the fire.

About 137 residents live at the complex and fire crews rushed to make sure everyone was accounted for.

Crews had a problem putting out the fire because of a shortage of water.

Tankers rolled in to try to quench the flames.

"I've lost everything except the clothes I have on," said resident Robert Waltenbaugh.

His apartment was severely damaged, but he says he and his friend will make it.

"Most of the men have been through the war.. World War two they seen a bunch of crap there. This is just another setback," he said.

Despite the destruction, all of the residents and the firefighters escaped without injury.

Most of the people were in church when the fire started.

Concordia says it will house all of the displaced residents in a new facility nearby.

The cause of the fire remains under investigation.

(© MMVI, CBS Broadcasting Inc. All Rights Reserved.)




Pennsylvania Senior Living Facility Destroyed
137 senior citizens were displaced, but no reported injuries


Updated: 11-09-2006 04:15:57 PM


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Michelle Simon
Firehouse.com User-Submitted Photostory

On Sunday, November 5, 2006 a fire destroyed a 114 unit, three story senior living facility located in Winfield Township, Butler County, Pa. The fire, which broke out at 11:30 Sunday morning, started in the roof area.

Sixteen fire departments and over one hundred firefighters in a three county area battled the blaze for over two hours before bringing it under control. Because of no hydrants in the area, water had to be shuttled in from tankers filling from nearby ponds.

Although there is no definite cause as yet, investigators believe the fire may have started in a roof area electrical room. The third floor of the complex was completely destroyed and heavy smoke and water damage was incurred on the first and second. Damages are estimated to exceed $10 million.

Although all 137 senior citizens of the Concordia Haven complex are displaced, there were no reported injuries.

watch the video (first and second one on the fire) to see what i mean. it was a hell of a fire...and a scary first half-hour when the original call was "Large fire, through the roof, residents trapped on the 3rd floor balconies."

The building was a pretty good building as far as alarm and sprinkler systems are concerned. But, THE ATTIC WAS HOLLOW. Sadly, i THINK there MIGHT HAVE BEEN one or two firewalls in the middle of the building, which wouldnt have done much good. The fire got up to the attic and roof and spread like a wildfire from there.

I wasnt personally at the call, but i know some guys who were, and everyone there did a hell of a job getting everyone out safely.

http://www.hoopieworld.com/incidents...0506_cabot.htm
Some more pictures there, especially the enroute ones showing the heavy smoke (they were 2nd due ambulance, and were there in about 5 minutes after the call came in)

[furlofmalta]

If I remember correctly we had this issue in California a few years back...
The answer to the question is an obvious yes.
Other mandates should include break away doors, multiple means of emergency egress, etc.

[randsc]

If I remember correctly we had this issue in California a few years back...
The answer to the question is an obvious yes.
Other mandates should include break away doors, multiple means of emergency egress, etc.

..."that" being break away doors. Would you believe that in NH the Bureau of Health Facilities and Fire Marsh. want to mandate them, but the Bureau of Elderly and Adult Services wants to forbid them (they're a "wander" hazard)? And naturally, none of these agencies actually has written their requirements into their administrative rules, they are informal (but strictly enforced). So what the hell is the provider supposed to do?

What makes this sort of bureaucratic crap especially irritating is that state agencies are operating outside the scope of their powers as defined by statute and administrative rules. The Bureau of Health Facilities admin rules expired 5 years ago. So why don't they just write these things into the rules? Because in NH, unfunded mandates are prohibited by the state constitution, and state law requires a cost-benefit analysis before new admin rules are enacted. So by keeping it on the QT, they hope to do whatever they like.

This is the sort of thing that causes providers and property owners to cringe when they see the FD coming.

[FlyingKiwi]

ALL care hospices, elderly homes etc were required to do this a few years back down here after a spate of death fires.

Did some bleat, did some go out of business, yes.

Should they have been in the business if their facilities were not adequate?

Should they have been allowed to care for elderly and or infirm without adequate protection in the first place?

Did some of them have below minimum night time staff to cope with an emergency?

Was there a settling period where adjustments were made, yes.

Have we had any deaths to fire since. NO.

Answer is obvious really.

[furlofmalta]

..."that" being break away doors. Would you believe that in NH the Bureau of Health Facilities and Fire Marsh. want to mandate them, but the Bureau of Elderly and Adult Services wants to forbid them (they're a "wander" hazard)? And naturally, none of these agencies actually has written their requirements into their administrative rules, they are informal (but strictly enforced). So what the hell is the provider supposed to do?

What makes this sort of bureaucratic crap especially irritating is that state agencies are operating outside the scope of their powers as defined by statute and administrative rules. The Bureau of Health Facilities admin rules expired 5 years ago. So why don't they just write these things into the rules? Because in NH, unfunded mandates are prohibited by the state constitution, and state law requires a cost-benefit analysis before new admin rules are enacted. So by keeping it on the QT, they hope to do whatever they like.

This is the sort of thing that causes providers and property owners to cringe when they see the FD coming.

I can't really remember the issue in Ca exactly but I think the same sort of beauracratic bs happened here as well.
I think it took multiple MCIs at these places within the span of a year or two to finally force the issue.
Hopefully New Hampshire shows more passion than Ca. and expidites the process.

[randsc]

ALL care hospices, elderly homes etc were required to do this a few years back down here after a spate of death fires.

Did some bleat, did some go out of business, yes.

Should they have been in the business if their facilities were not adequate?

Should they have been allowed to care for elderly and or infirm without adequate protection in the first place?

Did some of them have below minimum night time staff to cope with an emergency?

Was there a settling period where adjustments were made, yes.

Have we had any deaths to fire since. NO.

Answer is obvious really.

How is this level or care funded in NZ? Here, it is almost entirely Medicaid. The state and feds decide what level the reimbursement is at. So the provider has no control over revenue. Aggressive regulatory actions remove much of the provider's control over expenses. Staying solvent is a challenge to say the least.

I asked my fried if this was really a business he wanted to be in. He said he would literally make more money by selling the real estate to be broken up into apartments, and parking his money in something like T-bills. So I asked him why the hell he didn't do that, and quit working 90 hours a week and dealing with the hassles from the state. His reply? "These people have no where else to go"

Many of the providers approach sainthood. I hate to see them run down because they are stuck between a rock and a hard place, neither of their own making. I repeat, this is NOT a no-brainer.

[FlyingKiwi]

We have a mix of government pension that is paid for out of tax during your working life, and state benefits that are paid out of everyone elses tax. Along with personal contributions, weighted against value etc.

Sometimes it gets tricky even for us to work the damn system out.

I agree where someone is providing a "Social Service" for the state/city that the state/city should then be accountable for funding sprinklers, protection etc. This would be more of a homeless shelter style of arrangement as opposed to a Retirement Home / care facility.


Long term care facilities that provide medical care should NOT even have been allowed to open their doors without adequate protection in the first place.

If you are going to run a BUSINESS looking after the infirm or mentally ill, then having adequate protection for these people is part of the price of running the business.

Whatever charity you provide to other cases is irrelevant. And yes he may be a "saint" but that does NOT negate his primary responsibilities to those in his care.

[SBrooks]

this isn't a simple solution.

If you mandate sprinklers, it will be more expensive to stay in business. Ergo, some care centers will go out of business, and some that would open will not.

This will leave the marginal patients, namely the poor, without a care center. They will likely be forced to stay with their families, if they have any, who will not provide 24h care (they have to work), and are not likely to live in a sprinklered building.

So, yes, you can, with a rule change, drastically reduce the likelihood of a senior citizen dying in a fire at a senior home. However, you will have likely increased the likelihood of senior citizen's dying in private homes. It is likely to be a net loss, because at least in a non sprinklered group home, you've got people awake and on duty 24/7.

[randsc]

this isn't a simple solution.

If you mandate sprinklers, it will be more expensive to stay in business. Ergo, some care centers will go out of business, and some that would open will not.

This will leave the marginal patients, namely the poor, without a care center. They will likely be forced to stay with their families, if they have any, who will not provide 24h care (they have to work), and are not likely to live in a sprinklered building.

So, yes, you can, with a rule change, drastically reduce the likelihood of a senior citizen dying in a fire at a senior home. However, you will have likely increased the likelihood of senior citizen's dying in private homes. It is likely to be a net loss, because at least in a non sprinklered group home, you've got people awake and on duty 24/7.

Exactly right, thank you.