U.S. Considers Mandating Sprinkler Systems in All Nursing Homes

November 3, 2006

All nursing homes could soon be required to have sprinkler systems, a move aimed at updating an estimated 2,500 older facilities around the country.

The federal agency that oversees the safety of nursing homes has asked for feedback about how much time affected homes should have to comply with its proposed rule. The large majority of nursing homes in the country, about 14,000, already contain comprehensive sprinkler systems.

However, some deadly fires in recent years — most notably 2003 fires in Hartford, Conn., and Nashville, Tenn. — highlighted safety weaknesses in some older nursing homes.

The Hartford nursing home fire left 16 people dead.

Currently, federal regulations require that newly constructed nursing homes or those undergoing major renovations contain sprinkler systems. States are free to enact more stringent requirements, and more than a dozen now require that nursing homes have sprinkler systems to operate.

Lack of smoke alarms in nursing homes in Hartford and Nashville may have contributed to a delayed response time to the fires, according to a report by the Government Accountability Office. The fires killed a total of 31 people.

In its proposed rule, the Centers for Medicare and Medicaid Services notes that sprinkler systems are effective in reducing nursing home deaths. In facilities without sprinklers, there are 10.8 deaths per 1,000 fires. In those with them, that ratio drops to 1.9 deaths per 1,000 fires. There has never been a multiple death fire in a nursing home that had an automatic sprinkler system installed throughout the building, CMS said in its proposed rule.

“CMS is taking further action to protect the lives of our beneficiaries through a proven effective approach to fire safety,” said Leslie V. Norwalk, acting administrator of 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.”


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