M E M O R A N D U M. NFPA Technical Committee on Health Care Occupancies. Diane Matthews, Project Administrator

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1 M E M O R A N D U M TO: FROM: NFPA Technical Committee on Health Care Occupancies Diane Matthews, Project Administrator DATE: January 29, 2010 SUBJECT: NFPA 5000 A2011 ROP Letter Ballot Final Results The Final Results of the NFPA 5000 ROP Letter Ballot are as follows: 21 Members Eligible to Vote 21 Ballots Returned Reasons for negative votes, etc. from alternate members are not included unless the ballot from the principal member was not received. All votes were affirmative on all ballot items with the exception of those noted in the attached report. According to the final ballot results, all ballot items received the necessary 2/3 required affirmative votes to pass ballot. Attachment

2 Log #CP1d BLD-HEA Technical Committee on Fundamentals, Revise text to read as follows:. An area of a building separated from the remainder of the building by construction having a fire resistance of at least 1 hour and having all communicating openings properly protected by an assembly having a fire resistance rating of at least 1 hour. [ 2008] This definition is the preferred definition from the NFPA Glossary of Terms. Changing the secondary definition to the preferred definition complies with the Glossary of Terms Project. The BLD-HEA committee agrees with the Committee Statement associated with the BLD-MEA committee's rejection of the proposal: "The proposed definition is incorrect in that the whole building could be a fire area. The proposed definition would cause a hazardous area room protected by fire-rated barriers to be considered a fire area." 1

3 Log #130 BLD-HEA Joshua W. Elvove, Aurora, CO Revise/Add new text to read as follows: Patient Care Non-Sleeping Suite (Health Care Occupancies). See Patient Care Sleeping Suite (Health Care Occupancies). See (New) Non-Patient Care Suite See Patient Care Suite (Health Care and Ambulatory Health Care Occupancies). A series of rooms or spaces or a subdivided room separated from the remainder of the building by walls and doors. Patient Care Non-Sleeping Suite (Health Care and Ambulatory Health Care Occupancies). A suite for treating patients with or without patient beds not intended for overnight sleeping. Patient Care Sleeping Suite (Health Care Occupancies). A suite containing one or more patient beds intended for overnight sleeping. (New) Non-Patient Care Suite (Heath Care and Ambulatory Health Care Occupancies). A suite within a health care or ambulatory health care occupancy that is not intended for treating patients Adding patient care before suite and non-sleeping suite will clarify that these particular suite requirements only apply to health care or ambulatory health care occupancies. Ambulatory health care occupancies were added because suites are referenced in Changing Sleeping Suites to Patient Care Sleeping Suites ( ) will ensure the requirements of et al will not be incorrectly applied to areas where non-(health care) patient sleeping occurs (e.g., on call suites, residential board and care suites, etc.) Changing Non-Sleeping Suites to Patient Care Non-Sleeping Suites ( ) will ensure that the requirements of for Non-Patient Care Suites (e.g., the 200 ft travel distance requirement) are not incorrectly applied to Patient Care Non-Sleeping Suites since a Non-Sleeping Suite is also generally a Non-Patient Care Suite. Adding a new definition for Non-Patient Care Suites ( ) will assist when interpreting the requirements of Renaming suite designations will also require renumbering the placeholder definitions ( , ) since they are in alphabetical order and a new placeholder definition will be necessary for Non-Patient Care Suites. See companion proposal for suites for Chapters 18 & 19 where similar changes are being proposed. Revise as follows: Patient Care Non-Sleeping Suite (Health Care Occupancies). See Patient Care Sleeping Suite (Health Care Occupancies). See Non-Patient Care Suite See Patient Care Suite (Health Care and Ambulatory Health Care Occupancies). A series of rooms or spaces or a subdivided room separated from the remainder of the building by walls and doors. Patient Care Non-Sleeping Suite (Health Care and Ambulatory Health Care Occupancies). A suite for treating patients with or without patient beds not intended for overnight sleeping. Patient Care Sleeping Suite (Health Care Occupancies). A suite containing one or more patient beds intended for overnight sleeping. Non-Patient Care Suite (Heath Care and Ambulatory Health Care Occupancies). A suite within a health care or ambulatory health care occupancy that is not intended for sleeping or treating patients The action does what the submitter but in the last items changes "not intended for treating patients" to "not intended for sleeping or treating patients." The action also editorially removes two occurrences of the label "(New)." Affirmative: 20 Negative: 1 AMBROSE, J.: While I am not against this proposed code change that eliminates the suite requirements of the code from all non-patient care areas on a health care floor/building, there is no substantiation provided to justify that this code change is a valid or safe code change. As currently written in NFPA 5000, the suite provisions of the code applied to all areas on a health care floor/building including non-patient care areas unless that use/area was separated by a 2 hour fire barrier from the health care use. 2

4 k Log #CP750 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Changes of use or occupancy classification shall comply with 4.5.6, unless otherwise permitted by one of the following: (1) A change from a hospital to a nursing home or from a nursing home to a hospital shall not be considered a change in occupancy classification or a change in use. (2) A change from a hospital or nursing home to a limited care facility shall not be considered a change in occupancy classification or a change in use. (3) A change from a hospital or nursing home to an ambulatory health care facility shall not be considered a change in occupancy classification or a change in use. Any building of Type I(442), Type I(332), Type II(222), or Type II(111) construction shall be permitted to include roofing systems involving combustible supports, decking, or roofing, provided that all of the following criteria are met: (1) The roof covering meets Class A requirements in accordance with NFPA 256. (2) The roof is separated from all occupied portions of the building by a noncombustible floor assembly having not less than a 2-hour fire resistance rating that includes not less than 2½ in. (63 mm) of concrete or gypsum fill. (3) Structural elements supporting the 2-hour fire resistance rated floor assembly specified in (2) are required to have only the fire resistance rating of the building. Any building of Type I(442), Type I(332), Type II(222), or Type II(111) construction shall be permitted to include roofing systems involving combustible supports, decking, or roofing, provided that all of the following criteria are met: (1) The roof covering shall meet Class A requirements in accordance with NFPA 256. (2) The roof/ceiling assembly shall be constructed with fire-retardant-treated wood meeting the requirements of this. (3) The roof-ceiling assembly shall have the required fire resistance rating for the type of construction. Locks shall not be permitted on patient sleeping room doors, unless otherwise permitted by one of the following: (1) Key-locking devices that restrict access to the room from the corridor and that are operable only by staff from the corridor side shall be permitted, provided that such devices do not restrict egress from the room. (2) Locks complying with shall be permitted. Doors within a required means of egress shall not be equipped with a latch or lock that requires the use of a tool or key from the egress side, unless otherwise permitted by one of the following: (1) Locks complying with shall be permitted. (2)* Delayed-egress locks complying with shall be permitted. (3)* Access-controlled egress doors complying with shall be permitted. (4) Elevator lobby exit access door locking in accordance with shall be permitted. Doors that are located in the means of egress and are permitted to be locked under other provisions of shall comply with both of the following: (1) Provisions shall be made for the rapid removal of occupants by means of one of the following: (a) Remote control of locks (b) Keying of all locks to keys carried by staff at all times (c) Other such reliable means available to the staff at all times (2) Only one locking device shall be permitted on each door. Aisles, corridors, and ramps required for exit access in a hospital or nursing home shall be not less than 8 ft (2440 mm) in clear and unobstructed width, unless otherwise permitted by one of the following: (1) Where ramps are used as exits, the requirement of shall apply. (2)* Aisles, corridors, and ramps in adjunct areas not intended for the housing, treatment, or use of inpatients shall be not less than 44 in. (1120 mm) in clear and unobstructed width. (3) Where the corridor width is at least 6 ft (1830 mm), projections not more than 6 in. (150 mm) from the corridor wall, above the handrail height, shall be permitted for the installation of hand-rub dispensing units in accordance with

5 (4) Where the corridor width is at least 6 ft (1830 mm), projections shall be permitted in corridors, at both sides of the corridor, as follows: (a) Each projection shall not exceed a depth of 6 in. (150 mm). (b) Each projection shall not exceed a length of 36 in. (915 mm). (c) Each projection shall be positioned not less than 40 in. (1015 mm) above the floor. (d) Each projection shall have a minimum 48 in. (1220 mm) horizontal separation from adjacent projections. (5)* The requirement of shall not apply to exit access within a room or suite of rooms complying with the requirements of Aisles, corridors, and ramps required for exit access in a limited care facility or hospital for psychiatric care shall be not less than 6 ft (1830 mm) in clear and unobstructed width, unless otherwise permitted by one of the following: (1)* Aisles, corridors, and ramps in adjunct areas not intended for the housing, treatment, or use of inpatients shall be not less than 44 in. (1120 mm) in clear and unobstructed width. (2) Where the corridor width is at least 6 ft (1830 mm), projections not exceeding 6 in. (150 mm) from the corridor wall, above the handrail height, shall be permitted for the installation of hand-rub dispensing units in accordance with (3) Where the corridor width is at least 6 ft (1830 mm), projections shall be permitted in corridors, at both sides of the corridor, as follows: (a) Each projection shall not exceed a depth of 6 in. (150 mm). (b) Each projection shall not exceed a length of 36 in. (915 mm). (c) Each projection shall be positioned not less than 40 in. (1015 mm) above the floor. (d) Each projection shall have a minimum 48 in. (1220 mm) horizontal separation from adjacent projections. (4)* The requirement of shall not apply to exit access within a room or suite of rooms complying with the requirements of The requirements of shall not apply where otherwise permitted by one of the following: (1) Unprotected vertical openings in accordance with shall be permitted. (2) The provisions of (1)(a) shall not be permitted to apply to patient sleeping and treatment rooms. (3) Multilevel patient sleeping areas in psychiatric facilities shall be permitted without enclosure protection between levels, provided that all of the following conditions are met: (a) The entire normally occupied area, including all communicating floor levels, is sufficiently open and unobstructed, so that a fire or other dangerous condition in any part is obvious to the occupants or supervisory personnel in the area. (b) Egress capacity is sufficient to provide simultaneously for all the occupants of all communicating levels and areas, with all communicating levels in the same fire area being considered as a single floor area for purposes of determination of required egress capacity. (c) The height between the highest and lowest finished floor levels is not more than 13 ft (3960 mm), with the number of levels permitted to be unrestricted. An approved automatic smoke detection system shall be installed in corridors throughout smoke compartments containing patient sleeping rooms and in spaces open to corridors as permitted in nursing homes by , unless otherwise permitted by one of the following: (1) Corridor systems shall not be required where each patient sleeping room is protected by an approved smoke detection system. (2) Corridor systems shall not be required where patient room doors are equipped with automatic door-closing devices with integral smoke detectors on the room side installed in accordance with their listing, provided that the integral detectors provide occupant notification. Corridors shall be separated from all other areas by partitions complying with through unless otherwise permitted by one of the following: (1) Spaces shall be permitted to be unlimited in area and open to the corridor, provided that all of the following criteria are met: (a) The spaces are not used for patient sleeping rooms, treatment rooms, or hazardous areas. (b) The corridors onto which the spaces open in the same smoke compartment are protected by an electrically supervised automatic smoke detection system in accordance with , or the smoke compartment in which the space is located is protected throughout by quick-response sprinklers. (c) The open space is protected by an electrically supervised automatic smoke detection system in accordance with , or the entire space is arranged and located to allow direct supervision by the facility staff from a nurses' station or similar space. (d) The space does not obstruct access to required exits. (2) Waiting areas shall be permitted to be open to the corridor, provided that all of the following criteria are met: 4

6 (a) The aggregate waiting area in each smoke compartment does not exceed 600 ft2 (55.7 m2). (b) Each area is protected by an electrically supervised automatic smoke detection system in accordance with , or each area is arranged and located to allow direct supervision by the facility staff from a nursing station or similar space. (c) The area does not obstruct access to required exits. (3)* The requirement of shall not apply to spaces for nurses' stations. (4) Gift shops not exceeding 500 ft2 (46.5 m2) shall be permitted to be open to the corridor or lobby. (5) In a limited care facility, group meeting or multipurpose therapeutic spaces shall be permitted to open to the corridor, provided that all of the following criteria are met: (a) The space is not a hazardous area. (b) The space is protected by an electrically supervised automatic smoke detection system in accordance with , or the space is arranged and located to allow direct supervision by the facility staff from the nurses' station or similar location. (c) The area does not obstruct access to required exits. The requirements of through shall not apply to any of the following: (1) Stories that do not contain a health care occupancy and that are located directly above the health care occupancy (2) Areas that do not contain a health care occupancy and that are separated from the health care occupancy by a fire barrier complying with (3) Stories that do not contain health care occupancies and that are more than one story below the health care occupancy (4) Open-air parking structures protected throughout by an approved, electrically supervised automatic sprinkler system in accordance with Section 55.3 Doors in smoke barriers shall meet all of the following criteria: (1) They shall comply with but shall be exempted from (2) They shall be self-closing or automatic-closing in accordance with (3) Clearance under the bottom of smoke barrier doors shall not exceed ¾ in. (19 mm). Where the smoke compartment being modified is not protected throughout by an approved, electrically supervised automatic sprinkler system, corridor walls shall comply with all of the following: (1) They shall have a fire resistance rating of not less than ½ hour. (2) They shall be continuous from the floor to the underside of the floor or roof deck above. (3) They shall resist the passage of smoke. Where the smoke compartment being modified is not protected throughout by an approved, electrically supervised automatic sprinkler system, all of the following shall apply: (1) Doors protecting corridor openings shall be constructed of 1¾ in. (44 mm) thick, solid-bonded core wood or of construction that resists the passage of fire for not less than 20 minutes. (2) Door frames shall be labeled or of steel construction. (3) Existing roller latches demonstrated to keep the door closed against a force of 5 lbf (22 N) shall be permitted. The BLD-HEA committee was directed, by the Technical Correlating Committee, to review its occupancy chapter provisions that are of the list-type format and to revise, as needed, to clearly indicate whether the items in the lists apply to "all of", "one of", or "any of" the items. The revisions shown in the Recommendation field clarify intent. 5

7 l Log #CP756 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Multiple occupancies shall be in accordance with Section 6.2 and Where there are differences in the specific requirements in this chapter and provisions for mixed occupancies or separated occupancies as specified in and 6.2.4, the requirements of this chapter shall apply. (See ) Sections of health care facilities shall be permitted to be classified as other occupancies in accordance with the separated occupancies provisions of and either or Sections of health care facilities shall be permitted to be classified as other occupancies, provided that they meet all of the following conditions: (1) They are not intended to serve health care occupants for purposes of housing, treatment, or customary access by patients incapable of self-preservation. (2) They are separated from areas of health care occupancies by construction having a fire resistance rating of not less than 2 hours. (3) The construction type and supporting construction of the health care occupancy shall be based on the story on which it is located in the building in accordance with the provisions of Chapter 7. (4) The construction type of the areas of the building enclosing the other occupancies shall be based on the applicable provisions of Chapter 7 for the occupancy involved. Ambulatory care facilities, medical clinics, and similar facilities that are contiguous to health care occupancies, but that are primarily intended to provide outpatient services, shall be permitted to be classified as business occupancies or ambulatory health care facilities, provided that the facilities are separated from the health care occupancy by not less than 2-hour fire resistance rated construction and the facility is not intended to provide services simultaneously for four or more inpatients who are litterborne. Renumber through as through Doctors' offices... It is the intent... Clarification. Correlation with related change being made to NFPA 101 via Proposal STEVENS, S.: Wording should be consistent with NFPA and Wording in last sentence should be...simultaneously for four or more patients who are incapable of self preservation. 6

8 m Log #CP757 BLD-HEA Technical Committee on Health Care Occupancies, Revise current as follows: Sections of health care facilities shall be permitted to be classified as other occupancies, provided that they meet all both of the following conditions: (1) They are not intended to serve health care occupants for purposes of housing, treatment, or customary access by patients incapable of self-preservation. (2) They are separated from areas of health care occupancies by construction having a fire resistance rating of not less than 2 hours. (3) The construction type and supporting construction of the health care occupancy is based on the story on which it is located in the building in accordance with the provisions of Chapter 7. (4) The construction type of the areas of the building enclosing the other occupancies shall be based on the applicable provisions of Chapter 7 for the occupancy involved Insert a new before current (and renumber existing paragraphs as needed) to read as follows: Where separated occupancies provisions are used in accordance with either or , the most stringent construction type shall be provided throughout the building unless the 2-hour separation is a vertically-aligned fire barrier wall, and then the construction type shall be determined as follows: (1) The construction type and supporting construction of the health care occupancy shall be based on the story on which it is located in the building, in accordance with the provisions of (2) The construction type of the areas of the building enclosing the other occupancies shall be based on the applicable occupancy chapters of this. Correlation with similar change being made to NFPA 101 via Proposal In the NFPA 101 version, the new references but there is no similar provision in NFPA Thus, the language "unless the 2-hour separation is a vertically-aligned fire barrier wall" was inserted to capture the essence of the requirement from NFPA

9 n Log #CP758 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Contiguous Non-Health Care Occupancies. Ambulatory care facilities, medical clinics, and similar facilities that are contiguous to health care occupancies, but are primarily intended to provide outpatient services, shall be permitted to be classified as business occupancies or ambulatory health care facilities, provided that the facilities are separated from the health care occupancy by not less than 2-hour fire resistance-rated construction and the facility is not intended to provide services simultaneously for four or more inpatients who are litterborne. Ambulatory care facilities, medical clinics, and similar facilities that are contiguous to health care occupancies shall be permitted to be used for diagnostic and treatment services of inpatients who are capable of self-preservation. The use of ambulatory and business occupancies for patients who are capable of self-preservation has been eliminated based on the historical fire record of ambulatory health care facilities and business occupancies serving health care occupants. Diagnosis and treatment facilities are commonly placed in occupancies (ambulatory or business) that would not fall under the hospital provisions of the Code yet continue to provide a fire safe environment. STEVENS, S.: should be consistent with NFPA and Last sentence should read:...simultaneously for four or more patients who are incapable of self preservation Log #171 BLD-HEA Ignatius Kapalczynski, CT Office of State Fire Marshal Add new text to read as follows: (1) Not more than 10 locks need to be unlocked to relocate all occupants from one smoke compartment to an area of refuge (2) Unlocking of all necessary locks shall be accomplished with not more than two separate keys. Proposal establishes lock/key limits to achieve the goals of 18/ and 18/ where a manual locking condition similar to Condition IV is possible in Health Care. This limitation on key locking is taken from the Detention Occupancy. Detention recognizes the need to limit key operations for timely removal of occupants and this proposal places the same limitation on Health care locking which should not be more restrictive or unlimited (1) and (2). The change would have an adverse effect on psychiatric wards, but there is no technical substantiation for such change. 8

10 Log #129 BLD-HEA Joshua W. Elvove, Aurora, CO Revise text to read as follows: Doors that are located in the means of egress and are permitted to be locked under other provisions of shall comply with the following: (1) Provisions shall be made for the rapid removal of occupants by means of one of the following: (a) Remote control of locks from within the locked area (b) Keying of all locks to keys carried by staff at all times (c) Other such reliable means available to the staff at all times As currently written, staff within a locked area may not have the means to unlock a door from within the locked area. This puts staff dangerously at risk. Given this, there needs to be a requirement for staff located within the locked area to unlock the doors without having to rely on personnel located remotely. There is a need for the control room to be located outside the space as the patients must not have access to the unlocking device. Also, a single sleeping room could be considered to be the locked space so as to prevent the controls from being located at the nurses station Log #173 BLD-HEA Ignatius Kapalczynski, CT Office of State Fire Marshal Add new text to read as follows: (x) Egress door locks released by keypad activated codes shall require keypad activation on the ingress side to assure that the programmed code is demonstrated to be known and used at least once prior to entry by any staff entering the secured area. All keypads shall be programmed with the same code throughout any areas where staff movement may occur. Proposal offers a method to confirm that all staff is made aware of the keypad code(s) of the day and that keypads are programmed in a consistent manner. While awaiting documentation of an emergency where keypad codes were not remembered or confused, personal experience suggests that memorizing different changing codes for each nursing unit is particularly difficult for staff which traverses multiple units in the course of their duties and for per diem staff who must memorize numerous codes from the multiple facilities where they may be assigned on a temporary basis. The substantiation is inadequate to verify that staff has been unable to unlock doors where the keypad is only on the inside of the locked unit. To require a key pad on the outside of the locked unit might lead to unnecessary locking of the unit entry which is often left unlocked. 9

11 a Log #CP752 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows:. The number of means of egress shall be in accordance with Section 7.4. Not less than two exits shall be provided on every story. Not less than two separate exits shall be accessible from every part of every story. Not less than two exits shall be accessible from each smoke compartment, and egress shall be permitted through an adjacent compartment(s) but shall not require return through the compartment of fire origin. An exit is not necessary Correlation with changes being made to NFPA 101. The change is editorial and formatting in nature only. It makes no technical change. 10

12 Log #128 BLD-HEA Joshua W. Elvove, Aurora, CO Revise (A), (B) and (C) as follows:: Occupants of habitable rooms within sleeping suites shall have exit access to one of the following: (1) a corridor complying with without having to pass through more than one intervening room. (2)* a space separated from the suite by a minimum of one hour fire reistance rated construction that is not considered a hazardous area and leads to corridor without having to pass through another intervening room. Occupants of habitable rooms within non-sleeping suites shall have exit access to one of the following: a corridor complying with without having to pass through more than two intervening rooms. )* a space separated from the suite by a minimum of one hour fire reistance rated construction that is not considered a hazardous area and leads to corridor without having to pass through another intervening room. Non-sleeping suites of more than 2500 ft 2 (230 m 2 ) shall have not less than two exit access doors remotely located from each other. One means of egress from the suite shall be directly to Occupants of non-sleeping suites shall have exit access to one of the following: a corridor complying with a space separated from the suite by a minimum of one hour fire reistance rated construction that is not considered a hazardous area and leads to corridor without having to pass through another intervening room. For suites requiring two means of egress, one means of egress from the suite shall be permitted to be into another suite, provided that the separation between the suites complies with the corridor requirements of through Add the following new annex notes: A (A)(2) Examples include another suite, horizontal exit, or another smoke compartment. A (A)(2) Examples include another suite, horizontal exit, or another smoke compartment. A (B)(2) Examples include another suite, horizontal exit, or another smoke compartment. Current text is too restrictive as it mandates at least one means of egress from a suite be into a corridor, when other options (e.g., horizontal exits, smoke compartments, suites separated by fire resistance rated construction, are equally as safe. I have run into many situations where a suite has no access to a corridor, but has access to a stair and two additional suites that are separated from all adjacent suites by fire resistance rated construction, yet this configuration, regardless of the safeguards provided, does not meet the LSC. Proposed text aims to provide additional options to the traditional corridor. The committee is uncertain what form such spaces can take. What limitations are intended? Does the space need to be supervised? For small spaces under 2500 sq ft, the change would result in no requirement for direct corridor access such that it would be OK to route the one-and-only way out through an adjacent space. The submitter does not speak to this effect that the revised wording creates. How can such change be substantiated.? Yes, travel to a stair qualifies as reaching an exit, but stairs do not provide patients (think: difficult to move, especially vertically on stairs) with a helpful route as contrasted with the current requirements that facilitate the horizontal movement to another smoke compartment or another part of the floor. Affirmative: 20 Negative: 1 STEVENS, S.: It is incorrect to presume all patients are difficult to move. Text should allow options and leave it to facility and staff to use best option. O'CONNOR, D.: The proponent makes a good case for alternative options. The Committee should continue to explore the concepts proposed and work towards a solution in the ROC phase. 11

13 Log #127 BLD-HEA Joshua W. Elvove, Aurora, CO Revise , , , and as follows: Change Sleeping Suite to Patient Care Sleeping Suites Revise , , , and as follows:: Change Non-Sleeping Suite to Patient Care Non-Sleeping Suites Changing Sleeping Suites to Patient Care Sleeping Suites will ensure the requirements of et al will not be incorrectly applied to areas where non-(health care) patient sleeping occurs (e.g., on call suites, residential board and care suites, etc.) Changing Non-Sleeping Suite to Patient Care Non-Sleeping Suites will ensure that the requirements of for Non-Patient Care Suites (e.g., the 200 ft travel distance requirement) are not incorrectly applied to Patient Care Non-Sleeping Suites since a Non-Sleeping Suite is also generally a Non-Patient Care Suite. Note: also see companion proposal for revising suite definitions Log #174 BLD-HEA Ignatius Kapalczynski, CT Office of State Fire Marshal DELETE section. Proposal restores self closers on patient room doors. Prior Technical Committee statement places much greater faith in staff actions than actual incidents have documented. Staff supervision as addressed by the required emergency plan is adequate to assure that doors will be closed when needed, is not supported by staff actions in actual multiple fatality fires. Staff actions to affect rescue in the room of fire origin have resulted in delays or failure of other patient room doors being closed in timely manner and allowed the migration of smoke and heat beyond the room of origin. The General Accounting Office report following the 2003 Hartford, CT and Nashville, TN multiple fatality fires stated that staff training was not dependably effective. Proposal continues to be based on direct personal observations and research of what worked and what did not work at several health care facility fires. The BLD-HEA committee notes that the submitter probably intended to address and not The fires cited involved non-sprinklered nursing homes. 12

14 a Log #CP754 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Alcohol-based hand-rub dispensers shall be protected in accordance with Section 8.15 and Chapter 34, unless all of the following conditions are met: (1) Where dispensers are installed in a corridor, the corridor shall have a minimum width of 6 ft (1830 mm). (2) The maximum individual dispenser fluid capacity shall be as follows: (a) 0.32 gal (1.2 L) for dispensers in rooms, corridors, and areas open to corridors (b) 0.53 gal (2.0 L) for dispensers in suites of rooms (3) Where aerosol containers are used, the maximum capacity of the aerosol dispenser shall be 18 oz. (0.51 kg) and shall be limited to Level 1 aerosols as defined in NFPA 30B,. (4) (3) Dispensers shall be separated from one another by horizontal spacing of not less than 48 in. (1220 mm). (5) (4) Not more than an aggregate 10 gal (37.8 L) of alcohol-based hand-rub solution shall be in use outside of a storage cabinet in a single smoke compartment. (6) (5) Storage of quantities greater than 5 gal (18.9 L) in a single smoke compartment shall meet the requirements of NFPA 30,. (7) (6) Dispensers shall not be installed in the following locations: (a) Above an ignition source for a horizontal distance of 1 in. (25 mm) to each side of the ignition source (b) To the side of an ignition source within a 1 in. (25 mm) horizontal distance from the ignition source (c) Beneath an ignition source within a 1 in. (25 mm) vertical distance from the ignition source (8) (7) Dispensers installed directly over carpeted floors shall be permitted only in sprinklered smoke compartments. (9) The alcohol-based hand-rub solution shall not exceed 95 percent alcohol content by volume. (10) Operation of the dispenser shall comply with the following criteria: (a) The dispenser shall not release its contents except when the dispenser is activated, either manually or automatically by touch-free activation. (b) Any activation of the dispenser shall only occur when an object is placed within 4 in. (100 mm) of the sensing device. (c) An object placed within the activation zone and left in place shall not cause more than one activation. (d) The dispenser shall not dispense more solution than the amount required for hand hygiene consistent with label instructions (e) The dispenser shall be designed, constructed and operated in a manner that ensures accidental or malicious activation of the dispensing device are minimized. (f) The dispenser shall be tested in accordance with the manufacturer s care and use instructions each time a new refill is installed. The action inserts a new subitem (3) to recognize and regulate the aerosol form of alcohol-based solution. The same text was added to the health care occupancies chapters in NFPA 101 for the 2009 edition, but the same change could not be made to NFPA 5000 at that time because the issue has not been raised during the ROP phase of the revision process. New criteria for the manual or "touch free" automatic activation of the dispenser are being added as the current language does not make clear that automatic activation is permitted. A maximum limit on the alcohol content of the hand-rub solution as the percentage of alcohol is proposed so that the AHJ does not limit the percentage to less than needed for infection control. The alcohol content has increased since the devices were first introduced. The maximum 95 percent alcohol by volume limitation recognizes that some, small percentage of the volume needs to be water to facilitate spreading the solution on hand surfaces. 13

15 Log #172 BLD-HEA Ignatius Kapalczynski, CT Office of State Fire Marshal DELETE section. Requirement is obsolete. The prior Committee Statement has been repeated without change. Explanation of this unusual contradiction, an example or scenario, or an actual application of this situation has not been offered. The need to justify self contradiction by an AHJ is not apparent. Delete or refer to NFPA 13 Technical Committee to re-evaluate. TC statement: The current provision is needed to prevent the Catch-22 situation where the AHJ prohibits the installation of sprinklers in a particular room and then rules that the building, because the room is unsprinklered, is not a fully sprinklered building. The requirement is not obsolete. If the AHJ prohibits sprinklers then the owner/operator needs the protection afforded by this provision so as not to permit the AHJ to turn around and classify an otherwise fully-sprinklered building as being non-sprinklered. The BLD-HEA committee stands by its decision from the 2009 edition cycle for NFPA 101 to retain the provision. 14

16 a Log #CP751 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Corridors used for exit access within the ambulatory health care occupancy shall comply with both of the following: (1) They shall be smoke partitions in accordance with Section (2) They shall have not less than a 1-hour fire resistance rating in accordance with Section 8.4 in other than smoke compartments protected throughout by an approved, electrically supervised automatic sprinkler system in accordance with Section In smoke compartments protected throughout by an approved, electrically supervised automatic sprinkler system in accordance with Section 55.3, corridor doors, other than fire protection-rated doors serving hazardous areas; exit enclosures; or vertical openings, shall meet all of the following: (1) They shall be self-latching. (2) They shall comply with through (3) They shall be self-closing or automatic-closing in accordance with where the non-rated door serves a sprinklered hazardous area. Every story of the ambulatory health care facility shall be divided into not less than two smoke compartments, unless one of the following conditions exists: (1) Facilities are less than 5000 ft2 (465 m2) and are protected by an approved automatic smoke detection system. (2) Facilities are less than 10,000 ft2(929 m2) and are protected throughout by an approved, electrically supervised automatic sprinkler system installed in accordance with Section (3) An area in an adjoining occupancy is permitted to serve as a smoke compartment for the ambulatory health care facility, and all of the following criteria also are met: (a) The separating wall and both compartments meet the requirements of (b) The ambulatory health care facility is less than 22,500 ft2 (2100 m2). (c) Access from the ambulatory health care facility to the other occupancy is unrestricted. Doors in smoke barriers shall comply with all of the following: (1) They shall be not less than 1¾ in. (44 mm) thick, solid-bonded wood core or the equivalent. (2) They shall be self-closing or automatic-closing in accordance with (3) They shall be provided with positive latching hardware on other than cross-corridor doors. (4) They shall be provided with a vision panel if the door is a cross-corridor door. (5) Vision panels in doors in smoke barriers, if provided, shall be of fire-rated glazing or wired glass in approved frames. The BLD-HEA committee was directed, by the Technical Correlating Committee, to review its occupancy chapter provisions that are of the list-type format and to revise, as needed, to clearly indicate whether the items in the lists apply to "all of", "one of", or "any of" the items. The revisions shown in the Recommendation field clarify intent. 15

17 b Log #CP753 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows:. The number of means of egress shall be in accordance with Section 7.4. Not less than two exits of the types described in that are remotely located from each other shall be provided for each floor or fire section of the building. Any room, or any suite of rooms, of more than 2500 ft 2 (232 m 2 ) shall have not less than two exit access doors remotely located from each other. Not less than two exits of the types described in shall be accessible from each smoke compartment. Egress shall be permitted through adjacent compartments but shall not require return through the compartment of fire origin. Correlation with changes being made to NFPA 101. The change is editorial and formatting in nature only. It makes no technical change Log #126 BLD-HEA Joshua W. Elvove, Aurora, CO Revise text to read as follows: Any room and any patient care suite of rooms of more than 2500 ft 2 (232 m 2 ) shall have not less than two exit access doors remotely located from each other. The need to specifically address the number of exit access doors in suites is because ambulatory health care occupancies commonly use this configuration (e.g., emergency departments, radiology suites, etc.), and without such language, there would be no guidance in this area. The business occupancy chapters make no mention of suites, so it must be assumed that the suite provisions are only meant to apply to patient care suites, not administrative suites. Hence, it s only fitting that the term patient care be added in front of the word suite. This also aligns the requirements of with the definition for patient care suites. Revise as follows: Any patient care room and any patient care suite of rooms of more than 2500 ft 2 (232 m 2 ) shall have not less than two exit access doors remotely located from each other. The committee action does what the submitter requested and also fixes an oversight by adding "patient care" before the word "room." 16

18 b Log #CP755 BLD-HEA Technical Committee on Health Care Occupancies, Revise as follows: Alcohol-based hand-rub dispensers shall be protected in accordance with Section 8.15 and Chapter 34, unless all of the following conditions are met: (1) Where dispensers are installed in a corridor, the corridor shall have a minimum width of 6 ft (1830 mm). (2) The maximum individual dispenser fluid capacity shall be as follows: (a) 0.32 gal (1.2 L) for dispensers in rooms, corridors, and areas open to corridors (b) 0.53 gal (2.0 L) for dispensers in suites of rooms (3) Where aerosol containers are used, the maximum capacity of the aerosol dispenser shall be 18 oz. (0.51 kg) and shall be limited to Level 1 aerosols as defined in NFPA 30B,. (4) (3) Dispensers shall be separated from one another by horizontal spacing of not less than 48 in. (1220 mm). (5) (4) Not more than an aggregate 10 gal (37.8 L) of alcohol-based hand-rub solution shall be in use outside of a storage cabinet in a single smoke compartment. (6) (5) Storage of quantities greater than 5 gal (18.9 L) in a single smoke compartment shall meet the requirements of NFPA 30,. (7) (6) Dispensers shall not be installed in the following locations: (a) Above an ignition source for a horizontal distance of 1 in. (25 mm) to each side of the ignition source (b) To the side of an ignition source within a 1 in. (25 mm) horizontal distance from the ignition source (c) Beneath an ignition source within a 1 in. (25 mm) vertical distance from the ignition source (8) (7) Dispensers installed directly over carpeted floors shall be permitted only in sprinklered smoke compartments. (9) The alcohol-based hand-rub solution shall not exceed 95 percent alcohol content by volume. (10) Operation of the dispenser shall comply with the following criteria: (a) The dispenser shall not release its contents except when the dispenser is activated, either manually or automatically by touch-free activation. (b) Any activation of the dispenser shall only occur when an object is placed within 4 in. (100 mm) of the sensing device. (c) An object placed within the activation zone and left in place shall not cause more than one activation. (d) The dispenser shall not dispense more solution than the amount required for hand hygiene consistent with label instructions (e) The dispenser shall be designed, constructed and operated in a manner that ensures accidental or malicious activation of the dispensing device are minimized. (f) The dispenser shall be tested in accordance with the manufacturer s care and use instructions each time a new refill is installed. The action inserts a new subitem (3) to recognize and regulate the aerosol form of alcohol-based solution. The same text was added to the health care occupancies chapters in NFPA 101 for the 2009 edition, but the same change could not be made to NFPA 5000 at that time because the issue has not been raised during the ROP phase of the revision process. New criteria for the manual or "touch free" automatic activation of the dispenser are being added as the current language does not make clear that automatic activation is permitted. A maximum limit on the alcohol content of the hand-rub solution as the percentage of alcohol is proposed so that the AHJ does not limit the percentage to less than needed for infection control. The alcohol content has increased since the devices were first introduced. The maximum 95 percent alcohol by volume limitation recognizes that some, small percentage of the volume needs to be water to facilitate spreading the solution on hand surfaces. 17

19 Log #125 BLD-HEA Joshua W. Elvove, Aurora, CO New text to read as follows: A Portions of buildings that are frequented by inpatients who are capable of self-preservation should not be classified as health care occupancies. The current definition of a health care occupancy is an occupancy used to provide medical or other treatment or care simultaneously to four or more patients on an inpatient basis, where such patients are mostly incapable of self-preservation due to age, physical or mental disability, or because of security measures not under the occupant s control. The provisions for health care occupancies (i.e., Chapter 19) should only be meant to apply to occupants who need staff assistance and additional safeguards to ensure their safety, because they aren t capable of providing this on their own. In many cases, inpatients are not necessarily incapable of self-preservation (e.g., post surgical ortho-rehab patients) yet currently, the health care occupancy provisions apply to any area where 4 or more such inpatients are treated (e.g., PT clinic). Though a complete revision of the existing definition is preferred, the proposed annex note is meant to alert users that just because an area in being used to treat 4 or more inpatients, it should not necessarily mean that the health care occupancy provisions of Chapter 19 need apply (i.e., the occupancy might be better classified as an ambulatory health care occupancy assuming it serves 4 or more patients). Note: in many instances, 4 or more inpatients can be found in the dining facility, yet we don t expect that area to comply with the health care occupancy chapter requirements. Hence, in areas where inpatients receive treatment, the nature of the treatment and the condition of the inpatient should dictate whether the health care occupancy chapter requirements should apply (i.e., base occupancy classification upon true risk). Note: similar language might also be appropriate in a new annex for The subject is already adequately covered by