Press release



Nursing homes that do not have sprinkler systems or hard-wired smoke detectors will have to install battery-operated ones in patient rooms and public areas according to an announcement made today by the Centers for Medicare & Medicaid Services (CMS).


“This is an important rule that could save many lives by making real improvements in nursing home safety,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “Nursing home residents are an especially vulnerable population and we need to take every step possible to protect them.”


CMS took this unprecedented action after two tragic nursing home fires in Connecticut and Tennessee in 2003.  Neither home had smoke detectors in the patient rooms where the fires originated.  The agency worked closely with the National Fire Protection Association to develop ways to get effective fire protection into all facilities.


A review of the two incidents by the Government Accountability Office (GAO) asserted that smoke detectors could have resulted in quicker staff response that may have led to a better outcome.


Today’s action will considerably improve the safety of residents living in over 4,000 nursing homes that do not have sprinkler systems.  Newly constructed nursing facilities are required to be fully covered by a sprinkler system, while older homes built of noncombustible materials like concrete block are not. Homes will be given a year in which to comply with the new requirement.


The NFPA is the group that developed the 2000 edition of the Life Safety Code that CMS uses to set the standard in health care facilities. 


Also in today’s interim final rule is a provision that will allow nursing homes, hospitals, ambulatory surgical centers and other health care facilities to install dispensers of alcohol-based hand sanitizers in exit corridors that meet certain conditions.  This had not been allowed previously because of concerns that the alcohol rubs may serve as an accelerant in the event of a fire and block access to exits.  Studies on this concern, however, have shown that if certain conditions are met, that fire hazard is greatly reduced while there can be a significant benefit in reducing hospital-acquired infections. 


Alcohol-based hand rubs are more effective at destroying bacteria than ordinary soaps and water.  This is critically important in a health care setting.  The Centers for Disease Control estimates that two million patients a year get hospital-based infections and that 90,000 of those patients die.  Hospital-based infections can often be traced to a lack of hand washing by health care personnel with direct patient contact.


“As a physician, I am very familiar with the important role hand hygiene plays in stopping the spread of infections,” said Dr. McClellan. “Increasing the number of these dispensers in and near patient rooms has proven to significantly increase hand cleansing activities by health care professionals and even the patients themselves.”


Some precautions facilities must take include making sure the dispensers are not near a heat or ignition source, that they are at least four feet apart and that they are placed in corridors at least six feet wide.


The full interim final rule will be published in the March 25 Federal Register.