NFPA 99: New healthcare facility code requirements

The National Fire Protection Assn. sets forth the criteria to minimize the hazards of fire, explosion, and electricity in healthcare facilities providing services to human beings.

05/15/2012


Healthcare facilities contain a multitude of complex systems that all play varying roles in the provision of patient care and the protection of a building and its occupants. Since 1984, NFPA 99 has been a consolidated source for guidance on minimizing the hazards of fire, explosion, and electricity in healthcare facilities providing services to human beings. NFPA 99-2012: Health Care Facilities Code represents a significant rewrite of its 7-year-old predecessor document, NFPA 99-2005: Standard for Health Care Facilities. This extended revision cycle is indicative of the immense effort that has been put into the latest edition. This article highlights the changes in the new document.

Overview of changes

The change in designation of NFPA 99 from a “standard” to a “code” is most obvious. This change enables an authority to adopt NFPA 99 independently of other codes and standards. It also facilitates enforcement of the requirements within, as a code instructs the design professional when to implement a particular design element or system, whereas a standard only dictates how to implement a design element or system when it is required elsewhere.

The application of the new code has been clarified to apply to “all healthcare facilities other than home care.” Provisions for home care that were contained in the 2005 edition have been removed.

A quick look at the table of contents in the 2012 edition brings to light the most significant change—the removal of the occupancy chapters. In their place, Chapter 4: Fundamentals defines four facility system categories that are used in conjunction with a risk assessment to determine the building system design requirements. As defined in Section 4.1: Building System Categories, the new categories are as follows:

  • Category 1: Facility systems in which failure of such equipment or system is likely to cause major injury or death of patients or caregivers.
  • Category 2: Facility systems in which failure of such equipment is likely to cause minor injury to patients or caregivers.
  • Category 3: Facility systems in which failure of such equipment is not likely to cause injury to patients or caregivers, but can cause patient discomfort.
  • Category 4: Facility systems in which failure of such equipment would have no impact on patient care.

Note that the Chapter 4 annex material provides further information that enables appropriate categorization.

In addition to the move to a risk‐based approach, several other chapter additions and deletions have also been made:

  • The chapter on laboratories has been removed and all references to laboratory requirements point to NFPA 45: Standard on Fire Protection for Laboratories Using Chemicals.
  • Chapter 7: Information Technology and Communications for Health Care Facilities provides requirements for information technology and communication systems. A focus is placed on ensuring the integrity of voice, data, communication, and biomedical systems that are crucial to the operation of the modern healthcare facility.
  • Chapter 8: Plumbing addresses plumbing systems. This chapter primarily discusses water, air, and grease transport systems and their corresponding need to comply with the locally applicable plumbing codes.
  • Chapter 9: Heating, Ventilation, and Air Conditioning (HVAC) outlines requirements for HVAC systems. This chapter provides requirements for HVAC system components for maintenance of environmental conditions within the healthcare facility. Specific requirements are included for ventilation and conditioning of medical gas spaces and emergency power systems rooms.
  • Chapter 12: Emergency Management has been significantly enhanced to provide a more detailed framework to be used by those responsible for emergency management in new and existing healthcare facilities and to coincide with current Joint Commission requirements. Guidance is provided for a required emergency operations plan (EOP) based upon one of two healthcare facility categories: those that plan for an influx of patients due to an emergency; and those that manage existing patients but do not plan to receive additional patients during an emergency.
  • Chapter 13: Security Management provides a framework for development of a security management plan. Important function and components of a security plan are addressed, in addition to integration of the plan with building emergency evacuation concerns.
  • Chapter 15: Features of Fire Protection addresses fire protection requirements pertinent to healthcare facilities. Many of the requirements in this chapter are extracted from NFPA 101: Life Safety Code. Topics covered include construction and compartmentation, special hazard protection of flammable liquids and gases, fire detection and alarm, automatic sprinklers, and other extinguishing equipment. 

Risk‐based approach

The risk assessment used to determine the category for a particular facility system should follow a formal documented process. NFPA 99 does not specify the process but offers recommended guidance in the form of ISO/IEC 31010: Risk Management—Risk Assessment Techniques, NFPA 551: Guide for the Evaluation of Fire Risk Assessments, SEMI S10‐0307E: Safety Guideline for Risk Assessment and Risk Evaluation Process, or other formal process. The risk assessment is the responsibility of the facility management and would require involvement by additional parties that know the impacts of system failures.

This significant change to a risk‐based approach for selection of system design category is in recognition that the location of a particular medical procedure, whether a hospital or an outpatient clinic, should have less impact on the systems that support that medical procedure than on the nature of the risk to the patient, medical staff, or other building occupants. The risk‐based methodology will likely have a more significant impact on outpatient clinics and similar facilities that were not previously held to the more rigorous system design requirements in place for hospitals.

New vs. existing

Given the considerable changes in the NFPA 99-2012, the application of the code to existing facilities may pose some questions. The approach taken in this edition is not intended to require replacement of entire existing systems in good working order. In the case of alterations, renovations, or modernizations, only the modified portion of a system or individual component is required to compliance with the 2012 provisions. Furthermore, existing construction or equipment may remain in service as long as the authority having jurisdiction does not determine that its continued use constitutes a hazardous condition.

Adoption and enforcement

Any jurisdiction, such as a city, state, or other municipality, may adopt NFPA 99. As is typical in the regulatory community, it may take some time for the 2012 edition to be adopted and enforced. Another possible entity that could adopt the new code is a healthcare system, which could require compliance with the code above and beyond the applicable local building and fire code provisions. NFPA 99 is also referenced in NPFA 101; therefore, when NFPA 101 is applicable then the provision of NFPA 99 would also be applicable as referenced. This venue for adoption brings with it the possibility for NFPA 99 to have a more formal role in the Joint Commission Statement of Conditions (SOC) process in the future.

Summary

NFPA 99-2012 is a completely reworked document for 2012. The restructuring of the code and the move to a risk‐based facility service system assessment approach are intended to reflect the changing face of the healthcare industry, where many services and procedures are being provided in outpatient clinic-type facilities that in many cases will now require the more detailed design considerations that historically have been reserved for hospitals.


McLaughlin is an associate and the Los Angeles fire engineering practice leader at Arup. He has more than 10 years of experience in the application of building and fire code requirements to projects around the global, including significant experience with healthcare facilities.



No comments
The Top Plant program honors outstanding manufacturing facilities in North America. View the 2013 Top Plant.
The Product of the Year program recognizes products newly released in the manufacturing industries.
The Leaders Under 40 program features outstanding young people who are making a difference in manufacturing. View the 2013 Leaders here.
The new control room: It's got all the bells and whistles - and alarms, too; Remote maintenance; Specifying VFDs
2014 forecast issue: To serve and to manufacture - Veterans will bring skill and discipline to the plant floor if we can find a way to get them there.
2013 Top Plant: Lincoln Electric Company, Cleveland, Ohio
Case Study Database

Case Study Database

Get more exposure for your case study by uploading it to the Plant Engineering case study database, where end-users can identify relevant solutions and explore what the experts are doing to effectively implement a variety of technology and productivity related projects.

These case studies provide examples of how knowledgeable solution providers have used technology, processes and people to create effective and successful implementations in real-world situations. Case studies can be completed by filling out a simple online form where you can outline the project title, abstract, and full story in 1500 words or less; upload photos, videos and a logo.

Click here to visit the Case Study Database and upload your case study.

Bring focus to PLC programming: 5 things to avoid in putting your system together; Managing the DCS upgrade; PLM upgrade: a step-by-step approach
Balancing the bagging triangle; PID tuning improves process efficiency; Standardizing control room HMIs
Commissioning electrical systems in mission critical facilities; Anticipating the Smart Grid; Mitigating arc flash hazards in medium-voltage switchgear; Comparing generator sizing software

Annual Salary Survey

Participate in the 2013 Salary Survey

In a year when manufacturing continued to lead the economic rebound, it makes sense that plant manager bonuses rebounded. Plant Engineering’s annual Salary Survey shows both wages and bonuses rose in 2012 after a retreat the year before.

Average salary across all job titles for plant floor management rose 3.5% to $95,446, and bonus compensation jumped to $15,162, a 4.2% increase from the 2010 level and double the 2011 total, which showed a sharp drop in bonus.

2012 Salary Survey Analysis

2012 Salary Survey Results

Maintenance and reliability tips and best practices from the maintenance and reliability coaches at Allied Reliability Group.
The One Voice for Manufacturing blog reports on federal public policy issues impacting the manufacturing sector. One Voice is a joint effort by the National Tooling and Machining...
The Society for Maintenance and Reliability Professionals an organization devoted...
Join this ongoing discussion of machine guarding topics, including solutions assessments, regulatory compliance, gap analysis...
IMS Research, recently acquired by IHS Inc., is a leading independent supplier of market research and consultancy to the global electronics industry.
Maintenance is not optional in manufacturing. It’s a profit center, driving productivity and uptime while reducing overall repair costs.
The Lachance on CMMS blog is about current maintenance topics. Blogger Paul Lachance is president and chief technology officer for Smartware Group.