Life Safety Code requirements for Medicare, Medicaid facilities streamlined

Medicare and Medicaid participating health care facilities, including hospitals, long-term care facilities, hospices, and others will be required to adhere to the 2012 edition of the Life Safety Code (LSC) established by the National Fire Protection Association (NFPA) to ensure the safety of patients and residents. When necessary, CMS stated in an advance release of its Final rule, the agency will grant waivers of some provisions of the LSC when the application of the rules would result in an unreasonable hardship and if patients’ health and safety would not be jeopardized by provision of the waiver. This Final rule published in the Federal Register May 4, 2016.

A necessary update

Following strong industry encouragement, CMS’ Proposed rule (79 FR 21552), published April 16, 2014, proposed to amend fire safety standards, adopt the 2012 LSC, and eliminate references to earlier editions of the LSC. The agency emphasizes that enforcing earlier editions of the code can result in confusion and limitations on options. New buildings are typically designed to meet the standards of the latest LSC, enforced by state and local jurisdictions. Requiring facilities to comply with two different editions of the code could result in inconsistencies and increased costs without increased patient benefit.

2012 LSC changes

The 2012 LSC differs significantly from the 2000 LSC, which was the previous edition for Medicare and Medicaid facility compliance. The format of the LSC was altered, and the use of exceptions was removed for clarity. In addition, the 2012 version contains a “building rehabilitation” chapter that clarifies the improvement standards for different types of rehabilitation work. Each category, such as repair, renovation, or change of use, will have different standards. CMS believes that these guidelines will reduce costs for health facilities during minor construction projects.

The 2012 edition also classifies a “health care occupancy” as a facility serving four or more individual as inpatients. However, CMS finds the LCS’s exception for those serving fewer than this amount inapplicable to Medicare and Medicaid facilities, and will require all occupancies providing care to one or more patients to comply with relevant 2012 requirements.