The Centers for Medicare and Medicaid Services (CMS) is considering modifying a clause in a proposed rule in the Federal Register 42 CFR Part 483 that seemed to allow removal of automatic fire detection systems when a sprinkler system is installed in nursing homes.

The provision was part of the rule requiring installation of sprinkler systems in all U.S. long-term care facilities in order for them to be accredited to receive reimbursement from Medicare and Medicaid funds for care of their patients. CMS is the federal agency responsible for administering several federal health programs including Medicare and Medicaid. It is a division of the U.S. Department of Health and Human Services.

Representatives of the National Burglar and Fire Alarm Association (NBFAA), Irving, Texas, the Automatic Fire Alarm Association (AFAA), Jasper, Ga., the National Electrical Manufacturers Association (NEMA), Rosslyn, Va., Bay Alarm Co., Pacheco, Calif., and SimplexGrinnell, Boca Raton, Fla., met with CMS to seek inclusion of automatic fire detection systems in the rule.

John Chwat, director of government relations for NBFAA, said the group pointed out to CMS officials that ANSI/NFPA 101 sets standards for use of fire detection devices in nursing homes.

“They were very appreciative of the information about NFPA 101 and seemed to indicate that their comments on sunseting of fire alarms were confusing or misunderstood and may revise that,” Chwat reported. “They made great protestations to say that the sunseting proposed part of the rule was very unclear, and they were going to clarify it. They didn’t mean to say that smoke alarms would be sunseted, which is a violation of NFPA 101.”

Tom Hammerberg, the AFAA’s president and executive director, said of CMS, “If they are truly interested in life safety, a balanced approach is what they should be considering, with both detection and suppression, and that’s the part they’re going to look at in the future, hopefully. All three associations are promoting balanced fire protection, and we don’t feel any one technology provides the answer to all possible life safety concerns.”

The cost of installing sprinklers in the approximately 3,000 long-term care facilities in the United States without full sprinkler systems would be $4 to $6 per square foot, according to the Federal Register 42 CFR Part 483.

This compares with $0.99 to $1.31 per square foot for installation of automatic fire detection equipment, which the NBFAA obtained from a survey of its membership. The total number of U.S. long-term care facilities is estimated in 42 CFR Part 483 at approximately 18,000.

“As to whether they will drop the mandated sprinkler requirements to make a more balanced approach, we just don’t know right now,” Chwat explained. “We estimate the rule will come out in the middle of 2008 primarily because a new administration will be coming in the fall of next year.

“Most regulations get put on hold depending on what the next administration wants to set as priorities,” Chwat maintained. “They want to publish the final rule in the next six months.

“NBFAA will look at the rule when it comes out,” Chwat continued. “We’ll advocate some actions at the state level, and maybe work with NFPA on specifications for it.

“Mandating sprinklers alone in a nursing home venue is ill-advised,” Chwat maintained. “There needs to be a balanced approach. The detection should go in first, and there are systems that can have both detection and suppression, so for protection of the patients, detection is probably more important.”