building codes & standards for healthcare · 1/8/2020 · healthcare construction certificate...

Healthcare Construction Certificate - Level 1

Building Codes & Standards for

Healthcare


Building Codes and Standards

• Codes• Defend-in-Place

• Walls• Sprinklers• Fire Alarm

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Important Dates for Healthcare Facilities

• 2012 Edition NFPA Life Safety Code 101• CMS enforcement date: 11/1/16• TJC enforcement date: 11/7/16• DHS enforcement: 10/1/17

• 2015 ICC codes ( IBC, IEBC, IMC, IECC ) • 2014 FGI Guidelines - Ventilation only• Wisconsin enforcement: 5/1/18

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Building Codes for Healthcare

2012 NFPA 101 Major Changes:• Cooking Open to the Corridor• Gas Fireplaces in sleeping compartments• Fixed Furniture in 8’ Corridor• Combustible Decoration options• Relative Humidity in OR’s


New Referenced Codes and StandardsCategorical Waivers based on partial

use of 2012 LSC NO longer applicable

-2012

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-2011Chapter 43

Building Renovations

(Risk-Based, Elec, Med Gas, Ventilation, Equip)

-2012 HEALTH CARE CODE

2012 LSC


National Fire Protection Association - NFPA

2012 NFPA 99 Health Care Facilities Code• Chap 4 Risk Assessments• Chap 5 / 11 Medical Gas Systems and Equipment• Chap 6 / 10 Electrical Systems and Equipment• Chap 9 Heating, Ventilation, and Air (HVAC)• Chap 14 Hyperbaric Facilities• Chap 15 Features of Fire Protection


Unique Building Features in Healthcare

• Healthcare –Compartmentalization creates the ability to defend in place



• Electrical distribution systems

• Multiple “Transfer Switches”

• Isolated power systems with line isolation monitors or protect for wet locations in OR’s or GFI’s

• Life Safety Circuits for life support systems

• Diesel Generator Back-up



• Medical Gas systems

• Life safety to patients

• Labeling

• Clean



• Ventilation

• Smoke control

• Pressurization

• Filtration



• Sprinklers

• Fire protection system

• Active system

• Testing


Conflicts Exist in Code Adoptions Most Restrictive Applies

• Codes are not always in alignment

• NFPA sometimes conflicts with ICC

• State can Adopt a more stringent rule

• Most restrictive rule or code applies

• “The Difficulty” – plans cannot always clearly indicate what code standards are being applied to the existing construction


DHS Plan Review Applications


State Level

• DSPS – Department of Safety and Professional Services• Building and Structures Plan Review

• ICC – International Code Council – IBC, Energy, Fuel Gas, Existing Building Code, and Mechanical Code

• State Plumbing, Elevator, Pressure Vessels (Boilers & Hyperbaric).

• SPS 316 – Electrical – NFPA 70

• SPS 314 – State Fire Prevention – NFPA 1

• SPS 364 adopts FGI Design Guidelines (ventilation)


OSHA and DNR - Asbestos

• OSHA and DNR – Asbestos

• OSHA – 1910.1001(J)(2)i) Building & facility owners shall determine the presence, location and quantity of ACM and/or PACM at work site

• NR 447 – Pre-inspection is required prior to ANY demolition or renovation– Demolition: Wrecking or taking out of any load supporting structural member

– Renovation: Altering a facility or one or more facility components in any way


OSHA and DNR - Asbestos

• Identify friable and non-friable materials

– Obvious loose or crumbling ACM or suspect ACM

– Floor coverings and/or mastics

• DNR “FAQ’s” @ http://http://dnr.wi.gov/topic/Demo/AsbestosFAQ.html– The age of a building does not matter

– ACM are still made and available.

– Re-use of materials also increases the possibility that asbestos containing materials may be in a newer buildings.

– Remember multiple regulators DNR, DHS, OSHA, EPA, and local AHJs E.G. Milwaukee

• Thanks to Bill Best for this info


OSHA Silica Rule


Design Standards FGI Guidelines

• Facilities Guidelines Institutes (FGI):• Design and Construction of Health Care• State of Wisconsin: 2014 FGI Edition in SPS 364• The Joint Commission : 2014 FGI Edition

– 2013 Edition ASHRAE 170 Standard– HVAC provisions adoption by DSPS in 2018– Infection Control Risk Mitigation– Ventilation of Construction Zone


FGI Ventilation Table (Partial)


Assisted Living Facilities

• State of Wisconsin:– CBRF Community-Based Residential Facility

• DHS 83

– RCAC Residential Care Apartments Complex• DHS 89

– AFH Adult Family Homes• DHS 88

– Small CBRF’s (5-8 bed) per WCBC Code to UDC “Uniform Dwelling Code”


The Joint Commission Certification

• Management Plans:– Environment of Care

Environmental Safety, Security, Hazardous Materials and Waste, Fire Safety Medical Equipment Management, Utilities Systems

– CMS Validation Surveys by DHS

– Hospitals and Nursing Homes


Defend-in-Place Principle

• Smoke compartment walls and doors to provide measures of safety– Divide building into zones

• Zones provide evacuation options

• Horizontal evacuations (preferred)

• Vertical evacuation if necessary

• Building evacuation only if necessary


Life Safety Principles

• Save all patients and staff

• Control spread of fire

• Maybe extinguish fire at origin

• RACE: (Some Fire Departments like “ACER”)

• R – Rescue from room of origin

• A – Activate alarm system

• C – Contain the fire (close the door – positive latch)

• E – Evacuate or Extinguish (if possible)


Fire Safety Technology

• Sprinkler design– Standard sprinkler heads until 1990’s have RTI: 80

– Quick response sprinkler heads have RTI: 50

• Life savings and control of fire spread:– New sprinkler heads have changed the Life Safety Code parameters

and philosophy

– QR’s – defined new wall type – Smoke Resistant “Smoke-Tight” walls

• Formerly all walls rated like “Fire Barriers”

• Smoke Resistant walls require quality Maintenance


Fire Safety Technology

• Full Building Sprinkler Credits– Construction Type

– Travel Distance

– Delayed Egress Locking

– Hazardous Room Enclosures

– Corridor Walls and Doors

– Smoke Dampers

– Window Sizes

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Life Safety Plan


Walls Provide Time

• Critical Areas e.g.:– Operating Rooms

– Nurseries – NICU’s

– ICU’s

– CCU’s

– Psychiatric Units

– Emergency Dept.


Wall Types: Sound Smoke Tight or Fire Rated

• Fire Walls

• Fire Barriers

• Smoke Barriers

• Shaft Enclosures

• Smoke-Tight Walls – Smoke Protection Only– Sound Walls for FGI Requires Sound Privacy Acoustics

– Rated Walls have a FRR-Fire Resistive Rating

– Smoke Tight Walls have a Zero-”0” Rating but must be tight fitting CMS has a “Gap Memo”

– Conflict with NFPA 101 and IBC regarding smoke tight ceilings


Walls – Functional Uses• Building Separations – Fire Walls

• Occupancy Separations – Fire Barriers

• Hazardous Areas Separations – Fire Barriers

• Vertical Separations: Shafts – Stairs / Equipment

• “Smoke / Fire” Barrier Compartments

• Corridor Walls – “Smoke Tight” or “Fire Partitions”

• Horizontal Exits – “Used in the place of Stairs” for Exit Distance Compliance

• Stair Extensions – Exit Passageways – “Horizontal Tunnel or Shaft”


Smoke Zones

• Smoke Barrier compartment or Smoke Zones– 1-Hour Fire Barrier Wall

– Wall Floor to Deck

– Exterior to Exterior

– Doors 20 minute – Must self close. No Latching Required – but allowed

– Higher Ratings Than 1-Hour Will Require Additional Hardware


Room Separation – “Smoke Tight Walls Only”• Approved Automatic Sprinkler

System (AASS) – Philosophical Change:– Fire Barrier Separation

– Evacuation Critical

• QR – Residential Heads Sprinkler Protection– Sprinklers Heads As Life Saving Devices

– Glass Allowed but Smoke Tight Walls?

– Reduction in Barriers and Dampers Use


Building Separations – Fire Barriers


Fire Barriers & Door Assemblies

• Hazardous Areas:– Soiled utility rooms

– Store & supply rooms – size critical on design

– Equipment Rooms

– Oxygen storage rooms

– Mechanical & boiler rooms

– Trash & chute rooms

– Maintenance shops

– Paint shops


Floors-Shafts-Smoke Containment

• Mechanical Rooms & Shaft Design

• Vertical Sections of Hospitals– Floor to Floor Separation

– Shaft to Floor

– Floor Penetrations


Open Stairs & Shaft Walls

• Connecting Floor Levels: – Stairs

– Ventilation Shafts

– Pipe Shafts

– Electrical Shafts

– Lobbies-Atriums

– Open Stair Exceptions

– Smoke Control


Smoke Barrier Doors & Walls


Smoke Barrier Compartment Zones

• Define Areas of Refuge w/ Horizontal Evacuation

• Options to Total Evac.– RACE Terminology

• Rescue

• Alarm

• Control

• Evacuate or Extinguish


Security Doors – Special Locking or Access Control


Questions ?

building codes & standards for healthcare · 1/8/2020 · healthcare construction certificate...

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