Category: Life Safety Code/Recalls

Safety Reminders: Holiday Decorations

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It is that time of year when people are decorating their homes and businesses with festive décor and anticipating upcoming holiday celebrations.  Residents and staff in your care home also look forward to festivities and enjoy holiday decorations.  It is important for residents, staff and visitors to carry on traditions and to feel a sense of joy and peace we all want this time of year.

The Section for Long-Term Care Regulation (SLCR) wants to help you and your residents have a safe holiday season by sending out the following safety tips, references and regulatory reminders.

Fires or other accidents are not something anyone wants! 

Safe decorations include:

  • Artificial Christmas trees, and decorations that are non-combustible or flame retardant.
  • UL approved decorative lighting (use in supervised areas and turn off when not in use).
  • UL approved outdoor lighting.
  • Holiday decorations, including evergreen wreaths, ornaments, photos, etc. can be used on resident’s doors, and in hallways, as long as they do not exceed 3 ½” in depth and they are not blocking the entrances or exits.*

*Any combustible decorations hung from doors or walls in corridors may be used with a waiver.  Non-rated combustible decorations cannot exceed 20% of the wall space in an exit egress corridor.

SLCR published an article regarding holiday decorating in the winter 2011 edition of the quarterly newsletter.  Please visit http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

Although the 2000 Edition National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) is the official reference, the 2012 Edition contains some less restrictive requirements.  Please refer to the CMS memo regarding waivers here: CMS Memo S&C 13-58-LSC 2000 Edition National Fire Protection Association (NFPA) 101® Life Safety Code (LSC) Waivers, or visit the CMS website at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html.

Prohibited decorations include displays, hangings, and other decorations that block exits, visibility of exits, or fire protection appliances.  Never hang decorations from fire sprinkler heads or pipes.

NFPA 101, Section 19.7.5.4:  Combustible decorations shall be prohibited in any health care occupancy unless they are flame retardant.

NFPA 101, Section 7.1.10.1:  Means of egress shall be continuously maintained free of all obstructions or impediments to full instant use in the case of fire or other emergency.

NFPA 101, Section 7.1.10.2.1:  No furnishings, decorations, or other objects shall obstruct exits, access thereto, egress therefrom, or visibility thereof.

 

Please note, some county or city local ordinances may also require compliance with more restrictive standards, including the International Fire Code (IFC).

 

  • F323:  Electrical Safety – Any electrical device, whether or not it needs to be plugged into an electric outlet, can become hazardous to the residents through improper use or improper maintenance.  Electrical equipment such as electrical cords can become tripping hazards.  Halogen lamps or heat lamps can cause burns or fires if not properly installed away from combustibles in the resident environment.  The Life Safety Code prohibits the use of portable electrical space heaters in resident areas.

 

 

  • Can candles be used in nursing homes under supervision, in sprinklered facilities?

CMS Memo S&C-07-07:  Nursing Home Culture Change Regulatory Compliance Questions and Answers

Answer: Regarding the request to use candles in sprinklered facilities under staff supervision, National Fire Protection Association data shows candles to be the number one cause of fires in dwellings.  Candles cannot be used in resident rooms, but may be used in other locations where they are placed in a substantial candle holder and supervised at all times while they are lighted.  Lighted candles are not to be handled by residents due to the risk of fire and burns.

This holiday season, consider using battery-operated flameless candles.  They look and smell real!  Learn more about candle fire safety from the U.S. Fire Administration at www.usfa.fema.gov/citizens/home_fire_prev/holiday-seasonal/holiday.shtm.

If you have any questions regarding the Life Safety Code, please contact SLCR at 573-526-8524.  We wish you a wonderful and safe holiday season.

Change Your Clock – Change Your Batteries!

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When you change your clocks, do not forget to replace your smoke alarm and CO detector batteries.  Daylight Saving Time ends on Sunday, November 3, 2013.  For more safety tips, visit the U.S. Consumer Product Safety Commission (CPSC) at http://www.cpsc.gov/Newsroom/Multimedia/?vid=61711.

View the news release here:  www.cpsc.gov/en/Newsroom/News-Releases/2014/CPSC-Urges-Consumers-to-Replace-Batteries-in-Smoke-and-CO-Alarms-When-Turning-Clocks-Back-/.

SHOW-ME QUALITY – QAPI IN ACTION Webinars

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August 9, 2013:  Resident Safety Culture Success Stories

Learn about the National TeamSTEPPS program and Just Culture.  For more information, please visit Primaris at www.primaris.org/node/1715 or Click Here to Reserve your Webinar seat now.

August 20, 2013:  Summary of CMS Updates for Antipsychotic Medication Use for People with Dementia

Tracy Niekamp, Missouri Department of Health and Senior Services, will provide a summary of the recently updated guidelines survey teams will use to investigate and determine compliance regarding antipsychotic medication use for people with dementia.  Valuable resources and insights will be shared regarding compliance and quality care.  For more information, please visit Primaris at www.primaris.org/node/1715 or Click Here to Reserve your Webinar seat now.

Long-Term Care Emergency Preparedness Report 2012/2013

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The Section for Long-Term Care Regulation (SLCR) conducted the fifth annual Emergency Preparedness Survey of all licensed long-term care homes in Missouri.  SLCR received 538 completed surveys and would like to thank the homes that responded.  For the first time, SLCR also conducted an Emergency Generator Survey that asked specific questions regarding a home’s electrical generator capacity.  819 long-term care homes completed this survey.  SLCR welcomes any questions concerning the surveys or emergency preparedness planning at 573-522-1333.  The new report is available on our website, please visit http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

MC5 Regional Meetings – July 2013

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East – July 12, 2013:  Is our Iceberg Melting too?  An Expedition Toward Consistent Assignment

Brentwood Community Center, Room 104, 2505 S. Brentwood Blvd., Brentwood.  RSVP to Ruthie, rrochman@alz.org or 314-801-0446.

Southwest – July 16, 2013:  Food and Dining – Dining with Friends

Council of Churches, 627 N. Glenstone, Springfield.  RSVP to cindybutler@mchsi.com.

Northwest – July 17, 2013:  Life Safety Code and Culture Change

East Hills Library, 502 N. Woodbine Rd., St. Joseph.  RSVP to Karen Fletchall, wccc.karen@yahoo.com, 660-564-3304, or Freda Miller, fmiller@nwmoaaa.org, 660-822-6209.

Route 71 – July 19, 2013:  Interact III

Community Center, 200 N. Ash, Nevada.  RSVP to sghouser@medicalodges.com.

West – July 24, 2013:  Staff Turnover and Open Forum with DHSS

St. Mary’s Manor, 111 Mock Ave., Blue Springs.  RSVP to Kathy Vogt or Leslie Carter at 816-228-5655.

Please visit the Missouri Coalition Celebrating Care Continuum Change (MC5) website for details!

CMS Life Safety Code Reminders

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  • Fire extinguishers should not be mounted over five feet from the floor to the top of the extinguisher

 Fire extinguishers having a gross weight not exceeding 40 pounds shall be installed so that the top of the fire extinguisher is not more than 5 feet above the floor.  Fire extinguishers having a gross weight greater than 40 pounds shall be so installed that the top of the fire extinguisher is not more than 3 ½ feet above the floor.  In no case shall the clearance between the bottom of the fire extinguisher and the floor be less than 4 inches.  1998 NFPA 10, 1-6.10.

  • A facility which allows smoking needs to have a metal container with a self-closing cover provided in the area.  A smokers urn, only meets the requirement of an ashtray of safe design.  Providers are under the impression that if these urns are metal that they meet the requirement of the container with a self-closing cover

Metal self-closing containers for disposing of cigarette butts and ashes from ashtrays, and ashtrays of noncombustible material and safe design, shall be provided in all areas where smoking is permitted as required in NFPA 101, 18/19.7.4.

  • Facilities need to have a zone evacuation plan in their fire emergency procedures

The administration of every health care occupancy shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of a fire, for their evacuation to areas of refuge, and for their evacuation from the building when necessary.  All employees shall be periodically instructed and kept informed with respect to their duties under the plan.  A copy of the plan shall be readily available at all times in the telephone operator’s position or at the security center.  The provisions of 19.7.1.2 through 19.7.2.3 shall apply.  2000 NFPA 101, 18/19.7.1.1.

A written health care occupancy fire safety plan shall provide for the following:  1) Use of alarms 2) Transmission of alarm to the fire department 3) Response to alarms 4) Isolation of fire 5) Evacuation of immediate area 6) Evacuation of smoke compartment 7) Preparation of floors and building for evacuation, 8 Extinguishment of fire.  2000 NFPA 101, 18/19.7.2.2.

CMS website:  https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/LSC.html

National Fire Protection Association (NFPA) website:  http://www.nfpa.org/

Nursing Home Leadership Assistance

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In cooperation with the Missouri Department of Health and Senior Services, the MU Sinclair School of Nursing at the University of Missouri offers a Nursing Home Leadership Coaching Service to assist nursing home administrators and key operational leaders to meet the leadership challenges of the long-term care industry.  The services offered focus on helping nursing home administrators deal effectively with the complex management issues they face each day in their business and personnel operations.  The coaching is tailored to meet individual administrator needs within the context of each person’s unique operational situations, as well as within the variety of corporate and business models in Missouri.  Designed as a voluntary service, the Nursing Home Leadership Coach assists with such issues as Operational Improvement, Corporate Compliance, Budget Analysis, Regulations, Process Improvement Leadership Skills, Staff Retention, Contract Review, Survey Readiness, Staff Training, Quality of Life, and Culture Change.  The Coaching Service works collaboratively with our existing QIPMO program.  Dave Walker, LNHA, functions as the NHA Coach.  Nursing home administrators interested in consulting with Mr. Walker should contact Jessica Mueller, Project Coordinator at the MU Sinclair School of Nursing at (573) 882-0241 or by e-mail at muellerjes@missouri.edu.  Please visit: http://nursinghomehelp.org/coaching.html

  •  Nursing Home Survey Manual:  Resource Available!

Dave Walker, MU NHA Coach, has created a Long-Term Care Survey Manual for use by nursing home staff.  The purpose of the manual is to provide guidance on how to comply with State and Federal regulations.  The manual offers numerous forms and policies for nursing homes to consider using in order to prepare for their annual survey visit.  The manual is available at http://nursinghomehelp.org/, and may be downloaded by section or in its entirety.

2012 Annual Long-Term Care Provider Meetings

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Sponsored by the Missouri Department of Health & Senior Services, Section for Long-Term Care Regulation (SLCR).

Topics Include:

    SLCR Updates / Rule Changes  Regulatory Update Provider Meetings 2012

    CPR and Elopement Issues  CPR and Elopement Provider Meetings 2012

    2012 Life Safety Code  Life Safety Code Update Provider Meetings 2012

    New Dining Practice Standards New Dining Practice Standards Provider Meetings 2012

    Update from the Missouri Coalition Celebrating Care Continuum Change (MC5)

Please view the flyer and agenda here:   2012 ANNUAL PROVIDER MEETINGS

National Scald Prevention Campaign

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The Missouri Division of Fire Safety in conjunction with the National Scald Prevention Steering Committee

The Division of Fire Safety has made the Scald Prevention Brochure available for distribution.  Fire Safety Inspectors will also distribute the brochure when they conduct facility inspections.  The brochure is printed in both English and in Spanish.  Please visit the website for more information:  http://www.dfs.dps.mo.gov/

Emergency Protocol for Long-Term Care Homes

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The Emergency Protocol was developed in 2007 for communication between long-term care homes and the Section for Long-Term Care Regulation (SLCR), in the event a disaster occurs that results in a loss of a necessary service.  (Electricity, water, gas, telephone, etc.)  This protocol was established to streamline communication so that homes can focus on what is most important – the safety and well-being of the residents.

This protocol provides the cellular telephone number corresponding to the region in which your home is located if you experience a loss in a necessary service that has the potential to affect resident safety or well-being.  You are encouraged to contact the regional office main office telephone number during normal business hours as survey staff carry the cell phone and may be conducting a survey or inspection during working hours and may not answer immediately.  Please remember, this protocol is NOT to be used to self-report incidents normally reported to the Elderly Abuse & Neglect Hotline (1-800-392-0210). 

Region

Main Office

Emergency Only Cell Number
#1 Springfield

(417) 895-6435

(417) 425-8780
#2 Poplar Bluff

(573) 840-9580

(573) 778-6495
#3 Kansas City

(816) 889-2818

(816) 719-0089
#4 Cameron

(816) 632-6541

(816) 632-9371
#5 Macon

(660) 385-5763

(660) 651-1468
#6 Jefferson City

(573) 751-2270

(573) 619-3338
#7 St Louis

(314) 340-7360

(314) 623-2852

The State of Missouri map outlining the counties in each region is available at http://health.mo.gov/seniors/nursinghomes/providerinfo.php.

Additional resources for disaster and emergency planning are available at http://health.mo.gov/emergencies/.

If you have any questions about the Emergency Protocol, please contact the Section for Long-Term Care Regulation at 573-526-8524.

Sprinkler Maintenance During Freezing Conditions

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There are two major types of fire sprinkler systems; wet pipe and dry pipe. Wet pipe systems means the sprinkler pipes are always filled with water. Dry pipe systems means that most pipes are filled with pressured air – these systems may contain some water from condensation or improper draining of the system after testing.

When water inside pipes freezes, the ice will expand and that expansion can break pipes and fittings, causing leaks and loss of water or air pressure (loss of air pressure in a dry pipe system will cause water to flow into the pipes). The expansion could also force open sprinkler heads, causing accidental activation when these pipes thaw out. All wet pipe and dry pipe control valves must be kept at 40 degrees Fahrenheit to prevent freezing. NFPA 25 requires a daily inspection of enclosures to monitor temperatures around dry-pipe valves. If you have a low temperature alarm installed, then a weekly inspection is required.

If leaks are suspected, the best and easiest way to determine the location of these leaks is through visual inspection. Inspect every piping joint and sprinkler head on the entire system and while doing so, try to determine how well the sprinkler heads are connected to the system (DO NOT DAMAGE SPRINKLER HEADS).

If a sprinkler system is leaking water, contact the sprinkler company immediately. Most likely, the sprinkler company will give instructions to shut the water supply off to the system to prevent or reduce the water damage to the facility. If the sprinkler system is not in full service within 4 hours the facility is required to institute a fire watch. (It would be prudent to start a fire watch prior to this time frame if you know it could be some time before the sprinkler system is on line again.) When instituting a fire watch, the facility is required to contact the Section for Long-Term Care Regulation and the local fire authorities in order to coordinate a response to any fire event.