NFPA Notes

NFPA Notes

All areas of the building shall be accessible:  All areas of the facility must be accessible during all shifts by the charge nurse (or another designated staff, i.e. security) so that in the case of a fire, staff (including emergency response staff) can find and fight the fire (when possible). Reports show that recently facilities in varying areas of the country have had fires in areas that were locked (such as laundry rooms or the kitchen) during the evening/night shifts. When the fire alarm system sounded, staff did not have a key accessible to gain entry into the locked areas causing a delay in the response time.


  • NFPA 2012 101,

For health care occupancies, the proper protection of patients shall require the prompt and effective response of health care personnel.


  • NFPA Standard: 2012 NFPA 101,

All health care facilities shall be designed, constructed, maintained, and operated to minimize the possibility of a fire emergency requiring the evacuation of occupants.


  • NFPA 101 2012,

Emergency plans shall include the following:

(1) Procedures for reporting of emergencies

(2) Occupant and staff response to emergencies

(3) Evacuation procedures appropriate to the building, its occupancy, emergencies, and hazards (see Section 4.3)

(4) Appropriateness of the use of elevators

(5) Design and conduct of fire drills

(6) Type and coverage of building fire protection systems

(7) Other items required by the authority having jurisdiction


  • NFPA 2012 101,

Where means of egress doors are locked in a building that is not considered occupied, occupants shall not be locked beyond their control in buildings or building spaces, except for lockups in accordance with 22.4.5 and 23.4.5, detention and correctional occupancies, and health care occupancies.

Fire Reporting

Fire Reporting

19 CSR 30-85.022 (2) (F) for Skilled Nursing Facilities/Intermediate Care Facilities (SNFs/ICFs) and 19 CSR 30-86.022 (2)(C) for Residential Care Facilities (RCFs) and Assisted Living Facilities (ALFs) require that all facilities shall notify the department immediately after the emergency is addressed if there is a fire in the facility or premises and shall submit a complete written fire report (attached) to the department within seven (7) days of the fire, regardless of the size of the fire or the loss involved.


The Section for Long-Term Regulation defines fire as used in relation to fire/safety requirements as follows:  Fire is the active principle of burning, characterized by combustion.  This energy is evident when heat and/or smoke and/or light are present as the result of combustion.  Smoke is a product of combustion, and any time smoke is given off, combustion has occurred whether or not there has been a visible flame. Besides the obvious, some often-overlooked examples of fire include but are not limited to the following:

  • Smoking air conditioner unit or heater (whether or not the fire department responded);
  • Smoking pads or mop heads in the dryer (whether or not the fire department responded); and
  • Smoking trash in a waste receptacle (whether or not the fire department responded).


The facility submitted fire report must include the following:

  • A brief narrative of the event in the comments section of the report or in an attachment;
  • Documentation regarding whether or not the fire alarm and/or sprinkler system activated (if applicable) and if/when the system was back in service (if applicable);
  • In addition, the narrative must show whether or not fire extinguishers were used, and if so, when they were recharged or replaced;
  • A copy of the fire department report if the fire department responded; and
  • If a fire can be attributed to a particular person, the report must include identifying information for that person.

Emergency Protocol Update/Reminder

Emergency Protocol Update/Reminder

SLCR developed a protocol 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.


The phone number for Region 5 (Macon) has changed. This is the only change to the document attached.

MLN Emergencies, Disasters, and Lessons Learned: Are You Really Ready?

MLN Emergencies, Disasters, and Lessons Learned: Are You Really Ready?

  • November 16, 2016:  Macon
  • November 17, 2016:  Jefferson City

This presentation will discuss emergencies, disasters, risk assessment, and lessons learned from case studies. The presentation will provide participants with specific suggestions to help be better prepared in the event a disaster does occur.

Please see the Workshop brochure and more information including registration here.

Hurricane Sandy: A Lesson in Survival

Why it is important to have an emergency plan in place.  This article focuses on October 22, 2012 and sometime following, when the largest Atlantic hurricane on record left the East Coast in a state of emergency.  Read and understand what it was like as nursing homes were evacuated.  You also get a description of some challenges crews faced as well as the lessons learned from the experience.

Please see the full article from Long Term Living – July/August 2015 here.

Missouri Severe Weather Awareness Week

March 3 – 7, 2014:  Missouri Severe Weather Awareness Week

March 4, 2014:  Annual Missouri Severe Weather Drill

The annual drill will be held on March 4th, 2014, at 1:30 p.m.  In case of actual severe weather on March 4th, the drill will be postponed until Thursday, March 6th, also at 1:30 p.m.  For more information, visit SEMA at

Emergency Preparedness Winter Weather Special Update February 4, 2014

LTC Information Special Update  February 04, 2014 

The Section for Long-Term Care Regulation is sending the following weather-related reminders in light of Missouri’s considerable snowfall and ice accumulation across the state.  Please take time to familiarize yourselves with your home’s emergency plan, double-check your emergency reserves of food and other disaster-related preparedness items, and know that your service to the elderly in all types of weather is appreciated.

Winter Weather Information

Emergency Protocol for Long-Term Care Homes

The Emergency Protocol was developed in 2007 for communication between long-term care homes and the Section for Long-Term Care Regulation, 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 main office telephone number during normal business hours, as survey staff carry the emergency 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

Missouri regional map: – click on Long Term Care Regions

Disaster and emergency planning resources:

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

Ensure Your Local EMD has a Copy of Your Home’s Current Emergency Plan

Missouri is again experiencing extreme weather conditions, and there is a chance of even more inclement weather in the forecast.  The Section for Long-Term Care Regulation would like to remind you there are emergency preparedness representatives in your community to help you with emergency planning and are there to help in the event of a disaster.

You can find your local emergency management director (EMD) on the State Emergency Management Agency’s (SEMA) website at  Scroll down to Contact Your Local Emergency Management Agency and choose your county.

State regulations require all long-term care homes to provide a copy of their emergency plan to their local EMD.  Please reference the following regulations:

19 CSR 30-85.022 (33) and 19 CSR 30-86.022 (5)(A) All facilities shall have a written plan to meet potential emergencies or disasters and shall request consultation and assistance annually from a local fire unit for review of fire and evacuation plans.  If the consultation cannot be obtained, the facility shall inform the state fire marshal in writing and request assistance in review of the plan.  An up-to-date copy of the facility’s entire plan shall be provided to the local jurisdiction’s emergency management director.

For additional information regarding emergency preparedness, please contact Melissa Hope, Planner II, Division of Regulation and Licensure at

Resources are also available on the Department of Health and Senior Services website,