Medicare Compliance & Reimbursement

New proposed rule goes beyond CMS' March 2005 smoke-alarm requirement.

If you want to continue serving Medicare and Medicaid beneficiaries in your nursing home, you must install sprinkler systems throughout your buildings, according to a new proposed rule.

The Centers for Medicare & Medicaid Services (CMS) is pushing forward in its crackdown on fire safety in nursing homes, says an Oct. 27 agency announcement. In March 2005, the agency required all nursing homes without sprinkler systems to install battery-operated smoke detectors in all public areas and patient rooms, and throughout 2004 and 2005, CMS has increased its number of life-safety code (LSC) inspections by 17.

Now CMS wants nursing homes to take their fire-safety efforts a step further by installing sprinkler systems. "Under existing CMS regulations, newly constructed nursing homes and nursing homes undergoing major renovations, alterations or modernizations must be equipped with sprinkler systems," the agency says. "Currently, older homes are not required to have such systems."

Warning: If this proposed rule becomes final, CMS may bar any nursing home that doesn't comply with the rule from continuing to serve Medicare and Medicaid beneficiaries.

"Automatic sprinkler systems are integral to increasing safety in nursing homes, and we look forward to their installation in all of the nursing homes across the country," acting CMS administrator Leslie V. Norwalk said in a statement. "We appreciate the collaboration of the National Fire Protection Association [NFPA] and stakeholders throughout the industry in making these safety improvements as soon as possible."

All new sprinklers that nursing homes install will have to meet NFPA technical specifications, CMS notes.

The comment period for the proposed rule ends on Dec. 26, 2006, and CMS is looking for "public and industry input on an appropriate phase-in time to allow older homes to retrofit their facilities."

To view the proposed rule, go to http://a257.g.akamaitech.net/7/257/2422/01jan20061800/edocket.access.gpo.gov/2006/pdf/E6-17911.pdf.

By the end of 2006, CMS also plans to publish the number of LSC violations and smoke alarm and sprinkler system information on all nursing homes in the United States on its Nursing Home Compare Web site, the agency reports.