Officials disagree on smoke alarm requirements for nursing homes

Wednesday, August 20, 2008 | 1:56 p.m. CDT

JEFFERSON CITY - Health officials are planning to draft new fire rules for Missouri's long-term care facilities that likely won't mandate smoke detectors in every room.

A fire at a southwest Missouri group home that killed 11 people in November 2006 prompted lawmakers to require most assisted living, skilled nursing and residential care facilities to install complete fire alarms system by the end of this year and sprinklers by the end of 2012. It also gives the state fire marshal authority to inspect the facilities.

But the Department of Health and Senior Services - responsible for drafting rules to implement that law - and the state fire marshal have disagreed over whether to require bedroom smoke detectors as part of a complete fire alarm system.

A committee of lawmakers that can review proposed administrative rules and reject those that go beyond state law has now become involved. It voted 9-0 last week to reject the proposed fire rules that included the bedroom smoke detector mandate.

The Health Department's original proposed rules required smoke detectors be spaced no more than 30 feet apart in a facility's corridors and hallways. But the fire marshal pushed to require smoke detector in every bedroom.

Debra Cheshier, deputy director for the Health Department's division of regulation and licensure, said there had been "professional disagreement" between the Health Department and the fire marshal.

"There was not tension, but we did have some disagreements," she said.

Cheshier said that the department is now rewriting the proposed rules. She said the next draft likely will drop the rule requiring smoke detectors in all bedrooms. But the overall fire regulations will force many long-term care facilities to have some fire precautions in bedrooms, such as sprinklers.

State Fire Marshal Randy Cole did not immediately return a call Wednesday seeking comment.

The heightened fire safety requirements approved by lawmakers in 2007 requires that smoke detectors be wired to a fire alarm system that includes visual and audible alarms and is connected to the fire department.

Investigators believe that in 2006 a fire smoldered in the attic of the Anderson Guest House before bursting through the ceiling. The facility for the mentally ill and disabled was not equipped with sprinklers.

The facility's owners had been cited for previous fire safety violations at the several southwest Missouri facilities they operated. All four of their group homes are now closed, and the owners face charges of money laundering, conspiracy and health care fraud.

Jon Dolan, the head of the nursing home trade-group Missouri Health Care Association, said most skilled nursing facilities already have sprinklers and fire alarm systems. He estimated the average cost for a care facility to install bedroom smoke detectors at $25,000 to $35,000. But he said it could cost some nursing homes up to $150,000.

"The fire marshal came into the process late and created his own rules without statutory authority," Dolan said.

Lobbyists from several trade groups that represent long-term care facilities had urged lawmakers to reject the proposed fire safety rules.

Sen. John Griesheimer, who suggested rejecting the fire rules, said that the expense of adding the smoke detectors could put some facilities out of business.

"Maybe they were in the best interest of the most vulnerable, but if that's what we need to do, then we need to go back and change the law and not propose rules that go beyond the intent of the legislature," said Griesheimer, R-Washington.

Proposed Health Department rules for the sprinkler requirement also have prompted criticism from the long-term care industry. Lawmakers gave facilities with up to 20 beds until the end of 2012 to install sprinklers. But facilities that have "major" renovations must immediately install a sprinkler system.

The legislation left it up to the department to decide what was a major renovation and what was a small construction project. Some of the care facility trade-groups don't like the department's definition, which counts the addition of any room that is accessed by residents.

Denise Clemonds, the chief executive officer for the Missouri Association of Homes for the Aging, said that's too broad and goes beyond federal requirements. She said many facilities would face a quick deadline for installing sprinklers.



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