ICC GOVERNMENT RELATIONS NEWS

ICC Files Comments on CMS Proposals that Address Codes Required by Hospital and Healthcare Facilities

The Code Council has filed comments on two rulemaking proposals issued by the federal Centers for Medicare and Medicaid Services (CMS). The two proposals address separate areas, but are of real importance to the code community as both address codes required to be followed by hospital and healthcare facilities. Traditionally, since “Conditions of Participation” for hospitals and healthcare facilities were established under the Social Security Act and its amendments over the years, CMS has required all such facilities to adhere to the NFPA 101 Life Safety Code (LSC). Current regulations require compliance with the LSC, 2000 edition. Originally, when the Conditions were first established, there was no national fire or building code and the only national code that addressed fire and life safety issues was the NFPA LSC. In the first proposed rule, CMS proposed to reform regulations that CMS identified as “unnecessary, obsolete, or excessively burdensome.” The first of such reforms was a proposal to eliminate the requirement for End Stage Renal Disease (ESRD) facilities to comply with the regulation requiring compliance with the NFPA LSC, 2000 edition. CMS noted that the LSC requirements “duplicate many provisions of already existing State and local fire safety codes covering ESRD facilities.” CMS noted that there is an extremely low risk of fire in ESRD facilities, and that the costs of compliance with the LSC are high, “with little or no improvement in patient safety from fire…” ICC filed comments agreeing with the CMS proposal, and suggested that rather than try to carve out special situations where the LSC would apply, as the rule had proposed, that CMS set a simple baseline of requiring LSC compliance only for facilities that were not located in jurisdictions that had adopted the International Building Code and the International Fire Code or equivalent. The second rulemaking was a more general proposal, addressing several elements of the CMS Conditions of Participation for healthcare facilities, including the requirements for “Physical Environment” that currently require all healthcare facilities that wish to receive Federal payments to adhere to and be inspected to comply with NFPA LSC, 2000 Edition . The proposal indicated that in a future rulemaking, CMS intended to propose updating the current requirement to require use of the 2012 edition of the NFPA LSC. The Code Council filed comments strongly encouraging CMS to follow its own logic in the ESRD rulemaking, and allow for the use of either the IFC and IBC, as implemented and enforced at the State and local level, or the LSC, as currently required, rather than simply updating the edition of the LSC. ICC’s comments made reference to the recent Final Rule from the Occupational Safety and Health Administration (OSHA), that determined that employers whose facilities meet the requirements of the 2009 IFC would be deemed to comply with the OSHA “Exits Routes and Emergency Planning” requirements, just as OSHA had earlier recognized the LSC as evidence that the employer was in compliance with those OSHA regulations. The Code Council further argued that the savings across the universe of hospital facilities that currently must comply with both LSC and IFC/IBC requirements would exceed $6 billion, and make a real impact in saving money in the healthcare realm, for patients, hospitals and for the Federal government, which pays for many services at these hospitals. As with all Code Council formal comments and statements, these comments can be accessed and read from the ICC Government Relations page by clicking here.