REGULATORY REVIEW


tions be protected by a firestop system or device. In the LSC, this provision applies to both new construction and existing buildings. ASCA requested that existing facilities be exempted from this requirement as it would be a costly burden that would require exist- ing wires and other penetrating ele- ments to be removed and reinstalled. CMS finalized its proposal for fire protection requirements for penetra- tions, requiring a firestop system or device. As ASCA requested, however, CMS will not apply this requirement to existing facilities.


NFPA 99


CMS proposed to adopt the 2012 edi- tion of NFPA 99, with the exceptions of: Chapter 7 (Information Technol- ogy and Communication Systems for Health Care Facilities); Chapter 8 (Plumbing); Chapter 12 (Emergency Management) and Chapter 13 (Secu- rity Management).


The 2012 edition requires a number of changes affecting ASCs, including: ■


more stringent requirements on HVAC System Design (meeting ANSI 170 requirements);


■ ■


new requirements for special ground fault protection in all operating rooms;


more stringent requirements in piped medical gas systems which applies to health care facilities that require a Category 1 system (which applies to ASCs based on the definitions); and


■


a significant increase in the minimum number of power receptacles (from six to 36) for general cases, recoveries and operating rooms.


ASCA suggested that ASCs


should be exempted from the ANSI 170 requirements for HVAC systems and that CMS should maintain cur- rent requirements regarding electrical and medical gas systems, ground fault protection, piped medical gas systems and power receptacles. CMS clarified that the new requirements would apply only to new construction and new


22 ASC FOCUS AUGUST 2016


Although most of the changes are effective July 5, 2016, ASCs have until July 5, 2017, to comply with this requirement.”


—Kara Newbury, ASCA


equipment, but also finalized the adop- tion of NFPA 99 for all of the areas listed above.


Windowless Anesthetizing Locations In addition to specific citations from NFPA 101 and NFPA 99, CMS also proposed a new ASC requirement that previously applied only to hospitals in rooms where inhalation anesthesia was used. This proposed requirement would require new and existing facilities with “windowless anesthetizing locations to have a supply and exhaust system that automatically vents smoke and prod-


Track the Latest Regulatory and Legislative News for ASCs


Visit ASCA’s web site every week to stay up to date on the latest government affairs news affecting the ASC industry. Every week, ASCA’s Government Affairs Update newsletter is posted online for ASCA members to read. The weekly newsletter tracks and analyzes the latest legislative and regulatory developments concerning ASCs.


www.ascassociation.org/ GovtAffairsUpdate


ucts of combustion, prevents recircu- lation of smoke originating within the operating room, and prevents the cir- culation of smoke entering the system intake.” ASCA strongly opposed this requirement, as it was removed from the 2012 edition of NFPA 101 and had never been applied to ASCs previously. ASCA noted significant costs associ- ated with this new requirement for new facilities and significantly cost- lier requirements for existing facilities. CMS agreed that “requiring the instal- lation of smoke ventilation systems would not be an effective use of hospi- tal and ASC resources.” CMS did not finalize this proposal and removed this requirement from the regulation text as ASCA requested.


Implementation As previously mentioned, unless spec- ified otherwise, the provisions took effect July 5, 2016. CMS partners with State Agencies (SA) to assess facili- ties’ compliance with the LSC require- ments. SAs may contract with the state fire marshal offices or other state agen- cies responsible for enforcing state fire code requirements to perform the life safety surveys. In most cases, the SA schedules the LSC survey to coincide with the health survey; the timing of the LSC survey, however, is left to the discretion of the SAs.


Unreasonable Hardship/Waivers The LSC provides that in cases of unrea- sonable hardship, a waiver may be granted where it would not adversely affect resident health and safety. CMS will allow facilities to apply for waiv- ers from certain requirements before the facility is cited for a deficiency. Pre- viously, waivers were not considered unless there was a cited deficiency found during a fire-safety survey.


Kara Newbury is ASCA’s regulatory counsel. Write her at knewbury@ascassociation.org.


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