Healthcare Facilities Offer Unique Challenges

Are fire alarm system requirements for healthcare facilities different than for other occupancies? Are the requirements for fire alarms different from one code to another? Today, there are two new building codes available. The International Building Code is a consolidation of the three existing model building codes (BOCA’s National Building Code, ICBO’s Uniform Building Code, and SBCCI’s Standard Building Code1) and NFPA 5000, Building Construction and Safety Code. The NFPA 101, Life Safety Code, is also used extensively in healthcare applications.

Life safety in healthcare facilities is unique in the respect that not all occupants are ambulatory. Therefore, staff training and a defend-in-place strategy are both vital parts of the fire protection plan. There are special concerns due to the occupants’ ability to respond to fire alarm signals on their own accord. As described in Chapters 18 and 19 of the Life Safety Code, as well as in Chapter 19 of NFPA 5000, “All healthcare facilities shall be designed, constructed, maintained, and operated to minimize the possibility of a fire emergency requiring the evacuation of occupants. Because the safety of healthcare occupants cannot be ensured adequately by dependence on evacuation of the building, their protection from fire shall be provided by appropriate arrangement of facilities, adequate staffing and development of operating and maintenance procedures composed of the following: 1) design, construction and compartmentation; 2) provision for detection, alarm and extinguishment; and 3) fire prevention and the planning, training and drilling programs for the isolation of fire, transfer of occupants to areas of refuge, or evacuation of the building.”

NFPA 101, Life Safety Code, and NFPA 5000, Building Construction and Safety Code, have essentially the same requirements for fire alarm system for new healthcare occupancies.

Both NFPA 101 and NFPA 5000’s healthcare chapters apply to facilities providing housing on a 24-hour basis for four or more persons, and are occupied by persons who are mostly incapable of self-preservation because of age, physical or mental disability, or because of security measures not under the occupants’ control.

Both NFPA 101 and 5000 require manual fire alarm systems, but allow the fire alarm boxes in patient sleeping areas to be eliminated if located at nurses stations or other constantly attended areas. Detection devices would include devices like duct detectors, smoke detectors used to close smoke doors, and/or elevator, lobby and machine room smoke detectors.

In nursing homes, an automatic smoke detection system is required in corridors throughout smoke compartments containing patient sleeping rooms and in spaces open to corridors. If patient sleeping rooms are protected with system smoke detectors, corridor smoke detectors are not required. Corridor smoke detectors can also be eliminated where patient room doors have automatic door-closing devices with integral smoke detectors on the room side and these detectors provide occupant notification.

Doors in exit passageways, stairway enclosures, horizontal exits, smoke barriers, or in hazardous area enclosures are allowed to be held open only by automatic release devices. Activation of the building sprinkler system or fire alarm system will release all the doors either in the smoke compartment or in the entire facility.

Smoke dampers are not required in duct penetrations of smoke barriers in fully ducted HVAC systems for building protected throughout by an approved, supervised automatic sprinkler system. Supervised means monitored at an approved monitoring facility. This is important because in many cases, duct smoke detectors must be installed at each damper location to close the damper.

NFPA 101 and NFPA 5000 require manual fire alarm boxes in the natural exit access path from an area. There are no corridor smoke detection systems required.

The International Building Code (IBC) separates fire alarm requirements by Use Group. Group I-1 (Institutional) occupancies include facilities housing more than 16 persons on a 24-hour basis, who live in a supervised residential environment that provides personal care services. These would include residential board and care facilities, assisted living facilities, halfway houses, group homes, congregate care facilities, social rehabilitation facilities, alcohol and drug centers and convalescent facilities. Group I-2 facilities include care on a 24-hour basis for more than five persons who are not capable of self-preservation. They include hospitals, nursing homes, mental hospitals and detox centers.

Manual fire alarm systems and an automatic fire detection system are required in Group I occupancies. In addition, a supervised, automatic smoke detection system is to be provided in waiting areas that are open to corridors.

Corridors in nursing homes, detox centers and spaces open to the corridors are required to have an automatic fire detection system with two exceptions. Corridor smoke detectors are not required where patient sleeping rooms are equipped with system smoke detectors and these detectors provide visible indication in the corridor outside of the patient sleeping room as well as an audible and visible signal at the nurse’s station.



HAMMERBERG is president, education for the Automatic Fire Alarm Association and is responsible for the association's education programs. He is on the NFPA 72 Technical Committee for Inspection, Testing and Maintenance and is the editor of the 2002 NFPA 72 Handbook for the chapter on Inspection, Testing and Maintenance. He can be reached at


About the Author

Thomas P. Hammerberg

Life Safety Columnist
Thomas P. Hammerberg, SET, CFPS is president of Hammerberg & Associates Inc. He serves as Director of Industry Relations for the Automatic Fire Alarm Association (AFAA) Inc. and represents the association on a number of NFPA committees, including the...

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