October 22, 1975
Page 33516
By Mr. HATHAWAY (for himself and Mr. MUSKIE):
S. 2558. A bill to amend title XVII of the Social Security Act to provide for the updating of the life safety requirements which are applicable to nursing homes. Referred to the Committee on Finance.
Mr. HATHAWAY. Mr. President, I am pleased to introduce today along with Senator MUSKIE a bill which would make the 1973 Life Safety Code applicable to skilled nursing facilities under title XVIII and XIX of the Social Security Act, rather than the currently mandated sole standard of the 1967 Life Safety Code.
Our bill is similar to S. 1563 as introduced by Senator Moss who has done such valuable work in the field of nursing homes. In fact the first section of this bill is identical to that of S. 1563.
However, the second section of our bill takes account of the substantial efforts many nursing home owners have made to comply with the provisions of the 1967 Code.
The Life Safety Code is promulgated by the National Fire Protection Association. The association is an independent nonprofit group which analyzes the cause of fires involving loss of human life, and, based upon the results of its research, establishes construction standards to limit and hopefully to eliminate such loss in the future.
Since 1967, the NFPA has revised its Life Safety Code twice, in 1970 and 1973.These revisions have been the result of ongoing research and field testing, and incorporate various technological advances in fire protection equipment which have occurred over the intervening years.
In comparing the 1967 and 1973 Codes, it is apparent that the 1973 Code allows for some tradeoffs to be made between fireproof construction materials on the one hand and sprinklers, smoke detection, and other fire prevention technologies on the other. The 1967 Code primarily stresses the use of fireproof materials in lieu of detection and sprinkler technology, while the 1973 Code emphasizes greater use of sprinklers and detection, and less use of fireproof material. Because of the nature of these tradeoffs, full compliance with either code would protect the lives of the patients affected.
The intent of our second section is to allow those homes, which in the past few years have undertaken the expense of meeting the 1967 Code and have passed the requisite inspections, to continue to operate under that standard without the potential increased burden imposed by the 1973 Code, which would not add to patient protection, given full compliance with the prior Code.
Also, the bill would allow existing institutions which have been unable to fully comply with the 1967 Code due to its requirement of basic structural changes to instead meet the 1973 Code by installing the required equipment. Many of these homes have in the past few years been granted waivers based on a decision of the Secretary of HEW that their individual fire protection system offered equivalent safety features to the 1967 Code. This case-by-case system created an unfortunate climate of uncertainty both for nursing home operators and patients. This bill would end that uncertainty and allow operators to proceed alternatively under the 1967 Code or 1973 Code to meet their responsibility to patients and to the public.
Such a change is particularly desirable because some States, particularly the State of Maine, have mandated compliance with the 1973 Code for purposes of State laws on fire safety. Under current Federal law Maine's operators have also been required to meet the structural standards of the 1967 Code.
This system of double compliance results in an unjustified and wasteful expenditure since costs of compliance are ultimately passed through to patients and the Federal Government in the form of medicare and medicaid disbursements. Because this proposed legislation is so relevant to the current problem faced by Maine nursing home operators, I am pleased to report that my colleagues in the Maine delegation, Congressmen COHEN and EMERY, are introducing an identical bill today in the House.
Hopefully this legislation can be expedited so that the inequity and uncertainty of the present situation will be eliminated.
Mr. MUSKIE. I am pleased to introduce with Senator HATHAWAY legislation to implement the 1973 Life Safety Code for all skilled nursing facilities currently participating in the medicare and medicaid programs.
Nursing homes wishing to receive reimbursement under these programs must comply with federal requirements, including those embodied in the Life Safety Code. That code, which is a complex set of fire safety standards, is promulgated by the National Fire Protection Association which studies and analyzes the causes of fire and establishes a variety of construction standards to minimize loss of life to fire.
The importance of the association in nursing home safety standards was recognized by the 1967 Social Security Amendments and since then by the Department of Health, Education, and Welfare which has adopted the NFPA recommendations.
The committee on safety to life of the National Fire Protection Association works on a continuing basis to monitor improvements in the field of fire prevention and publishes revised editions of the Life Safety Code every 3 years to reflect technological improvements in systems and devices, in addition to new construction methods.
The 1973 edition of the Life Safety Code, which our proposal would implement, represents the latest in fire safety technology.
The 1967 code has rigid structural requirements and emphasizes the use of noncombustible materials. By comparison, the 1973 Code is more flexible and allows greater use of automatic sprinkler systems and other smoke and fire detection devices to achieve a comparable standard of fire safety.
Implementation of the most current version has been strongly recommended by the National Fire Protection Association, and by the American Health Care Association and the National Symposium on Participative Management in Nursing Homes.
Earlier this year, I cosponsored legislation which would serve to implement the 1973 code. The bill we introduce today would also provide that if nursing homes can meet an equivalent safety standard under the 1967 code, they should be accommodated with that alternative.
Many skilled nursing facilities across the Nation have gone to great expense in meeting the basic structural requirements of the 1967 code. Section 2 of this legislation would recognize those efforts and allow them the alternative of continuing to comply with that code without the additional strain which may be placed upon them through compliance with another set of standards that would not materially improve the safety of their patients.
I should also point out that under this section, deficiencies in meeting fire safety standards for either code must still be corrected and waivers on certain code provisions must be granted or renewed with periodic inspections and plans made for appropriate correction.
This legislation will also help clarify those confusing situations where different versions of the Life Safety Code are presently applied. In my home State of Maine, for instance, compliance with the 1967 code is a Federal requirement for all skilled nursing facilities participating in medicare and medicaid programs, while at the same time, State law has embraced portions of the 1973 code.
I will work for prompt passage of this bill and am collaborating with my colleagues from Maine in the House of Representatives in assisting nursing homes meet fire safety standards for the health and safety of residents, and for the benefit of skilled nursing facilities.