State Must Toughen Provisions Regarding Fire Safety At Assisted Living Facilities Or Risk The Lives Of The Elderly And Persons With Disabilites

PHILADELPHIA, PA—(March 2009)—The well-being of frail elders and persons with disabilities in assisted living residences will continue to be at risk unless soon-to-be-released state regulations require these facilities to follow national best practices for fire and life safety.

Since its formation a year ago, the Pennsylvania Assisted Living Consumer Alliance (PALCA), which is comprised of more than 30 organizations including AARP, has called on the Pennsylvania Department of Public Welfare (DPW) to issue licensing rules that ensure the care and safety of residents. No such rules exist at the moment.

“Best practices for life and fire safety measures must be a cornerstone of the new state regulations,” said Alissa Halperin, Senior Attorney and Deputy Director of Policy Advocacy at the Pennsylvania Health Law Project, the organization leading PALCA’s efforts (www.paassistedlivingconsumeralliance.org). “Anything less than that would be irresponsible and unconscionable.”

Since DPW released its draft regulations last summer, PALCA has urged department officials to toughen provisions regarding fire safety. In the draft, for instance Pennsylvania officials did not address issues concerning older assisted living buildings that do not meet today’s fire safety and life safety laws standards. Many of these older residences adhere to outdated and inadequate methods that were in place years ago when these structures were built. Even worse, most older rules treat assisted living facilities more like hotels or dormitories than like facilities providing care to residents with complex health and daily care needs.

“It’s critical that the rules protect residents in the event of fire whether the building is old, new or anything in between,” said Crystal Lowe of the Pennsylvania Association of Area Agencies on Aging. “Fire is dangerous in any building regardless of its age. People need to be warned quickly and be able to be moved safely out of its way.”

National best practices for fire and life safety have recently been updated to specifically address assisted living residences. Every three years, the bipartisan National Fire Protection Association (www.nfpa.org) updates it Life Safety Code 101.

The National Fire Protection Association 2009 (NFPA) standards require that new facilities be designed and constructed to facilitate the “defend-in-place” occupant protection strategy. This strategy requires the facility to be able to withstand the effects of fire for the time necessary to either evacuate the occupants or relocate them to a safe location within the building.

For existing buildings that seek to obtain an assisted living license, best practices for fire and life safety would require that the facility, as a whole, be classified by the occupants' evacuation capability — or their ability to move, as a group, to a point of safety in the event of a fire - which was broken down into three subclasses — prompt, slow, and impractical and that the fire—and that the appropriate fire and life safety requirements be followed.

While Pennsylvania follows the NFPA rules for nursing homes and other long term care institutions, the state must affirmatively adopt the NFPA rules for assisted living facilities in order for them to apply.

“Imagine the horror if an elderly parent or grandparent perished in a fire at a facility held to outdated standards,” Lowe said. “We cannot let pass this opportunity to prevent such tragedies from happening.”

Pennsylvania’s new assisted living regulations must require facilities to meet the national best practices for fire and life safety contained in the NFPA Life Safety 101. New facilities should have to meet the code standards and existing facilities should be reclassified based on their new use and the evacuation capability of their anticipated occupants under the new assisted living rules.

The new state rules also must require facilities to be inspected for fire safety once every three years under the NFPA standards. In the past, facilities only needed approval once, when first licensed, to satisfy the state.

The new rules must also ensure that any facility found in violation of applicable fire safety standards should be issued a provisional license and required to remedy the problem immediately. If it can’t or won’t comply, residents should be relocated until the facility is safe again.

“The safety measures we believe are necessary are no-brainers,” Halperin said. “How comfortable could you feeling knowing your loved one is in a facility governed by standards that became outdated decades ago?”

About 50,000 people currently live in Pennsylvania facilities that may call themselves assisted living facilities. These residences have emerged in the past generation to house people whose care needs are not so great that they require a nursing facility. But they generally need more help with bathing, dressing, medication management and other basic care needs than may be provided in personal care homes. Assisted living has been a marketplace phenomenon for consumers who want independence, privacy, and choice, but who also want the ability to "age in place" - meaning they will not have to move when their care needs increase.

PALCA was formed to make sure that new licensing rules will protect the elderly and those with disabilities who reside in assisted living facilities.