New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-P - Former Division of Public Health Services
Chapter He-P 800 - RESIDENTIAL CARE AND HEALTH FACILITY RULES
Part He-P 803 - NEW HAMPSHIRE NURSING HOME RULES
Section He-P 803.27 - Emergency and Fire Safety

Universal Citation: NH Admin Rules He-P 803.27

Current through Register No. 52, December 26, 2024

(a) The administration of the licensed facility shall have, in effect and available to all supervisory personnel, written copies of a plan for the protection of all persons in the event of fire, including:

(1) Evacuation to areas of refuge;

(2) All personnel shall be periodically, at least annually if no changes are made to the plan, be instructed and kept informed with respect to their duties under this written plan. Copies of this plan shall be readily available at all times in a central location, example, reception area, nurses station, or security center;

(3) The emergency procedures required by the emergency response plan shall include, but are not limited to, evacuation routes, emergency notification numbers, and emergency instructions and shall be posted in locations accessible to personnel and visitors;

(4) The nursing home fire safety plan shall provide for the following:
a. Use of alarms;

b. Transmission of alarm to fire department;

c. Emergency phone call to fire department;

d. Response to alarms;

e. Isolation of fire;

f. Evacuation of immediate area;

g. Evacuation of smoke compartment;

h. Preparation of floors and building for evacuation; and

i. Extinguishment of the fire;

(5) Ensuring that the fire safety and evacuation plans are available to all supervisory personnel;

(6) Ensuring that all employees receive in-service annual training to clarify their responsibilities in carrying out the emergency plan;

(7) The required plan shall be readily available at all times;

(8) Conducting fire drills, including the transmission of a fire alarm signal and simulation of emergency fire situation, as follows:
a. Infirm, bedridden, or cognitively impaired residents shall not be required to be moved during drills to safety areas or to the exterior of the building;

b. Drills shall be conducted quarterly on each shift to familiarize nursing home personnel with the signals and emergency action required under varied conditions; and

c. When drills are conducted between 9:00 p.m./2100 hours and 6:00 A.M./0600 hours, a coded announcement may be used instead of audible alarms;

(9) Facilities shall complete a written record of fire drills and include the following:
a. The date and time including AM/PM the drill was conducted and if the actual fire alarm system was used;

b. The location of exits used;

c. The number of people, including residents, personnel, and visitors, participating at the time of the drill;

d. The amount of time taken to completely evacuate the facility or to an approved area of refuge or through a horizontal exit;

e. The name and title of the person conducting the drill;

f. A list of problems and issues encountered during the drill;

g. A list of improvements and resolution to the issues encountered during the fire drill; and

h. The names of all staff members participating in the drill; and

(10) Written records of the fire drills that shall be maintained on site and available to the department during an inspection or investigation conducted in accordance with RSA 151:6 and RSA 151:6-a.

(b) All nursing homes shall have:

(1) At least one ABC type fire extinguisher on every level or every 75 feet of corridor as required by NFPA 10;

(2) Be manually inspected when initially placed in service;

(3) Be inspected either manually or by means of an electronic monitoring device/system at intervals not exceeding 31 days;

(4) Be inspected at least once per calendar month; and

(5) Documentation of manual fire extinguisher inspections that shall be maintained on-site in accordance with NFPA 10 and available at the time of the inspection or investigation. Documentation of electronically monitored fire extinguishers shall be provided to the department within 2 business days of the completion of the inspection or investigation.

(c) All nursing homes shall meet the health care chapter of NFPA 101 as adopted pursuant to RSA 153:1, VI-a and amended in Saf-FMO 300 by the fire marshal with the board of fire control, pursuant to RSA 153:5.

(d) Extension cords shall be prohibited except as allowed in accordance with NFPA 101 as adopted pursuant to RSA 153:1, VI-a and amended in Saf-FMO 300 by the fire marshal with the board of fire control, pursuant to RSA 153:5.

(e) Immediately following any fire or emergency, such as a gas incident, terrorism, or other threatening condition, the licensee shall notify the department by phone to be followed by written notification within 72 hours, with the exception of a false alarm or emergency medical services (EMS) transport for a non-emergent reason.

(f) The written notification in (d) above shall include:

(1) The date and time of the incident;

(2) A description of the location and extent of the incident, including any damage;

(3) A description of events preceding and following the incident;

(4) The name of any employee or resident who was evacuated as a result of the incident, if applicable;

(5) The name of any employee or resident who required medical treatment as a result of the incident, if applicable; and

(6) The name of the individual the licensee wishes the department to contact if additional information is required.

(g) Storage and use of oxygen cylinders or systems shall comply with NFPA 99, Health Care Facilities Code including but not limited to:

(1) Oxidizing gases such as oxygen and nitrous oxide shall be separated from combustibles or flammable materials by one of the following:
a. Minimum distance of 6.1 m or 20 ft;

b. Minimum distance of 1.5 m or 5 ft if the entire storage location is protected by an automatic sprinkler system designed in accordance with NFPA 13, Standard for the Installation of Sprinkler Systems; or

c. A gas cabinet constructed per NFPA 30, Flammable and Combustible Liquids Code, or NFPA 55, Compressed Gases and Cryogenics Fluids Code, if the entire storage location is protected by an automatic sprinkler system designed in accordance with NFPA 13;

(2) Cylinders shall be protected from damage by means of the following specific procedures:
a. Oxygen cylinders shall be protected from abnormal mechanical shock, which is liable to damage the cylinder, valve, or safety device;

b. Oxygen cylinders shall not be stored near elevators or gangways or in locations where heavy moving objects will strike them or fall on them;

c. Cylinders shall be protected from tampering by unauthorized individuals;

d. Cylinders or cylinder valves shall not be repaired, painted, or altered;

e. Safety relief devices in valves or cylinders shall not be tampered with;

f. Valve outlets clogged with ice shall be thawed with warm, not boiling water;

g. A torch flame shall not be permitted, under any circumstances, to come in contact with a cylinder, cylinder valve, or safety device;

h. Sparks and flame shall be kept away from cylinders;

i. Even if they are considered to be empty, cylinders shall not be used as rollers, supports, or for any purpose other than that for which the supplier intended them;

j. Large cylindersexceeding size E and containers larger than 45 kg or 100 lb weight shall be transported on a proper hand truck or cart complying with NFPA 99, section 11.4.3.1;

k. Freestanding cylinders shall be properly chained or supported in a proper cylinder stand or cart; and

l. Cylinders shall not be supported by radiators, steam pipes, or heat ducts; and

(3) Cylinders and their contents shall be handled with care, which shall include the following specific procedures:
a. Oxygen fittings, valves, pressure reducing regulators, or gauges shall not be used for any service other than that of oxygen;

b. Gases of any type shall not be mixed in an oxygen cylinder or any other cylinder;

c. Oxygen shall always be dispensed from a cylinder through a pressure reducing regulator;

d. The cylinder valve shall be opened slowly, with the face of the indicator on the pressure reducing regulator pointed away from all persons;

e. Oxygen shall be referred to by its proper name, "oxygen", not air, and liquid oxygen shall be referred to by its proper name, not liquid air;

f. Oxygen shall not be used as a substitute for compressed air;

g. The markings stamped on cylinders shall not be tampered with, because it is against federal statutes to change these markings;

h. Markings used for the identification of contents of cylinders shall not be defaced or removed, including decals, tags, and stenciled marks, except those labels/tags used for indicating cylinder status such as full, in use, or empty;

i. The owner of the cylinder shall be notified if any condition has occurred that might allow any foreign substance to enter a cylinder or valve, giving details and the cylinder number;

j. Neither cylinders nor containers shall be placed in the proximity of radiators, steam pipes, heat ducts;

k. Very cold cylinders or containers shall be handled with care to avoid injury;

l. A precautionary sign, readable from a distance of 1.5 m or 5 ft, shall be displayed on each door or gate of the storage room or enclosure; and

m. The sign shall include the following wording as a minimum:

CAUTION:

OXIDIZING GAS(ES) STORED WITHIN

NO SMOKING

(h) If the licensee has chosen to allow smoking under He-P 803.14(w), an outside location or a room used only for smoking shall be provided which:

(1) Has a dedicated ventilation system, so that smoke or odors cannot escape or be detected outside the designated smoking room;

(2) Has walls and furnishings constructed of non-combustible materials;

(3) Has metal waste receptacles and safe ashtrays; and

(4) Is in compliance with the requirements of RSA 155:64-77, the Indoor Smoking Act and He-P 1900.

#9856-A, eff 1-26-11

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