Strange Observations – Part 26

Continuing in a series of strange things that I have seen while consulting at hospitals…

Ah.. Portable electric heaters. A problem for nearly every hospital.

Staff gets cold and Facilities Management cannot adjust the HVAC system to keep everyone happy. So portable electric heaters brought from home start showing up.

You need to do frequent rounding of suspicious trouble spots (you know where they are) to make sure staff does not bring in portable heaters.

Portable Space Heaters

Q: Are portable heaters permitted in long term care facilities in offices and other locations?

A: Portable space-heating devices are prohibited in healthcare care occupancies (such as hospitals, nursing homes, limited care facilities and hospice centers with more than 12 beds), with the exception of those portable heaters whose heating elements do not exceed 212 degrees F which are only permitted in smoke compartments which do not contain sleeping rooms, or patient care or treatment. For free standing medical offices which are classified as business occupancies, then the Life Safety Code has no restrictions on portable heaters. But if those offices are located in the healthcare occupancy, then you must comply with the above requirements. Depending on your authorities having jurisdiction, portable heaters may not be permitted even in areas that do not contain patient care, treatment or sleeping beds.

Portable Heaters

Q: As the cold weather starts to creep up on us I’m continuously asked by staff if they can have a personnel heater in their office space (not patient care areas). What kind of heaters are permitted and where?

A: Portable space heaters whose heating element does not exceed 212°F (100°C) are permitted in non-patient care or non-patient treatment areas in healthcare occupancies. These portable heaters would have to be inspected upon purchase and be accounted for in the organization’s equipment utility equipment inventory.

Patient care areas area loosely defined as a smoke compartment which contains patient care or treatment activities. This is in accordance with the 2000 edition of the Life Safety Code, section 19.7.8. You should conduct a risk assessment for the use of portable space heaters even if they are compliant and not used in patient care areas. The presence of a portable heater implies the HVAC system is not performing adequately to meet the requirements of the building. That is a “red flag” for a surveyor who can investigate and determine what corrective action that you have taken, other than placing a portable heater there. Also, the facility’s electrical distribution system may not be able to handle additional heating appliances. Portable heating appliances should only be used as a short-term solution, rather than a final fix.

Portable Space Heaters

As I write this posting, it is very cold in Northern Illinois. Keeping a healthcare facility warm and cozy for staff is always a challenge in cold weather, but one of the biggest challenges is herding all those portable space heaters that seem to pop up without warning.

Portable space heaters are often found in the strangest places in hospitals and nursing homes, even though the major accreditors for healthcare organizations do not permit them in patient care or treatment areas of healthcare occupancies.

Portable space-heating devices are prohibited in healthcare care occupancies (such as hospitals, nursing homes, limited care facilities and hospice centers with more than 12 beds), with the exception of those portable heaters whose heating elements do not exceed 212 degrees F which are only permitted in smoke compartments which do not contain sleeping rooms, or patient care or treatment. [LSC 19.7.8]

However, in free standing medical offices which are classified as business occupancies, then the Life Safety Code has no restrictions on the use of portable space heaters.

But you need to be careful about using portable heaters in areas that are not traditional patient care or treatment areas. For example: The administrative offices of a healthcare occupancy (such as a hospital, nursing home, limited care facility or a hospice center with more than 12 beds) may be part of a smoke compartment that includes patient care or treatment areas.

The bigger picture is: If staff needs to use a portable space heater, then what does that say about the facility’s HVAC system? Even if an approved portable heater is used in an approved non-patient care or treatment area, it becomes a ‘red flag’ for a surveyor. Once it is noticed, a tracer may begin on why it is in use. If a surveyor determines the facility’s HVAC is not adequate to maintain staff’s comfort, it can be scored as a deficiency under EC.02.05.05 for a Joint Commission survey, or under section 482.41(c) [A-0722] for a CMS survey.

If you already have an approved Fire Safety Evaluation System (FSES) equivalency, or are considering one, then portable space heaters are not permitted in your organization at all. Question ‘D’ on worksheet 4.7.10 prohibit portable electric space heaters anywhere in your facility, if you are granted an approved FSES equivalency.

The bottom line… portable space heaters are trouble. Without the knowledge of the facility manager, staff tends to bring in  portable heaters from home without understanding what kind/style is permitted, and will use them in areas where they are not allowed. Heaters with orange glowing elements exceed the 212 degree F maximum allowed by the Life Safety Code. They add a load onto the electrical distribution system, which may not be designed to handle the extra current. The wrong type of heater may even start a fire if combustible products come into contact with them.

A good life safety code surveyor should be very skeptical of any portable space heater that they observe.

Portable Space Heater in Unoccupied Space

Q: We have a contractor who wants to use a propane gas-fired portable heater to warm an unoccupied space that is currently under renovation in the hospital. The central heating system has been removed for replacement and the contractor is worried about freezing water pipes. What concerns should I have about this arrangement?

A: There is a lot to be concerned about. First of all, section 19.7.8 of the Life Safety Code (LSC) does not allow portable heating devices where the heating elements exceed 212°F in patient care areas. The Joint Commission has interpreted that to say portable heaters are not allowed in the same smoke compartment where patient care is provided. So, if the unoccupied space is also in a smoke compartment that includes patient care activities, then it is not permitted. Section 19.5.2.2 requires heating devices to be designed and installed with a proper chimney for venting, and the combustion air must come from the outside. An approved, suspended unit heater would be permitted in this application provided it is mounted high enough to be out of the reach of persons working in the area, and it would have to be installed with the appropriate safety features to immediately stop the flow of fuel and shut down the heater in the case of extreme temperature or ignition failure. Combustibles will have to be removed and not allowed to accumulate.

NFPA 241 Standard for Safeguarding Construction, Alteration, and Demolition Operations (1996 edition) requires all temporary heating equipment to be monitored for safe operation and maintained by properly trained personnel.