Sleep Labs

Q: Are sleep labs considered healthcare occupancies or business occupancies? I have a fire marshal who says it has to be a healthcare occupancy.

 A: These types of things are interpretations. There is not a firm paragraph in the Life Safety Code that says “Sleep labs are business occupancies”. But, if you (or the AHJ) examines the different definitions of occupancies in the Life Safety Code, then one draws the conclusion that it is a business occupancy. For example:

Healthcare occupancy consideration:

“A healthcare occupancy is used to provide medical or other treatment or care simultaneously to four or more patients on an inpatient basis, where such patients are mostly incapable of self-preservation due to age, physical or mental disability, or because of security measures not under the occupants control.” (6.1.5.1 of the 2012 LSC)

“The healthcare facilities regulated by this chapter shall be those that provide sleeping accommodations for their occupants and are occupied by persons who are mostly incapable of self-preservation because of age, because of physical or mental disability, or because of security measures not under the occupants control.” (18.1.1.1.5)

So, let’s examine how a sleep Lab meets this criteria:

  • A patient in a sleep lab is not an inpatient of the facility;
  • A patient in a sleep lab is not being provided medical care, or other treatment. The sleep lab is monitoring the patient… not providing care.
  • A patient in a sleep lab is fully capable of self-preservation.
  • The sleep lab does provide sleeping accommodations, but that alone does not make it a healthcare occupancy because the patients are not inpatients, are not receiving care or treatment, and are not incapable of self-preservation. If just providing sleeping accommodations makes the sleep lab a healthcare occupancy, then all residential, hotels, dormitories and apartment facilities would have to be designated a healthcare occupancy.

Therefore… the conclusion is a sleep lab is not a healthcare occupancy. Now, a sleep lab may be located in a hospital that is a healthcare occupancy and that would be a mixed occupancy situation. But if the sleep lab is located offsite from the hospital, it does not have to be considered a healthcare occupancy.

 Ambulatory healthcare occupancy consideration:

  • “An occupancy used to provide services or treatment simultaneously to four or more patients (one or more patients per CMS) that provides, on an outpatient basis, one or more of the following:
  • Treatment for patients that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others;
  • Anesthesia that renders the patients incapable of taking action for self-preservation under emergency conditions without the assistance of others;
  • Emergency or urgent care for patients who, due to the nature of their injury or illness, are incapable of taking action for self-preservation under emergency conditions without the assistance of others.” (6.1.6.1)

While a patient in a sleep lab is an outpatient, that person is not receiving services or treatment that renders them incapable of self-preservation.

  • The sleep lab patient is not under anesthesia.
  • The sleep lab patient does not have an illness or injury that prevents them to take self-preservation action under emergency conditions without the assistance of others.
  • The sleep lab patient is not receiving emergency or urgent care.

 

Therefore, the conclusion is a sleep lab is not an ambulatory healthcare occupancy. To further this discussion… a sleep lab is not a hotel or dormitory, and is not a residential board & care occupancy. So, the conclusion is, a sleep lab is a business occupancy… not unlike your typical physician-office exam room. A patient in a sleep lab is being examined… not treated. That is how the Life Safety Code is interpreted. The challenge many facility managers have is convincing state or local AHJs that a sleep lab is a business occupancy. Once they see ‘sleeping accommodations’ and ‘healthcare’ they automatically want to lump it in with healthcare occupancy. If you have this situation, then you need to educate those AHJs so they understand that sleep labs are business occupancies.