New vs. Existing Construction for Ambulatory Healthcare Occupancies

A reader asked me recently what the Life Safety Code differences were between a new construction ambulatory healthcare occupancy, and an existing construction ambulatory healthcare occupancy. I did not immediately know, so I took the time to research this and I was surprised to learn what the differences (or non-differences) were.

The differences between new construction and existing construction of ambulatory healthcare occupancies are not monumental, but rather subtle. According to the 2000 Life Safety Code, here are some comparisons:

Description Chapter 20 New Construction Chapter 21 Existing Construction
Construction Type No restrictions for 1 story facilities; Building of two or more stories limited to Type 1 (443), Type I (332), Type II (222), Type III (211), Type IV (2HH), Type V (111). Type II (000), Type III (200), and Type V (000) are permitted if the entire building is protected with sprinklers.  Same
Occupant Load 100 square feet/person Same
Special Locking Arrangements Only permitted on exterior doors Same
Clear Width of Corridor 44 inches Same
Travel Distance between room and exit 100 feet Same
Travel distance between any point in a room and exit 150 feet Same
Travel distance increased for sprinklered buildings 50 feet Same
Emergency Power from Generators as per NFPA 99 Required when general anesthesia or life-support equipment is used. Same
Hazardous Areas Must meet the requirements of 8.4 and be protected with sprinklers, or protected with 1-hour construction Same
Anesthetizing Locations Must be protected in accordance with NFPA 99 Same
Fire alarm systems Manually initiation required Same
Portable fire extinguishers Required Same
Sprinkler System Not Required Same
Corridors Openings in corridor walls such as mail slots and pass-through windows permitted in windows and doors provided the opening is not more than 20 square inches. The opening may increase to 80 square inches if the room is protected with sprinklers. No Restrictions/No Requirements
Subdivision of Building Space Ambulatory healthcare occupancies must be separated from other occupancies with 1-hour fire rated barriers with ¾ hour fire rated doors Same
Smoke Compartmentation The ambulatory healthcare occupancy must be divided in to not less than two smoke compartments. Facilities less than 5,000 square feet that are protected by a smoke detection system are exempt. Facilities less than 10,000 square feet and protected by sprinklers are exempt. Same
Smoke Compartment Size Not less than 15 square feet area (net) must be provided for every occupant in the ambulatory healthcare facility on either side of the smoke compartment barrier. Smoke compartments are limited to 22,500 square feet in size. Travel distance to reach a smoke compartment barrier doors must not exceed 200 feet. No Restrictions
Fire Drills Required quarterly on all shifts Same
Combustible decorations Prohibited, unless they are flame retardant Same
Portable Space Heating Devices Prohibited, unless the heating elements do not exceed 212°F and only used in non-sleeping staff and employee areas. Same