Storage in Patient Rooms

Q: Nursing staff has a tendency to stuff patient rooms that are not used as often with extra beds, furniture etc. Building does not have sprinklers on these patient floors so the concern is fuel load in a nonrated room. Is there a particular code I can cite to discourage this behavior?

A: Yes… Section 4.6.7 in the 2012 LSC says when you have a change in use (that’s what is happening… the patient room is not being used as a patient room anymore, but now is used as a storage room with combustible supplies), you need to comply with chapter 43. Section 43.7.1.2 (2) says when existing healthcare occupancies are fully protected throughout with automatic sprinklers, when you have a change is use in a room that does not exceed 250 square feet, the result is the room does not have to meet new construction requirements but is permitted to meet existing conditions for hazardous rooms. This is significant as the room where the extra beds and furniture are placed would not have to meet the more restrictive new construction requirements for adding sprinklers and making the walls become 1-hour fire rated barriers, with a ¾ hour fire rated door assembly. The room would only have to be sprinklered and the walls and doors made to resist the passage of smoke and the door be self-closing. But this is only permitted if the entire building is protected with sprinklers, and you say it is not. Therefore, you have no choice; you must reconstruct the former patient room to be 1-hour fire rated with a ¾ hour fire rated door assembly and install sprinklers in the room. This could cost you $10,000 – $20,000 per room depending on the current arrangement of the facility. This is an example of staff changing the use of a room or area without checking with facilities to see if it is permitted. Your best bet would be to complete the sprinkler installation in your building.

Brad Keyes
Brad Keyes, CHSP

Brad is a former advisor to Healthcare Facilities Accreditation Program (HFAP) and former Joint Commission LS surveyor. He guides clients through  organizational assessment; management training; ongoing coaching of task groups; and extensive one-on-one coaching of facility leaders. He analyzes and develops leadership effectiveness and efficiency in work processes, focusing on assessing an organization’s preparedness for a survey, evaluating processes in achieving preparedness, and guiding organizations toward compliance. 

As a presenter at national seminars, regional conferences, and audio conferences, Brad teaches the Keyes Life Safety Boot Camp series to various groups and organizations. He is the author or co-author of many HCPro books, including the best-selling  Analyzing the Hospital Life Safety Survey, now in its 3rd edition. Brad has also authored a variety of articles in numerous publications addressing features of life safety and fire protection, as well as white papers and articles on the Building Maintenance Program. Currently serving as the contributing editor of the monthly HCPro newsletter Healthcare Life Safety Compliance  gives Brad further insight into the industry’s trends and best practices.