Upgrading from Business to Healthcare Occupancy

Q: We have an attached building that houses an ambulatory surgical center and the building is classified as a business occupancy. We want to convert it from business occupancy to healthcare occupancy so we can have overnight patient care sleeping accommodations. What should we be concerned about?

A: It is classified as business occupancy and you have an ambulatory surgical center in the building? That doesn’t seem right, but I’m glad you’re going to fix that problem. Construction type is one of the many issues that must be dealt with in converting a building from business occupancy to healthcare occupancy, but there are other issues to consider as well. The first thing that needs to be understood is, changing from business to healthcare means the building has to meet new construction requirements found in chapter 18 of the 2000 Life Safety Code, not in chapter 19 which is for existing construction. Therefore, here is a quick summary of the things to investigate to ensure you are in compliance with chapter 18, mainly because these items may not be required in business occupancy. (NOTE: This is not an all inclusive list):

  • Construction Type requirements (as already noted)
  • Occupant load factors are different for healthcare
  • Means of egress components are more restrictive for healthcare, such as fire escape stairs are not permitted
  • Means of egress doors have different locking arrangements that actually favor healthcare
  • Stair width for existing is 44 inches while the business occupancy building may have been constructed to lessor standards
  • Horizontal exits, while not required, if used in the renovated business occupancy cannot have any penetrations (duct, conduit, etc.)
  • Corridor width MUST be 8 feet wherever inpatients are housed or treated, but may be 44 inches wide where inpatients would never be (such as a basement support services or administration).
  • The minimum clear width of the doors in a means of egress is 41.5 inches, which is far wider than what you would find in a business occupancy
  • Healthcare allows the use of suites, both for sleeping arrangements and non-sleeping arrangements which is a great benefit to the hospital
  • Dead-end corridors are only permitted to be 30 feet in healthcare while they are permitted to be 50 feet in business
  • Travel distances to an exit is less in a healthcare occupancy as compared to a business occupancy
  • Emergency lighting is required in healthcare
  • Protection from hazards is more restrictive with healthcare
  • Medical gases must be in compliance with NFPA 99 (1999 edition) which means a Level 1 piped system would have to be installed for a surgery
  • Interior finish requirements are more restrictive, but this is not usually a problem
  • A fire alarm system is required, with more devices and appliances than what a business occupancy would require
  • The entire building would have to be sprinklered with quick response sprinklers
  • Corridors in healthcare are required to be separated from all other spaces, while there is no requirement for corridors in business
  • There are multiple examples where spaces may be open to the corridor in healthcare that the hospital may take advantage of
  • Corridor walls have construction requirements
  • Corridor doors have certain requirements
  • Healthcare requires each floor to be subdivided into at least two smoke compartments and there are specific construction requirements for the compartment barriers and doors
  • Utilities must comply with section 9.1, which includes gas, electrical and emergency power
  • Healthcare facilities must have Level 1 emergency power as described and prescribed in NFPA 99. This requires significant changes to life safety branch and critical equipment branch, which business occupancies would not have to comply with.
  • The healthcare facility must have evacuation plans and relocation plans and fire drills once per quarter per shift
  • Combustible decorations are not permitted in healthcare
  • Portable heating devices are not permitted in patient care areas

That’s just a quick list of things but I’m sure there are more items in greater detail that you would need to comply with as well. As you can see, this is a large undertaking to convert a building that was never intended to be healthcare occupancy into a hospital. Most organizations choose to build a brand new building when they realize the cost in converting an existing building.