The call is in, and Nursing homes need better safety. The need for better fire and smoke protection has been documented in this article.
The recent Government Accountability Office report Nursing Home Fire Safety: Recent Fires Highlight Weaknesses in Federal Standards and Oversight, thoroughly assesses the fire protection situation in the nation’s nursing homes. The report (available at www.gao.gov/new.items/d04660.pdf) itemizes waivers granted to nursing homes, which allow them to operate with substandard smoke and fire detection and containment measures, but concludes that the installation of sprinklers would alleviate the risk without requiring corrections to the deficiencies identified. This is a dangerous assumption for several reasons.
Too many deaths have been report in nursing homes as a direct result of in adequate fire protection. The report says that multiple deaths in two nursing home fires resulted from smoke inhalation rather than the fire itself. It also itemizes several contributing factors which allowed the smoke that killed the residents to migrate basically undetected and unimpeded from the source of the fire to the resident rooms nearby. These factors include lack of working smoke detectors, lack of automatic smoke dampers in the ductwork, open fire doors, failure of the nursing home staff to respond according to emergency plans, and the ability of smoke to travel in the open and undivided area above the suspended ceiling into resident rooms.
The report faults the night staff at one facility for not responding properly to the existing fire emergency plans, but only touches on how realistic those plans might have been. It suggests that staffing was inadequate, averaging at best one nursing staff person per nine residents. This ratio would allow less than seven minutes of care per resident per hour under normal conditions. If the plan was merely to ensure that fire doors were closed once an alarm went off, perhaps the staff was at fault. However, the emergency plans might have involved moving residents to another area in the facility, which cannot be done quickly–if at all–by one staff person responsible for nine residents, especially when many residents have physical limitations that prevent their rapid removal