ANCOR Requests CMS Accommodate ICF/IDD Difficulties with Life Safety Code Regulations

ANCOR sent the Centers for Medicare and Medicaid Services (CMS) a letter requesting a two-year delay of enforcement of a particular section of a fire safety regulation for providers of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). The regulation is titled “Fire Safety Requirements for Certain Health Care Facilities”, and the provision of concern is specific to attics.  While ICF/IID providers have been working to comply with the broader regulation, which governs other aspects of fire codes for ICF/IID and has an implementation deadline of July 5, 2019, components specific to sprinklers in attics have proven particularly challenging for providers. Most notably, providers have found that CMS largely underestimated the cost of these modifications.

As written in the letter:

“In 2012, CMS estimated the cost per square foot to install sprinklers in an attic was $3.00, and the average estimated square footage per attic per facility was 1500 square feet, for a total of $4,500 per ICF/IID. Facilities that do not use their attics for living purposes may choose to install a heat detection system in the attic instead of sprinklers. In 2012, CMS estimated the cost to install a heat detection system to be $1,000 per facility. Feedback from ANCOR members indicates that most providers chose to avoid the more complicated and expensive sprinkler costs for attics and chose to install heat detection systems to comply with the LSC attic requirements. However, feedback from ANCOR members also suggests that the cost of already completed heat detection renovations and the estimated costs of any newly installed heat detection systems comes at a cost between $1,200 and $8,099 per facility.

These costs are significantly higher than those estimated by CMS. In addition, if an existing facility’s fire alarm panel was not adequate to support the required heat detection upgrade, a new fire alarm panel would be required at an estimated cost of $20,000 to $25,000 per ICF/IID facility. This cost was not considered by CMS in their original cost estimate noted above. Therefore, based upon these revised cost estimates we believe that the original CMS 3-year phase-in period is not adequate and poses an unreasonable hardship upon an ICF/IID facility due to cost and should warrant an extension of the phase-in period.”