The 2012 edition of the NFPA 99 Health Care Facilities Code marked a significant change in how healthcare facilities determined the level of protection or type of systems to provide. Previously, NFPA dictated protection levels based on the occupancy type of the facility, but given healthcare’s shift to buildings and spaces with flexible use, this method was no longer effective.

The new edition of NFPA 99 instead features a risk-based approach to protection and safety requirements. Types of equipment and systems are evaluated based on the risks posed to the patients by the procedures being provided, rather than the building occupancy type. This change is designed to provide better protection and safety for patients and healthcare providers and allows for flexibility and cost savings for hospitals. This updated Health Care Facilities Code breaks types of equipment and systems into four risk categories, based on how system failure will affect the patient or caregiver.

Understanding NFPA 99 Risk Categories

The new edition of NFPA 99 requires a risk assessment for any new construction or equipment, and existing construction and equipment will need to follow inspection, testing, and maintenance (ITM) guidelines associated with the risk category of the existing system or equipment. Risk assessments should be designed to help users assign one of the four risk categories to systems and equipment:

Category 1: Failure of equipment or systems is likely to cause major injury or death to patients or caregivers.

Category 2: Failure of equipment or facility systems is likely to cause minor injury to patients or caregivers.

Category 3: Failure of facility systems or equipment is not likely to cause injury to patients or caregivers, but could cause discomfort.

Category 4: Failure of facility systems or equipment will have no impact on patient care.

When users have assigned a risk category to systems and equipment, they can apply appropriate protection according to the guidelines laid out in NFPA 99. Though this is a different method for healthcare facilities, it puts the safety of patients and caregivers front and center, and provides the opportunity for more flexible and cost-effective life safety and protection systems for many facilities.

NFPA 99 Healthcare Facility Risk Assessment Methods

As mentioned, the 2012 NFPA 99 requires a risk assessment for any new construction and equipment, as well as for any existing construction and equipment that’s risk category has not been determined. This is new, and the NFPA does not offer an alternative to a risk assessment.

Healthcare facilities may be wondering, then, how to conduct that risk assessment. The NFPA does not mandate any specific method but instead leaves it up to the provider to choose any risk-assessment method that their facility is comfortable with, so long as it is a documented and defined procedure.

NFPA Guidelines for Healthcare Facilities in Light of COVID-19

The risk-based approach of the NFPA 99 is particularly relevant as hospitals and other health care locations are repurposing buildings and putting up temporary structures to meet impending demands due to the COVID-19 crisis. The NFPA published a statement in April acknowledging the impossibility of constructing or modifying health care spaces in strict compliance with fire and life safety codes when health care facilities are under such stress of capacity and time.

In light of the COVID-19 crisis, the NFPA urged health care facilities to use the intent of code documents, like the risk-based approach of NFPA 99, along with the goals and objectives of NFPA 101, to guide facility’s decisions as they put in place safety measures and systems.

The NFPA has also offered a range of resources for health care facilities working hard to keep patients healthy during the extreme demand of the pandemic. Their fact sheet, Maintaining Safe Health Care Facilities in Extraordinary Times is a good place to start if your facility is looking for ways to implement safety measures in new and temporary healthcare structures built to serve patients during the COVID-19 crisis.

Fire protection and facility safety requirements are constantly changing for hospitals and health care locations, especially now, as your facility works to meet shifting demand associated with the pandemic. If you have more questions about these updated requirements for healthcare facilities or are looking for fire protection or safety systems for your facility, the team at Vanguard is happy to help.