I’m sure by now everyone is well aware that The Centers for Medicare & Medicaid Services (CMS) has adopted the 2012 edition of NFPA 101: Life Safety Code®, effective July 5th. So, what does this mean for healthcare facilities? Stricter requirements for the maintenance of your facility’s fire protection systems, with a written documentation of the inspection kept for your Authority Having Jurisdiction (AHJ). Included in these new requirements is stricter maintenance of your facility’s fire doors and emergency egress paths.
Fire doors are designed to prevent the passage of fire and smoke, while providing an easy access for evacuation. There are tons of different parts that go into making a fire door work, which unfortunately allows for more opportunities for the door to be deficient. Too often, fire doors are found propped open, objects blocking access to the door, or missing or painted fire door labels. These are only a few of the issues from The Door Security and Safety Foundation’s Top Ten Fire Door Deficiencies, but they are serious issues. Keeping fire doors closed and making sure nothing is blocking them may not seem like it would be a big deal. However, in a fire emergency, it could be a matter of having a few extra seconds to evacuate or a fire spreading through areas that it ordinarily wouldn’t be able to. If fire doors are always propped open or not properly maintained, fire and smoke can cause property damage and harm those who occupy it.
The National Fire Protection Association (NFPA) requires annual fire door inspections with a written record of the inspection. NFPA 80, Section 5.2.4.2: states that, as a minimum, the following items must be verified:
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No open holes or breaks exist in surfaces of either the door or frame.
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Glazing, vision light frames & glazing beads are intact and securely fastened in place, if so equipped.
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The door, frame, hinges, hardware, and noncombustible threshold are secured, aligned, and in working order with no visible signs of damage.
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No parts are missing or broken.
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Door clearances at the door edge of the door frame, on the pull side of the door, do not exceed clearances listed in 4.8.4 (the clearance under the bottom of the door shall be a maximum of 3/4″) and 6.3.1 (top & edges 1/8″).
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The self-closing device is operational; that is, the active door completely closes when operated from the full open position.
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If a coordinator is installed, the inactive leaf closes before the active leaf.
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Latching hardware operates and secures the door when it is in the closed position.
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Auxiliary hardware items that interfere or prohibit operation are not installed on the door or frame.
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No field modifications to the door assembly have been performed that void the label.
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Gasketing and edge seals, where required, are inspected to verify their presence and integrity.
Fire door inspections are complex and require a qualified inspector in the field to perform the annual inspection as accurately as NFPA 80 requires. And although fire door inspections and repairs seem like an impossible task, they are the key to making sure fire doors will properly close and latch in the event of a fire. So don’t wait for a fire to happen, ensure your facility’s fire doors work by having them inspected and repaired according to the new code requirements.
