The Joint Commission has revised a number of hospice requirements to demonstrate Joint Commission equivalency with Medicare Conditions of Participation (CoPs). Effective July 1, 2015, the revisions affect a number of chapters in Joint Commission accreditation manuals. For facility-based (inpatient) hospices, significant changes have been made to the occupancy requirements. Life Safety standards for Rooming and Lodging (LS.04.01.20, LS.04.01.30, and LS.04.01.50) are removed, and Health Care occupancy standards LS.01.01.01-LS.02.01.70 will be effective. Previously, The Joint Commission required facility-based hospice providers with 11 or fewer patients to meet the Rooming and Lodging requirements in chapter 26 of the National Fire Protection Association (NFPA) Life Safety Code® (NFPA 101-2000). However, the Centers for Medicare & Medicaid Services (CMS) requires all facility-based hospice providers to comply with the requirements for Health Care Occupancies in chapters 18 and 19 of the NFPA Life Safety Code, 2000 edition. Therefore, these changes are applicable to all Joint Commission accredited facility-based hospice providers – both deemed and non-deemed organizations.
Some significant differences between Rooming and Lodging occupancy requirements and Health Care occupancy requirements include:
- Separation between different occupancies, such as Health Care or Business occupancies, must be at least two-hour fire resistant rating barriers. Also, Health Care occupancies require smoke compartments. Hazardous areas, such as soiled utility rooms, must also be separate from patient care areas.
- Means of egress (exit access, exits and exit discharge) are clear and unobstructed; Health Care occupancies require that the 8-foot patient care corridor be kept clear of storage; and door configurations must operate as designed.
- The fire alarm system must activate automatically based on NFPA 72-1999.