One of the primary functions of any medical facility is to promote the safety and well-being of its patients and employees. In order to fulfill this function, medical facilities must maintain rigorous regulatory compliance. For example, hospitals and medical offices may need to maintain certain protocols regarding the use of anesthesia, the sanitization of recovery rooms, the hygiene habits of doctors and nurses, and so forth. Maintaining compliance allows medical practices to retain their credentials, but more importantly, it helps them to consistently put health and safety first.

One specific type of compliance to consider is compliance with the National Fire Protection Association (NFPA). As its name suggests, this body provides procedures and protocols to minimize injury and loss of life due to fires. For medical practices, this is a much bigger deal than you might imagine.

For instance, a study from 2013 published in the Journal of Clinical Anesthesia noted that fires happen with an “alarming frequency” in hospital settings. More recently, data from the NFPA itself indicates that there are more than 1,000 hospital fires in the United States every year.

The same study finds that, despite this high rate of fires, there are virtually no deaths that result from them. The reason? More and more hospitals and medical practices take the NFPA’s fire safety standards seriously. At the same time, however, it must be said that many practices are not totally up to code, or else they lack the protocols to ensure their adoption of any revised standards.

The best way to ensure your medical facility is up to code is to work with a skilled, compliance-minded vendor. Before we get to that, it may be worth stepping back to make some broader observations about the nature and scope of NFPA compliance.

Which Healthcare Environments Require NFPA Compliance?

There are a couple of NFPA codes that apply specifically to healthcare environments: NFPA 99: Health Care Facilities Code and NFPA 101: Life Safety Code.

In NFPA 101, there is a thorough list of the types of organizations that must maintain NFPA compliance, along with short descriptions of each. The code lists:

  • Hospitals. The NFPA describes hospitals as buildings that are active on a 24-hour basis, providing medical, psychiatric, obstetrical, or surgical care for a minimum of four inpatients.
  • Ambulatory facilities. Ambulatory facilities provide outpatient services to four or more patients at a time.
  • Business occupancy. Business occupancy is a term that describes pretty much any facility in which the transaction of business (other than mercantile) takes place. Most doctors’ and dentists’ offices, if they do not fall under the ambulatory care designation, qualify here.

    • Most healthcare practices will fall under one of these basic categories, including oral health, mental health, and physical health facilities. The NFPA codes denote specific fire safety guidelines for each type of facility.


    It’s also worth mentioning that different cities operate under different iterations of the NFPA code. For instance, a surgery center in one state may operate under the 2015 NFPA 99, which has more stringent requirements than the 2012 version but is more lax than 2018’s version.


    Additionally, codes are enforced differently by a local AHJ (authority having jurisdiction) than they are by state health departments. It’s important to know when a facility is governed by the state health department or local jurisdiction. There are many codes that may be overlooked by AHJs that are not experienced with healthcare codes. A facility that is permitted and receiving a certificate of occupancy may not be accredited due to a code infraction, which the accreditation agency will know to look for.

    Which Functional Systems are Encompassed by NFPA Compliance?

    It is also important to note that any hospital or healthcare organization is like a living organism, with a number of individual systems that work in tandem to promote patient outcomes. Virtually all of these systems are encompassed by NFPA codes, including:

    • Gas
    • Ventilation systems
    • HVAC
    • Electrical systems
    • Plumbing
    • Communication systems
    • Fire protection systems
    • Patient and provider risk assessments

    NFPA codes classify each of these systems based on the risk of failure and the potential implications for injury, discomfort, and/or loss of life.

    Also note that specialized facilities, including bariatric chambers and clinical laboratories, have their own unique fire safety guidelines, all outlined in the NFPA codes.

    One thing the NFPA codes make plain is that fire safety is a systemic concern, and in order for any facility to be truly safe, all individual components of the fire safety system must be working harmoniously with one another. For example, having a sprinkler system is essential, but it is only meaningful when combined with an alarm system.

    What Are the Fire Safety Requirements Provided by the NFPA?

    For a comprehensive list of fire safety requirements, it is best to review the NFPA code in full. To provide a basic sense of what this document addresses, however, consider a brief synopsis of some of the primary guidelines for hospitals.

  • Compartmentation. It is important for hospital facilities to be designed and constructed in a way that impedes the spread of fire. That is what compartmentation is all about: Building layouts that wall off fires, retarding their progression through the building, and giving fire safety personnel time to act.
  • Fire sprinklers. Simply put, fire sprinklers are required throughout any building that is designated for healthcare occupancy. These sprinkler systems must be inspected to ensure their proper installation, and major components of the system must be further inspected monthly, annually, or semi-annually to ensure proper maintenance. Critically, inspections must be performed by qualified professionals, and the results must be carefully documented.
  • Fire extinguishers. Fire extinguishers must be placed throughout the building. The NFPA code also mandates that these extinguishers be selected, placed, tested, and inspected according to specified standards. Any food preparation areas, such as the hospital kitchen, must have fume hoods and full fire suppression systems.
  • Additional requirements. NFPA codes sometimes mandate that medical facilities have fire alarms and that these fire alarms be appropriately placed, maintained, and tested. Generators and alternate power sources are also required. Finally, operational plans and fire safety strategies must be prepared, and all personnel must be fully educated. Details of the fire safety plan should be clearly posted. For example, posters demonstrating the safest escape route should be placed in prominent, visible places.

    • NFPA Compliance: Risk and Reward

    Studies are pretty clear that, by maintaining compliance with NFPA protocols, medical facilities can significantly reduce their risk of on-site injury and loss of life. At the same time, failure to comply can put any facility in a high level of danger. We will discuss this danger in our follow-up post, then provide further information about the need to partner with a qualified vendor, such as HampMED.