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NFPA 99 - health care facilities code

Written by Steve Hudgik September 2013

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NFPA 99 is a code, developed and published by the NFPA, that establishes criteria to minimize the  potential for fire, explosion, and electricity hazards in health care facilities.  Unlike many other codes, instead of targeting physical locations, NFPA 99 addresses the risks associated with medical procedures.  In other words, NFPA 99 establishes safety requirements based and what is being done, not where it is being done.

While the NFPA 99 code is not enforceable as law, it is written so that it can be directly adopted by cities, counties, and states as their code covering health care facilities. In addition, NFPA 99 may be used by healthcare organizations to set minimum standards for their facilities.

An Overview of NFPA 99

Health care protects people and improves their quality of life. NFPA 99 protects the people who work in health care. To accomplish this NFPA 99 is regularly updated to stay current with new health care technology, procedures, and treatments.

Using the chapter titles from NFPA 99, the following is a brief overview of what is covered by the 2012 version:

  • Fundamentals
  • Gas and Vacuum Systems
  • Electrical Systems
  • IT and Communications Systems
  • Plumbing
  • HVAC Systems
  • Electrical Equipment
  • Gas Equipment
  • Emergency Management
  • Security Management
  • Hyperbaric Facilities
  • Features of Fire Protection

Fundamentals of NFPA 99

In the "Fundamentals" chapter NFPA 99 defines "patient care" areas as "any portion of a health care facility wherein patients are intended to be examined or treated." Section 1.3 of NFPA 99 divides patient care areas into four classifications:

  1. Critical care rooms
  2. General care rooms
  3. Basic care rooms
  4. Support rooms

These classifications identify the level of patient risk. Based on the risk, the required level of system reliability is established. The four categories of system reliability are:

  • Category 1 – These are systems that must work, or be available at all times, to support patient needs.
  • Category 2 – Are systems that are expected to provide a high level of reliability. However, there can be limited short durations of equipment downtime without a significant impact on patient care.
  • Category 3 – These systems are normal building systems. They may support patient needs, but should they fail, their failure does not immediately affect patient care.
  • Category 4 – These systems have no impact on patient care. Should they fail there would be no noticeable impact on patients.

Each physical area in a health care facility is identified as being in one of these four categories.

NPFA 99 Gas and Vacuum Systems

This chapter covers the performance, maintenance, installation, and testing of gas and vacuum systems that are not portable.  Portable compressed gas systems are covered in a later chapter. This chapter covers topics such as:

  • Nonflammable medical gas systems with operating pressures below 300 psi (2068 kPa) gauge.
  • Vacuum systems.
  • Waste anesthetic gas disposal (WAGD) systems, also referred to as scavenging systems.
  • Equipment or assemblies intended for connection to the medical gas, vacuum, or WAGD systems. In some instances this equipment is also referred to as a scavenging system.

NFPA 99 Electrical Systems

The electrical systems chapter covers the maintenance, testing, and performance of electrical systems in health care facilities. The electrical requirements in NFPA 99 only cover patient care locations. NFPA 99 does not cover non-patient care areas such the business office and waiting rooms.

An example of a NFPA 99 electrical requirement is that, with some exceptions, chassis leakage currents may not exceed 300 microamperes.  In addition, for electrical equipment intended for use within the  patient care vicinity, there is a limit of ½ ohm for the resistance between a conductive chassis surface and a grounding point. NFPA 99 defines the patient care vicinity as:

"a space, within a location intended for the examination and treatment of patients, extending 6 feet (1.8m) beyond the normal location of the bed, chair, table, treadmill, or other device that supports the patient during examination and treatment. A patient care vicinity extends vertically 7feet 6inches (2.3m) above the floor.” 

The ballot for NFPA 99 2012 listed the following electrical areas as not being addressed in the 2012 version because they are covered by other NFPA codes:

  1. Specific requirements for wiring and installation of equipment are that are covered in NFPA 70, National Electrical Code (NEC).
  2. The requirements for illumination and identification of egress routes and exits are covered in NFPA 101, Life Safety Code.
  3. Requirements for installation, testing, and maintenance of fire protection signaling systems are covered in NFPA 72, National Fire Alarm and Signaling Code.
  4. For the requirements for signaling systems, also see NFPA 101, Life Safety Code, in addition to NFPA 72, National Fire Alarm and Signaling Code.
  5. The requirements for the installation of fire pumps are covered in NFPA 20, Standard for the Installation of Stationary Pumps for Fire Protection. There is an except that allows the alternate source of power to be the essential electrical system.
  6. The requirements for the installation of stationary engines and gas turbines are covered in NFPA 37, Standard for the Installation and Use of Stationary Combustion Engines and Gas Turbines.

NFPA 99 IT and Communications Systems

The chapter on communications covers the maintenance, performance, and testing of information technology and communications systems in health care facilities.

In some cases this chapter references other codes. For example, cables and installation must be installed in compliance with NFPA 70, the National Electrical Code, and with EIA/TIA 568-B. Distribution system cable labeling, record keeping, and alphanumeric schemes must be in accordance with the TIA/EIA-606-A code.

There are also specific requirements, including requirements for structures.  For example states that:

“In a facility where the primary data center is located remotely, two entrance facilities (EF) and redundant telecommunications service entrances shall be provided.”

NFPA 99 Plumbing

This is chapter 8 of NFPA 99. As with the other chapters it covers the maintenance, performance, and testing of a system, in this case the plumbing. As is common in NFPA 99 it supplements other codes to address issues that are specific to health care facilities.

NFPA 99 HVAC Systems

This chapter covers the maintenance, performance, and testing of heating, cooling, and ventilating systems in health care facilities. Let's look at an example from this chapter that covers the ventilation of enclosed areas containing HVAC systems.

NFPA 99 requires that natural ventilation be provided using two non-closeable louvered openings. They each must have a minimum aggregate free opening area of 24 sq. in./1000 cubic ft of the fluid stored in the space. In addition:

  • the area cannot be less than 72 square inches
  • one opening must be within one foot of the floor, with the other opening located within one foot of the ceiling
  • the openings must be be located to ensure cross ventilation
  • the openings most open directly to the outside atmosphere without ducting

Mechanical ventilation must be provided, if natural ventilation requirements cannot be met.

NFPA 99 Electrical Equipment

This chapter provides the maintenance, performance, and testing requirements for the electrical equipment used in health care facilities. It supplements other codes such as the NEC and NFPA 70E.

NFPA 99 Gas Equipment

This is chapter 11. It covers the performance, maintenance, and testing of gas equipment in health care facilities.

NFPA 99 Emergency Management

This chapter provides principles for emergency management, and disaster preparedness, response, mitigation, and recovery in health care facilities. Because no single type of an emergency management plan is feasible for every health care facility, this chapter provides the principles used in the preparation and implementation of an emergency plan. These principles are universally applicable. The specific implementation must be tailored to the facility.

NFPA 99 Security Management

The performance, maintenance, and testing of security equipment and systems is covered in this chapter.

NFPA 99 Hyperbaric Facilities

Hyperbaric chambers have unique hazards, including electrical, explosive, implosive, and fire hazards. This chapter provides information on how to recognize the hazards of hyperbaric chambers, and their associated facilities, that operate at gauge pressures from 0 kPa to 690 kPa (0 psi to 100 psi), and how to protect against those hazards.

NFPA 99 Features of Fire Protection

The final chapter covers the performance, maintenance, and testing of fire protection equipment in health care facilities.

The information presented in this document was obtained from sources that we deem reliable; Graphic Products does not guarantee accuracy or completeness. Graphic Products, Inc. makes no representations or warranties of any kind, express or implied. Users of this document should consult municipal, state, and federal code and/or verify all information with the appropriate regulatory agency.

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