2023 Tennessee Code › Title 68 - HEALTH, SAFETY AND ENVIRONMENTAL PROTECTION (§§ 68-1-NEW — 68-221-1319) › HEALTH (§§ 68-1-NEW — 68-6-201) › Chapter 11 - HEALTH FACILITIES AND RESOURCES (§§ 68-11-101 — 68-11-2308) › Part 2 - REGULATION OF HEALTH AND RELATED FACILITIES (§§ 68-11-NEW — 68-11-277) › Section 68-11-235 - Fire safety in nursing homes - Sprinkler plans - Compliance dates - New facilities - Effect of noncompliance - Fire drills - Reimbursement for Medicaid certified facilities

(a)
As used in this section, the term "nursing home" or "facility" means any nursing home as defined in §
68-11-201
.
(b)
No later than August 1, 2004, any nursing home that is not fully sprinklered as of May 3, 2004, must provide a smoke alarm or smoke detector, or both, in each patient room, which may be a single-station smoke alarm that is powered by battery or electrical current, or a series of smoke detectors that are connected together and have a central fire alarm panel, or any combination thereof.
(c)
Any nursing home that is not fully sprinklered as of May 3, 2004, must submit to the department of health a sprinkler plan for the full sprinklering of the facility.
(1)
If the facility provides patient care above the ground floor, the facility must submit the sprinkler plan no later than November 3, 2004.
(2)
If the facility provides patient care only on the ground floor, the facility must submit the sprinkler plan no later than April 3, 2005.
(d)
A facility not fully sprinklered as of May 3, 2004, may choose to completely replace the facility as an alternative to complying with subsection (c). If the facility elects to do so, it must submit to the commission a letter stating its intent to replace the facility and estimating the completion dates for the request for a certificate of need, commencement of construction of the facility, and licensure of the facility. This letter must be submitted to the commission within the time frame in either subdivision (c)(1) or (c)(2) that would otherwise apply to the facility.
(e)
Any facility that has submitted a sprinkler plan to the department prior to May 3, 2004, shall not be required to resubmit its plans.
(f)
The department of health must review and approve or disapprove any sprinkler plan for a nursing home within thirty (30) days of the plan being submitted by or on behalf of the nursing home. Any sprinkler plan for a nursing home submitted prior to July 1, 2004, must be reviewed and approved or disapproved by the department no later than August 1, 2004.
(g)
If the department disapproves a sprinkler plan submitted by or on behalf of a nursing home, that nursing home or the nursing home's contractor shall promptly resubmit the plan with any needed corrections or clarifying information. Once resubmitted, the department of health must review and approve or disapprove of the plan no later than thirty (30) days after the plan is resubmitted.
(h)
A licensed nursing home that is not fully sprinklered as of July 1, 2004, shall become fully sprinklered in accordance with the following compliance dates:
(1)
If the facility provides patient care above or below the ground floor, the facility must complete installation of sprinklers within twelve (12) months from July 1, 2004, or twelve (12) months from the date of approval of its sprinkler plan, whichever is later.
(2)
If the facility provides patient care only on the ground floor, the facility must complete installation of sprinklers within eighteen (18) months from July 1, 2004, or eighteen (18) months from the date of approval of its sprinkler plan, whichever is later.
(3)
A facility may request that the department extend its timeframe for installation of sprinklers, if the water service supplied by the local water utility or municipality is insufficient to operate the sprinkler system.
(i)
A facility not fully sprinklered by July 1, 2004, may choose to completely replace the facility as an alternative to complying with subsection (h). If the facility elects to do so, the new facility must be approved by the health facilities commission, must be constructed according to building plans that have been approved by the department of health, and must be in construction beyond the footing stage no later than three (3) years after July 1, 2004.
(j)
On and after July 1, 2004, the health facilities commission shall not issue a license to any new facility, unless that facility is fully sprinklered and provides a smoke alarm or smoke detector, or both, in each patient room prior to licensure. The smoke alarms or detectors may be single-station alarms that are powered by battery or electrical current, or a series of smoke detectors that are connected together and have a central fire alarm panel, or any combination thereof.
(k)
Failure to comply with this section shall be grounds for discipline or licensure action, or both, by the commission pursuant to §
68-11-207(a), (b), and (c)
. Any facility that fails to comply with the requirements and timeframes of this section may be required to appear before the commission to explain its noncompliance.
(l)
At least once per year, each licensed nursing home shall coordinate a fire drill with its local fire department. The local fire department shall observe the fire drill and provide input to the facility relative to the fire safety of the facility.
(m)
For medicaid-certified facilities that install the required sprinkler and smoke detector systems after July 1, 2004, the cost of such installation shall be reimbursed over a five-year period beginning after the installation is complete and based on the facility's medicaid cost ratio as computed by the comptroller of the treasury. The costs of such installation shall not be included in the facility's medicaid rate calculations, but shall be reimbursed in addition to each facility's medicaid per diem rate and not subject to the medicaid maximum rate.
(n)
For medicaid-certified facilities that installed sprinkler systems between August 1994 and July 1, 2004, the cost of such installation shall be reimbursed over a five-year period beginning July 1, 2004, based on the facility's medicaid cost ratio as computed by the comptroller of the treasury. The cost reimbursed over the five-year period will be calculated as total installation cost minus any depreciation cost for the sprinkler system the facility has claimed on medicaid cost reports prior to July 1, 2004. The costs of such installation shall not be included in the facility's medicaid rate calculations, but shall be reimbursed in addition to each facility's medicaid per diem rate and not subject to the medicaid maximum rate.
(o)
This section shall control to the extent that any existing law is in conflict with this section.
Amended by 2023 Tenn. Acts, ch. 466, s 55, eff. 7/1/2024.
Amended by 2022 Tenn. Acts, ch. 1119, s 63, eff. 7/1/2022.
Amended by 2022 Tenn. Acts, ch. 1119, s 62, eff. 7/1/2022.
Acts 2004, ch. 590, § 1; 2004, ch. 856, § 1.