Patient Room Decorations
by Brad Keyes, CHSP, on Dec 18, 2019 12:00:11 AM
Q: Where does "Homelike Environment" end and fire safety begin? We have a resident in our nursing home who likes to push-pin everything she makes in activities to her wall. On a recent Life/Safety visit, the surveyor noted that she had "too much stuff" on her walls and that it was a "fire hazard". We are supposed to encourage "homelike" and "Individualized Care", then we are told that we have to tell the resident that they cannot decorate their "home" as they desire. I know there has to be a balance, but the items do not impede entrance nor egress to the room and, while there are a lot of items, high and low, they are not on top of one another nor sticking out more than 3 or 4 inches from the wall. One might consider them to be "cluttered", however, they are not on the floor. Also, he said that everything from pictures to wreaths to whatever has to be "flame retardant". Are we to spray everything that a family brings in from home?
A: I am very empathetic to your problem as I understand that CMS state agencies want you to create a “home-like” environment for long-term care patients, but yet, you are required to comply with the 2012 edition of the Life Safety Code. However, there is some relief available to you on this subject. Since CMS adopted the 2012 edition of the Life Safety Code effective July 5, 2016, section 184.108.40.206 changes how decorations may be displayed in the patient’s room:
- Combustible decorations are permitted to be attached to walls, ceiling and non-fire rated doors as long as the decorations do not interfere with the operation of the doors
- Combustible decorations may not exceed 20 percent of the wall, door and ceiling areas inside any room or space of a smoke compartment that is not fully protected by sprinklers
- Combustible decorations may not exceed 30 percent of the wall, door and ceiling areas inside any room or space of a smoke compartment that is fully protected by sprinklers
- Combustible decorations may not exceed 50 percent of the wall, door and ceiling areas inside patient sleeping rooms having a capacity of no more than 4 patients, in a smoke compartment that is fully protected by sprinklers
When calculating the percentage of area of the walls covered by decorations, you calculate only the wall-sections that are used by the decorations. In other words, if the south-wall of the patient room is the only wall that has decorations pinned to it, then you only use the area of the south wall, and not the other three walls in the room.
I don’t know if the decorations covering the walls that the surveyor saw were within the above limitations, but I would think your organization could calculate the square footage of the decorations and ensure it stays within the limits.