Firefighters, fire marshals, and fire chiefs know how vulnerable senior living and long term care settings can be in the case of a fire. Residents with limited mobility, intellectual limitations, oxygen use, and other issues can create hurdles that must be planned for in advance. With an intentional, ongoing commitment to fire and life safety, facilities can overcome these challenges so they are better prepared should an emergency occur.
A fire and life safety strategy should be based upon three foundational elements:
- Comprehensive fire and life safety audits.
- Inspection, testing, and maintenance of fire and life safety systems.
- A competent and prepared staff.
Comprehensive Fire and Life Safety Audits
Long term care facilities are dynamic and constantly evolving environments. Frequent modifications, relocations, and operational changes can make maintaining fire and life safety compliance challenging. Staff turnover further complicates matters, often leading to the loss of critical institutional knowledge about a facility’s safety history.
While regular audits and local fire inspections are important, they may not be enough. Conducting routine audits, especially by an external life safety expert with experience in senior living and long term care facilities, adds an essential layer of protection. An external surveyor or inspector often spots code violations that internal staff may overlook simply due to familiarity.
Over time, staff can become desensitized to safety risks that blend into the daily environment. That’s why an annual fire and life safety audit conducted by a trained and objective professional is critical to maintaining a safe, compliant facility.
Common deficiencies often identified during an audit include:
- Fire and smoke barrier penetrations.
- Fire doors blocked or propped open.
- Egress/exit doors and corridors blocked or obstructed.
- Fire protection equipment that has not been properly maintained.
- Non-code-compliant modifications to facilities.
- Impaired fire protection systems.
- Delayed egress systems not functioning properly.
Inspection, Testing, and Maintenance of Fire Protection Systems
Because long term care facilities care for residents who may be vulnerable in the event of a fire, fire and life safety codes mandate the installation of critical, built-in fire protection systems. These systems are not a “one-and-done” method of protection. They require continuous inspection, testing, and maintenance to remain effective. The codes outline specific requirements for what needs to be done and when to ensure the systems function properly in an emergency.
To support this, providers should develop a comprehensive Fire Protection Systems Plan. This plan should clearly assign responsibility for system maintenance, establish a schedule for all required inspections and testing, and ensure proper documentation of all related activities.
The facility Fire Protection Systems Plan should include coordination with qualified fire protection contractors that includes annual testing of fire sprinklers, fire alarms, and emergency lighting. Facility staff should also be trained to recognize and report deficiencies promptly. Adopting a proactive approach to inspection testing, maintenance, and documentation, enables these systems to remain reliable and compliant, and, most importantly, protect residents and staff.
A Competent and Prepared Staff
Sound policies and procedures are elements that enable a competent and prepared staff. The policies and procedures should include staff training requirements, fire drill protocols, defined roles and responsibilities, and processes for ongoing verification and accountability.
Staff training should include a program for fire safety orientation of new hires. It is critical that new hires complete this training as soon as possible, prior to working on their own. Staff also need to be trained in the facility’s fire response plan and staff roles along with annual training in the R.A.C.E. (Rescue, Alarm, Contain, Extinguish) technique, which is specifically required by the Life Safety Code. Annual training in fire extinguisher use and training in evacuating non-ambulatory and residents with cognitive impairments ensures staff will be prepared when a fire event occurs.
Fire drills should be held quarterly, covering all shifts. The drills should simulate realistic scenarios so that staff think about their actions as they would during an actual fire. These scenarios should include blocked exits and night staffing levels. Staff performance should be evaluated on the time it takes to evacuate residents, proper use of fire doors and smoke compartments, and how they communicate with emergency first responders. Each drill should include a formal evaluation component to help identify training needs or gaps in existing policies and response plans.
Staff roles and responsibilities should be clearly defined and written into the facility fire plan. The plan should clarify roles such as who pulls the fire alarm, who checks rooms and restrooms for stragglers, and who accounts for residents in the assembly area. The fire plan also needs to include information as to how to notify other staff of a fire, who will coordinate with first responders and relay resident information. Procedures for notifying families during or after the incident should also be included.
Ongoing verification is important for two key reasons:
- Due to the vulnerable population in long term care facilities and the unique challenges, staff play a key role in overall fire safety. When every second counts, staff must be prepared and confident. Competency verification ensures every staff member not only knows the policies and procedures but can also demonstrate their ability to perform effectively under pressure.
- Competency verification is required to meet fire and life safety compliance standards such as the NFPA 101 Life Safety Code and any state or locally adopted codes. These codes require documented fire and emergency plans, regular staff training, periodic fire drills and exercises, and clear records demonstrating staff participation and competency.
Based on best practices in emergency services, providers should initiate communication with local firefighters and first responders to develop joint training opportunities and conduct meaningful drills with both staff and residents. Holding training sessions and drills together allows both entities to become familiar with the others’ policies and procedures and, more importantly, what each can expect of the other during an emergency as well as identify any potential gaps that need to be addressed. This collaborative approach fosters stronger teamwork between facility staff and emergency personnel and enhances overall confidence and preparedness.
Seconds Matter
Fires in senior living and long term care facilities can turn tragic in moments, but proactive fire and life safety programs save lives. Implementing a comprehensive strategy built on three foundational elements: regular fire and life safety audits, inspection and maintenance of fire protection systems, and a competent, confident staff provides a strong foundation for preparedness. When paired with collaboration from local first responders, long term care communities can effectively overcome challenges and be fully prepared when seconds matter.
A former firefighter, fire marshal, and fire chief, Dale Lyman, CFPS, is a senior fire protection consultant at Telgian Engineering & Consulting. Lyman authored the Ambulatory Surgery Center Safety Guidebook (Elsevier Publishing, 2017) and ASC Life Safety Survey Prep Guide (Kindle Direct Publishing, 2023). He can be reached via email at dlyman@telgian.com.