Let There Be Light(s): Power Strips In Long Term Care Settings…

Stan Szpytek

Stan Szpytek

Hello, ProviderNation. The current “buzz” in life safety compliance in health care is focused on the “Categorical Waiver for Power Strips Use in Patient Care Areas” that CMS issued on Sept. 26, 2014.

A number of life safety professionals around the nation are weighing in on this important matter and providing health care facilities with useful guidance and resources. Here is some comprehensive information released by Russell Phillips & Associates Oct. 16, 2014, and is shared with full permission:

The Centers for Medicare & Medicaid Services’ (CMS’) much-anticipated release of a Survey & Certification Memorandum addressing power strips provides some important clarification to the ongoing confusion and misinterpretation regarding the permitted use of power strips in health care settings. However, the CMS information also raises some new questions and leaves some definitions open for interpretation. It appears that CMS will be providing some additional clarification in the future. In the meantime, here are some clarifying points regarding power strip use and the intent of the S&C Memorandum.

There are essentially three specific components to the S&C Memorandum:

  1. Utilizing Power Strips for Medical Equipment: CMS is permitting a categorical waiver that will permit health care facilities to apply the 2012 edition of NFPA 99 (The Health Care Facilities Code) relative to power strips.
  2.  Long Term Care Exemption: Under certain circumstances, CMS is exempting long term care facilities from the prescriptive and restrictive requirements relative to power strips that are outlined in the 2012 edition of NFPA 99 (The Health Care Facilities Code).
  3. Long Term Care Exemption: Under certain circumstances, CMS is exempting long term care facilities from the prescriptive and restrictive requirements relative to power strips that are outlined in the 2012 edition of NFPA 99 (The Health Care Facilities Code).

This information will likely be applicable to other authorities having jurisdiction with CMS deemed status.

Applying The 2012 Edition Of NFPA 99 (The Health Care Facilities Code)

Historically, NFPA 99 has only included provisions for the use of power strips in anesthetizing locations. However, the 2012 edition of NFPA 99 includes provisions for using power strips to power rack-, table-, pedestal-, or cart-mounted equipment. Section outlines a number of conditions, including the necessity for the power strip to be permanently attached to the equipment assembly. When meeting all the prescribed conditions, this will permit what is already the common practice of utilizing power strips to power various medical equipment assemblies.

NFPA defines the “patient care vicinity” as a location intended for the examination and treatment of patients expanding six feet beyond the device supporting the patient (that is, bed, table, or chair) and 7.5 feet above the floor. Power strips are not permitted in the “patient care vicinity” for nonpatient care equipment, including patient personal electronic devices (that is, phones, tablets, or other portable devices). Such items must be plugged directly into a normal receptacle. Power strips may be used to power electronic devices outside of the “patient care vicinity.”

All power strips should have a UL listing. Power strips serving medical equipment should be listed as UL 1363A or UL 60601-1. Power strips serving other items such as personal electronics should be listed as UL 1363.

Long Term Care Exemption 

CMS is providing long term care facilities relief from the strict prescriptive power strip requirements in certain situations. Facilities that “do not use line-operated electrical appliances for diagnostic, therapeutic, or monitoring purposes” are exempt from the requirements outlined in the 2012 edition of NFPA 99.

Ultimately, the power strip requirements will apply if electronic medical equipment is plugged in and connected to a resident. This is intended to address higher-acuity situations where residents may be connected to monitors or similar electrical treatment or diagnostic equipment. This is not intended to encompass common equipment such as electric beds and oxygen concentrators. In these arrangements, there is not a direct electrical connection between the equipment and a resident.

For long term care facilities that meet the exception, power strips can be utilized for items such as cell phones, tablets, and other personal electronics. However, the following requirements and best practices have not changed:

  1. Do not use multiple plug adaptors or power strips to compensate for an inadequate number of permanent electrical outlets. If permanent electrical devices in a room exceed the number of wall electrical outlets, consider having additional electrical outlets installed by a licensed electrician.
  2. Power strips can be considered for items such as computers, tablets, clocks, audio devices, and temporary electrical items used by a resident or patient that are powered or charged in a sleeping room.
  3. Do not use receptacle “splitters,” and do not “daisy chain” (connect multiple) power strips together.

As always, your state and/or local Authority Having Jurisdiction ultimately has the final say in what they will or will not accept.

Categorical Waiver

To take advantage of the categorical waiver option, the health care facility is not required to formally apply or communicate with CMS. Rather, it must document its decision to utilize the power strip categorical waiver provision. Additionally, the organization must make the survey team aware of its application of the categorical waiver at the survey opening meeting / conference for any life safety compliance related survey.

A template for the categorical waiver and other excellent resources can be obtained from Russell Phillips & Associates in their resource library.

Other American Health Care Association (AHCA) state affiliates like the California Association of Health Facilities (CAHF) are providing their members with ongoing technical consultative support by releasing information like these excerpts from a bulletin recently developed by Jason Belden, CAHF’s facility Infrastructure policy analyst / program liaison:

“As many of you know, CMS has issued a survey and certification letter that has relaxed or reversed some of the guidelines for use of power strips in patient rooms. This is still not a blanket acceptance for the use of power strips in patient rooms, however. We have received a number of questions due to the technical nature of the memo regarding what are patient care areas, what are examples of line-operated patient care electrical equipment, what type of power strips are OK to be used, and where can they be mounted.” 

“When mounting the UL 1363A or 60601-1 power strips, they must be mounted to the device itself. Mounting brackets can be purchased to directly mount the equipment without having to drill holes. Once that power strip is mounted, other devices can be connected to it, providing the total amount of amperage doesn’t exceed 75 percent of the listed maximum amperage. The other power strips cannot be mounted, but they must follow traditional location guidelines. They can’t pose a tripping hazard, they can’t be located in an area that is regularly subject to water, they can’t hang off the ground, etc.”

All of this information is certainly good news for providers. Be sure to follow the guidance presented in this article and work with all of applicable Authorities Having Jurisdiction (AHJ) and your facility’s management team to ensure that the right types of electrical power strips are being utilized in a safe and compliant manner in your facility.

Stan Szpytek is the president of Fire and Life Safety (FLS) and is the life safety/disaster planning consultant for the Arizona Health Care Association and California Association of Health Facilities. Szpytek is a former deputy fire chief and fire marshal with more than 35 years of experience in life safety compliance and emergency preparedness. FLS provides life safety and disaster planning consultative services to health care and senior living providers around the nation. For more information, visit www.EMAllianceusa.com or email Szpytek at Firemarshal10@aol.com.

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Filed under Long term care, Post-acute care

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