HospitalInspections.org
Bringing transparency to federal inspections
KIOWA COUNTY MEMORIAL HOSPITAL
No Description Available
Tag No.: K0050
Based on record review and staff interview, the facility fails to transmit the fire alarm during drills conducted outside the time frame allowed for coded drills and fails to assure that fire drills are held at unexpected times under varying conditions, at least quarterly on each shift.. This deficient practice has the potential of affecting staff preparation and experience in providing for the protection of all patients, staff, and visitors in the event of a fire. The deficiency affects all occupants and all patients in 2 of 2 smoke zones. The facility has a capacity of 15 and a census of 2 at the time of the survey.
Findings Include:
During the tour conducted 08/19/2015 at approximately 1:30 p.m., during a review of records for the last 5 quarters, it is observed:
-- 1. Fire drills performed in the fourth quarter of 2014 on the 1st and 2nd shifts and the 2nd quarter of 2015 on the 1st shift were conducted as "silent" drills and did not have the fire alarm activated during the drill.
--2. Fire drills performed on the 2nd shift in the fourth quarter of 2014 and first and second quarters of 2015 were performed in close proximity, as follows: 5:00 p.m., 4:00 p.m. and 4:00 p.m., respectively.
Maintenance Director and Maintenance Manager were present and acknowledged the results of the records review.
NFPA Standard: Requires drills be conducted at least quarterly on each shift under varied conditions to simulate the unusual conditions occurring in case of fire. The fire alarm shall be transmitted during drills although a coded announcement may be used between 9:00 p.m. and 6:00 a.m. The fire alarm shall be transmitted the day before or the day after the coded drill. 2000 NFPA 101, 18.7.1.2
LIFE SAFETY CODE STANDARD
Tag No.: K0050
Based on record review and staff interview, the facility fails to transmit the fire alarm during drills conducted outside the time frame allowed for coded drills and fails to assure that fire drills are held at unexpected times under varying conditions, at least quarterly on each shift.. This deficient practice has the potential of affecting staff preparation and experience in providing for the protection of all patients, staff, and visitors in the event of a fire. The deficiency affects all occupants and all patients in 2 of 2 smoke zones. The facility has a capacity of 15 and a census of 2 at the time of the survey.
Findings Include:
During the tour conducted 08/19/2015 at approximately 1:30 p.m., during a review of records for the last 5 quarters, it is observed:
-- 1. Fire drills performed in the fourth quarter of 2014 on the 1st and 2nd shifts and the 2nd quarter of 2015 on the 1st shift were conducted as "silent" drills and did not have the fire alarm activated during the drill.
--2. Fire drills performed on the 2nd shift in the fourth quarter of 2014 and first and second quarters of 2015 were performed in close proximity, as follows: 5:00 p.m., 4:00 p.m. and 4:00 p.m., respectively.
Maintenance Director and Maintenance Manager were present and acknowledged the results of the records review.
NFPA Standard: Requires drills be conducted at least quarterly on each shift under varied conditions to simulate the unusual conditions occurring in case of fire. The fire alarm shall be transmitted during drills although a coded announcement may be used between 9:00 p.m. and 6:00 a.m. The fire alarm shall be transmitted the day before or the day after the coded drill. 2000 NFPA 101, 18.7.1.2