HospitalInspections.org

Based on observation, interview and review of the National Fire Protection Association (NFPA) standards, the facility failed to provide a resilient all-weather path and safe access to a public way from seven of nine patient exits, and failed to accommodate abrupt changes in elevation of walking surfaces exceeding elevation differences of 1/2 inches in accordance with NFPA 101, 2000, Chapter 7 Means of Egress. This deficient practice affects the entire facility census of 66.

Findings included:

1. Observation on 12/12/12 at 1:00 PM., showed an exit off the northwest "Annex" corridor that opened onto an outdoor concrete porch, six feet wide and four feet deep, dropped approximately 12 inches to a steep, sparsely vegetated grassy decline which lead to a wooded drainage ditch approximately 10 feet away from the step. The only level surface in the traverse from the exit termination was the four foot concrete porch that ended in a 12 inch drop-off. The nearest public way was the circle drive at the front of the building, which was more than 20 feet across a grass and dirt lawn surface.

2. Observation on 12/12/12 from 1:00 PM through 2:00 PM showed six other emergency patient exits around the perimeter of the building, (NW and SW Adult corridors, Senior A wing, Senior B wing and Pre/Post Adolescent wing, for a total of seven of nine patient emergency exits). Each of the exits terminated at a six foot wide by four foot deep concrete pad that was approximately three to eight inches above ground level and required evacuees to traverse up to 100 feet of grass-covered lawn before a hard path to safety, rescue, or recovery could be accessed.

3. During an interview on 12/12/12 at 2:00 PM., Staff UU stated that none of their previous surveys had cited or discussed an all-weather path to safety or observed that the drainage ditch and low lying areas could cause an impediment. He stated that they had discussed with the architects placing an all weather ramp off of the northwest exit that would compensate for the uneven terrain and getting stuck in mud. However, their plan did not call for the ramp or path to continue south until it intercepted the circle drive at the front of the building, and no action had been undertaken to initiate the project or expand the current renovation project to include ramps and walk-ways from the building's emergency exits.

4. Review of the NFPA 101, 2000, Chapter 7-Means of Egress standards showed the following:

-Means of egress shall be continuously maintained free of all obstructions or impediments to full instant use in the case of fire or other emergency. (7.1.10.1)

-Exits shall terminate directly at a public way or an exterior exit discharge. Yards, courts, open spaces, or other portions of the exit discharge shall be of required width and size to provide all occupants with a safe access to a public way. (7.7.1)

-Abrupt changes in elevation of walking surfaces shall not exceed 1/4 inches. Changes in elevation exceeding 1/4 inches, but not exceeding 1/2 inches, shall be beveled 1 to 2. Changes in elevation exceeding 1/2 inches shall be considered a change in level and shall be subject to the requirements of 7.1.7. (7.1.6.2)

-Walking surfaces shall be nominally level. The slope of a walking surface in the direction of travel shall not exceed 1 in 20 unless the ramp requirements of 7.2.5 are met. The slope perpendicular to the direction of travel shall not exceed 1 in 48. Means of egress shall be continuously maintained free of all obstructions or impediments to full instant use in the case of fire or other emergency. (7.1.6.3)