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In February 2003, an early morning fire at the Greenwood Health Center, a nursing home in Hartford, CT, claimed the lives of sixteen residents. A similar fire in Nashville, TN later that year killed fifteen residents. In both cases, these facilities lacked an automatic fire sprinkler system.

Over 1.6 million elderly and disabled Americans live in nursing homes across the country. With limited mobility and health related impairments, this population is particularly at risk during a fire. The only way to virtually eliminate the threat of fire for these Americans is to install a fully operational automatic fire sprinkler system. 

Of the over 17,000 nursing homes nationwide, the Government Accountability Office (GAO) estimates that approximately 20 to 30 percent lack an automatic fire sprinkler system. 

While there is no record of a multi-death fire in a nursing home with an automatic fire sprinkler system, the federal government has no comprehensive standard which requires all nursing homes to have sprinkler systems, regardless of age. 

On July 16, 2004, the Government Accountability Office (GAO) released a report which concluded that “the substantial loss of life in the Hartford and Nashville fires could have been reduced or eliminated by the presence of properly functioning automatic sprinkler systems.” Alarmingly, the report also found that “state and federal oversight of nursing home compliance with fire safety standards is inadequate.” 

According to the GAO and industry experts, the single biggest obstacle preventing most nursing homes from installing sprinklers is the cost. Already burdened by the increasing cost to care for their residents and shortfalls in the Medicare funding they rely on, they simply cannot afford these systems. In addition, while CMS has it within their authority to increase fire safety standards and mandate the installation of sprinklers, it has repeatedly shied away from doing so because of the cost that would be passed on to nursing homes. 

On December 8, 2005, I joined Representative Peter King (R-NY) in introducing the Nursing Home Fire Safety Act (HR 4491).  The bill addresses the primary obstacle – the cost - to installing sprinklers by directing the Secretary of Health and Human Services to establish both a loan program and need-based grant program to aid nursing homes in tackling the high cost of installing sprinklers. 

The loan program would assist nursing homes that cannot afford the up-front cost of retrofitting their facilities, but could afford to pay back a low interest government backed loan.  The grant program would target those nursing homes in the greatest need of financial assistance in installing sprinkler systems by requiring the Secretary of Health and Human Services to give priority to homes that lack the resources to install these systems on their own. 

In addition, the bill expresses the sense of Congress that every nursing home in America should be equipped with full sprinkler systems within five years and that CMS should move quickly to adopt stronger fire safety standards. 

Legislative Information

• Text of HR 4491
• Bill Summary
• Current cosponsors of HR 4491
• Current status of HR 4491
• Introductory statement from Congressional Record

Letters of Support

• American Association of Homes and Services for the Aging
• American College of Health Care Administrators
• American Healthcare Association
• American Fire Sprinkler Association
• American Nurses Association
• Catholic Health Association
• CT Citizens Coalition Nursing Home Reform
• Good Samaritan Society
• National Association of Geriatric Nursing Assistants
• Tennessee Health Care Association
• National Citizens Coalition for Nursing Home Reform
• National Fire Protection Association
• National Fire Sprinkler Association
• National Volunteer Fire Council

GAO Report on Nursing Home Fire Safety (GAO-04-660)

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