Form Cms-2786r - Fire Safety Survey Report - Health Care 2012 Life Safety Code Page 41
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50Name of Facility
2012 LIFE SAFETY CODE
ID
NOT
MET
N/A
REMARKS
PREFIX
MET
K913
Electrical Systems – Wet Procedure Locations
Operating rooms are considered wet procedure locations, unless otherwise
determined by a risk assessment conducted by the facility governing body.
Operating rooms defined as wet locations are protected by either isolated
power or ground-fault circuit interrupters. A written record of the risk
assessment is maintained and available for inspection.
6.3.2.2.8.4, 6.3.2.2.8.7, 6.4.4.2
K914
Electrical Systems – Maintenance and Testing
Hospital-grade receptacles at patient bed locations and where deep
sedation or general anesthesia is administered, are tested after initial
installation, replacement or servicing. Additional testing is performed at
intervals defined by documented performance data. Receptacles not listed
as hospital-grade at these locations are tested at intervals not exceeding 12
months. Line isolation monitors (LIM), if installed, are tested at intervals of
≤ 1 month by actuating the LIM test switch per 6.3.2.6.3.6, which activates
both visual and audible alarm. For LIM circuits with automated self-testing,
this manual test is performed at intervals ≤ 12 months. LIM circuits are
tested per 6.3.3.3.2 after any repair or renovation to the electric distribution
system. Records are maintained of required tests and associated repairs or
modifications, containing date, room or area tested, and results.
6.3.4 (NFPA 99)
K915
Electrical Systems – Essential Electric System Categories
☐ Critical care rooms (Category 1) in which electrical system failure is likely
to cause major injury or death of patients, including all rooms where electric
life support equipment is required, are served by a Type 1 EES.
☐ General care rooms (Category 2) in which electrical system failure is
likely to cause minor injury to patients (Category 2) are served by a Type 1
or Type 2 EES.
☐ Basic care rooms (Category 3) in which electrical system failure is not
likely to cause injury to patients and rooms other than patient care rooms
are not required to be served by an EES. Type 3 EES life safety branch has
an alternate source of power that will be effective for 1 1/2 hours.
3.3.138, 6.3.2.2.10, 6.6.2.2.2, 6.6.3.1.1 (NFPA 99), TIA 12-3
Form CMS-2786R (10/2016)
Page 41
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