Health: Consumer Services and Healthcare Regulation: Life Safety Code Program

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Healthcare Regulation</a> </h2> </div> <ul class="vertical menu accordion-menu" data-accordion-menu data-submenu-toggle="true" data-multi-open="false"> <li> <a href="/health/cshcr/acute-and-continuing-care">Acute & Continuing Care</a> </li> <li> <a href="/health/cshcr/health-care-engineering">Health Care Engineering</a> </li> <li> <a href="/health/cshcr/reports-on-health-care-facilities">Reports on Health Care Facilities</a> </li> <li class="list-group-item list-group-item-nav "> <a href="/health/ltc" >Long Term Care/Nursing Homes </a> </li> <li> <a href="/health/cshcr/medical-radiology-services">Radiology</a> </li> <li> <a href="/health/cshcr/health-care-facility-information-center">Healthcare Facility Information Center</a> </li> <li> <a href="/health/cshcr/home-and-community-based-care">Home and Community Based Care</a> </li> <li> <a href="/health/cshcr/certificate-of-public-advantage">Certificate of Public Advantage <span class="show-for-sr"> - Click to Expand</span> </a> <ul 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href="/health/cshcr">Consumer Services and Healthcare Regulation</a></li> <li><span class="show-for-sr">Current: </span>Life Safety Code Program</li> </ul> </nav> <h1 class="info-heading"> Life Safety Code Program</h1> </section> <section id="content_container_623891"> <p>The Life Safety Code (LSC) is a set of fire protection requirements designed to provide a reasonable degree of safety from fire. It covers construction, protection, and operational features designed to provide safety from fire, smoke, and panic. The NFPA 99 Health Care Facilities Code (HCFC) is a set of requirements intended to provide minimum requirements for the installation, inspection, testing, maintenance, performance, and safe practices for facilities, material, equipment, and appliances. The LSC and HCFC, which is revised periodically, is a publication of the National Fire Protection Association (NFPA), which was founded in 1896 to promote the science and improve the methods of fire protection. The basic life safety from fire requirement for facilities participating in the Medicare and Medicaid programs is compliance with the 2012 edition of the NFPA LSC and HCFC. Centers for Medicare and Medicaid Services (CMS) partners with State Agencies (SA) to assess facilities for compliance with the LSC requirements.</p> </section> <section id="content_container_623893"> <h3>Contact</h3><table id="table09482"><tbody><tr><td><strong>Indiana Department of Health</strong><br />Division of Long Term Care<br />2 North Meridian Street, 4B<br />Indianapolis, IN 46204 </td><td><strong>Program Supervisor</strong><br />Amy Kelley<br /><a href="mailto:amkelley@health.IN.gov">amkelley@health.IN.gov</a></td></tr><tr><td> Long Term Care Receptionist: 317-233-7442<br />IDOH Main Switchboard: 317-233-1325 </td><td> 317-234-8502<br />Fax: 317-233-7322</td></tr></tbody></table> </section>  <section id="accordion_container_623895" class="accordion-container normal-width light-bg" data-ctype="accordion" style="background-color: ;"> <section id="content_container_623895"> <h3>Information and Policies</h3> </section> <ul class="accordion " data-accordion data-deep-link="true" data-deep-link-smudge="true" data-deep-link-smudge-delay="200" data-deep-link-smudge-offset="50" data-allow-all-closed="true" data-multi-expand="true" style="display:flex; flex-direction:column;" >  <li style="order:1" class="accordion-item orderFirst" data-accordion-item> <a href="#Emergency_Preparedness_Information" class="accordion-title"> Emergency Preparedness Information </a> <div class="accordion-content" data-tab-content id="Emergency_Preparedness_Information"> <p><a href="/health/cshcr/indiana-health-care-quality-resource-center/emergency-preparedness-resource-center">Emergency Preparedness Resource Center</a></p><p><a href="https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-emergency-preparedness-appendix-z-state-operations-manual-som">State Operations Manual Appendix Z</a></p> </div> </li>  <li style="order:2" class="accordion-item " data-accordion-item> <a href="#Forms" class="accordion-title"> Forms </a> <div class="accordion-content" data-tab-content id="Forms"> <p><a href="/health/files/Ambulatory_Surgical_Checklist.pdf">Ambulatory Surgical Center (ASC) and End Stage Renal Disease (ESRD) Life Safety Code (LSC) Entrance Conference Documentation Checklist</a></p><p><a href="/health/files/Battery_operated_Smoke_Detector_Maintenance_log.doc">Battery Operated Smoke Detector Maintenance Log</a></p><p><a href="/health/files/Battery-operated_Emergency_Lights_Testlog.doc">Battery Operated Emergency Lights Test Log</a></p><p><a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2786M.pdf">CMS-2786M Worksheets for Determining Evacuation Capability, Intermediate Care Facilities for Individuals with Intellectual Disabilities. (Applicable to Existing Facilities Only)</a></p><p><a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2786R.pdf">CMS-2786R Fire Safety Survey Report 2012 Code - Health Care Medicare-Medicaid</a></p><p><a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2786U.pdf">CMS-2786U Fire Safety Survey Report 2012 Code – Ambulatory Surgical Centers & End Stage Renal Disease Medicare</a></p><p><a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2786V.pdf">CMS-2786V Fire Safety Survey Report 2012 Code- Intermediate Care Facilities for Individuals with Intellectual Disabilities, Small Facilities</a></p><p><a href="https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS2786W.pdf">CMS – 2786W Fire Safety Survey Report 2012 Code – Intermediate Care Facilities for Intellectual Disabilities, Large Facilities</a></p><p><a href="/health/files/Fire_Drill_Report_A.doc">Fire Drill Report A</a></p><p><a href="/health/files/Fire_or_smoke_Damper_Maintenance_log.doc">Fire or Smoke Damper Maintenance Log</a></p><p><a href="/health/files/Fire_Watch_log.doc">Fire Watch Log</a></p><p><a href="/health/files/Hospital_Entrance_Conference_Checklist.pdf">Hospital Entrance Conference Checklist </a></p><p><a href="/health/files/ICF.pdf">ICF/DD Life Safety Code (LSC) Entrance Conference Documentation Checklist</a></p><p><a href="https://forms.in.gov/Download.aspx?id=10659">Life Safety Code Initial / Recertification / PSR / Walk - Thru Survey Exit Conference</a></p><p><a href="https://forms.in.gov/Download.aspx?id=7523">Life Safety Code Waiver Request</a></p><p><a href="/health/files/Monthly_Generator_Load_Test_log.doc">Monthly Generator Load Test Log</a></p><p><a href="/health/files/Nursing_Home_Life_Safety_Code_Entrance_Conference_Documentation_Checklist.pdf">Nursing Home Life Safety Code Entrance Conference Documentation Checklist</a></p><p><a href="https://forms.in.gov/Download.aspx?id=10553">Nursing Home Smoke Detector Status Report</a></p><p><a href="/health/files/Receptacle-Testing-Form-1.pdf">Receptacle Testing Form #1</a></p><p><a href="/health/files/Receptacle-Testing-Form-2.pdf">Receptacle Testing Form #2</a></p><p><a href="/health/files/Receptacle-Testing-Form-3.pdf">Receptacle Testing Form #3</a></p><p><a href="/health/files/Sample_Weekly_Generator_Test_log.doc">Sample Weekly Generator Test Log</a></p> </div> </li>  <li style="order:3" class="accordion-item " data-accordion-item> <a href="#Letters" class="accordion-title"> Letters </a> <div class="accordion-content" data-tab-content id="Letters"> <p><a href="/health/files/Natural_Gas_Five_Criteria_Template_Letter_Final.pdf">Natural Gas Five Criteria Template Letter</a></p><p><a href="/health/files/NFPA_Safety_Alert_regarding_Antifreeze_in_Residential_Sprinklers.pdf">NFPA Safety Alert Regarding Antifreeze in Residential Sprinklers</a></p><p><a href="/health/files/SCLetter07-11.pdf">Use of Alcohol-based Skin Preparations in Anesthetizing Locations</a></p> </div> </li>  <li style="order:4" class="accordion-item " data-accordion-item> <a href="#Links" class="accordion-title"> Links </a> <div class="accordion-content" data-tab-content id="Links"> <p><a href="http://www.cms.hhs.gov/CertificationandComplianc/11_LSC.asp">Life Safety Code Requirements</a></p> </div> </li>  <li style="order:5" class="accordion-item orderLast" data-accordion-item> <a href="#Manuals" class="accordion-title"> Manuals </a> <div class="accordion-content" data-tab-content id="Manuals"> <p><a href="/health/files/Emergency_Evacuation_Planning_Guide_for_People_with_Disabilities.pdf">Emergency Evacuation Planning Guide for People with Disabilities</a></p><p><a href="https://www.nfpa.org/Codes-and-Standards/Resources/Glossary-of-Terms">NFPA Glossary of Terms</a></p><p><a href="https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/LSC">State Operations Manual, Appendix I - Life Safety Code</a></p> </div> </li> </ul> </section> </article> <footer> <section id="footer_agency" data-ctype="agency-footer"> <div class="row expanded"> <div id="footer_agency-brand" class="columns small-12 medium-3"> <img class="logo_agency" alt="Agency Logo" src="/health/images/banners/health-reverse-horizontal.png" height="40"> </div> <div id="footer_agency-links" class="columns small-12 medium-9"> <div class="row expanded"> <div class="columns small-12 medium-expand"> <h2>About the Agency</h2> <ul><li role="none"><a href="/health/directory/office-of-the-commissioner/about-the-agency/leadership" style="padding: 0.5rem 0px">Leadership</a></li><li role="none"><a href="/health/directory/office-of-the-commissioner/about-the-agency/mission-and-vision" style="padding: 0.5rem 0px">Mission & Vision</a></li><li role="none"><a 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