This regulation requires nursing facilities to maintain an emergency electrical power system that provides lighting for all entrances and exits, supports fire detection and alarm systems, and powers life support systems during normal power interruptions. When residents rely on life support equipment, an on-premises emergency generator meeting NFPA 99 standards is mandatory. Surveyors must verify periodic testing records, proper lighting coverage, and that generators transfer power within 10 seconds of outage. A Type I Essential Electrical System is required where residents use life support equipment such as ventilators.
View official sourceF906 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.90(c) Emergency Power. §483.90(c)(1) An emergency electrical power system must supply power adequate at least for lighting all entrances and exits; equipment to maintain the fire detection, alarm, and extinguishing systems; and life support systems in the event the normal electrical supply is interrupted. §483.90(c)(2) When life support systems are used, the facility must provide emergency electrical power with an emergency generator (as defined in NFPA 99, Health Care Facilities) that is located on the premises. Guidance: §483.90(c)(1) and (c)(2) “Emergency electrical power system” includes, at a minimum, a generator or battery-operated power system for the lighting for all entrances and exits, fire detection and alarm systems, and extinguishing systems. Life support systems are required to be powered by an emergency generator that is located on the premises, see 483.90(c)(2). An “exit” is defined as a means of egress which is lighted and has three components: an exit access (corridor leading to the exit), an exit (a door), and an exit discharge (door to the street or public way). We define an entrance as any door through which people enter the facility. Furthermore, when an entrance also serves as an exit, its components (exit access, exit, and exit discharge) must be lighted. A waiver of lighting required for both exits and entrances is not permitted. “Life support systems” is defined as one or more items of electrically powered equipment whose operation is necessary to maintain a patient or resident’s life. For example, ventilators, suction machines if necessary to maintain an open airway, etc.. The determination of whether a piece of equipment is life support is a medical determination dependent upon the condition of the individual residents of the facility e.g. suction machine maybe required “life support equipment” in a facility, depending on the needs of its residents. “Essential Electrical System” is defined as a system of alternate sources of power and all commercial distribution systems and ancillary equipment, designed to ensure continuity of electrical power to designated areas and functions of a health care facility during disruption of normal power sources, and also to minimize disruption within the internal wiring system. Procedures: §483.90(c)(1) and (c)(2) Review results of inspections by the designated State fire safety authority that the emergency power system has been tested periodically and is functioning in accordance with the Life Safety Code, NFPA 99 and NFPA 110. Check placement of lighting system to ensure proper coverage of the listed areas. Review records of monthly and annual tests to ensure that emergency lighting system for, at least, lighting all entrances and exits is operational. If life support systems are used determine if there is a working emergency generator at the facility. A generator is not required if a facility does not use life support systems. Check that the emergency generator starts and transfers power under load conditions within 10 seconds after interruption of normal power. Where residents are on life support equipment, do not test transfer switches by shutting off the power unless there is an uninterruptible power supply available. A type I Essential Electrical System is required to be installed if the facility uses life support systems and residents are on life support equipment such as a ventilator to assist in breathing. Probes: §483.90(c)(1) and (c)(2) Is emergency electrical service adequate? Additional guidance is available in the National Fire Protection Association’s Life Safety Code NFPA 101 and NFPA 99, Health Care Facilities Code, sections 18.5.1.2, 18.5.1.3 and 18.2.9.2 and 18.2.20.5 which are surveyed in Tags K292 and K915 of the Life Safety code survey. Is there a working generator if the facility is using life support systems and is it maintained in accordance with the manufacturer’s recommendations and NFPA 99 and NFPA 110? Does the facility have a type I electrical system installed throughout the facility or at least to building areas where required in accordance with NFPA 72 and NFPA 99? If applicable, is the generator and emergency electrical system tested and maintained in accordance with NFPA 99 and NFPA 110 and are records of such maintained?