Water damage from failed sprinkler systems can lead to significant property damage claims as well as business interruption issues. Attention to regular inspection, testing, and routine maintenance of fire protection systems can help mitigate this exposure.
On May 4, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to update healthcare facilities' fire protection guidelines (this includes hospices and senior living facilities), bringing them in line with provisions of the National Fire Protection Association’s (NFPA) 2012 editions of NFPA 101 Life Safety Code and NFPA 99 Health Care Facilities Code. The final rule makes it increasingly important for healthcare organizations to complete the required activities outlined in the NFPA 25 Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems.
While the NFPA 25 outlines the mandatory activities and their frequencies, the standard does not indicate who might typically best perform the various items; and, quite often, facility staff does not have adequate knowledge or experience in these systems. This bulletin offers a guide on what visual inspections, at a minimum, may be completed by in-house personnel. Organizations should consult with an outside fire protection contractor to perform activities that are more advanced, including those for routine testing and maintenance, as well as those activities that are outside of their internal capabilities.
The NFPA defines an inspection as “a visual examination of a system or portion thereof to verify that it appears to be in operating condition and is free of physical damage.” The inspection process provides some assurance that a fire sprinkler system will perform when it is needed most.
Depending on the size and experience level of facility staff, organizations may choose to perform the following visual inspections internally, and refer to an outside contractor for the additional activities required by the NFPA.
Daily Visual Inspections:
- Sprinkler Systems – Heated Valve Enclosures (without temperature alarm – during cold weather)
Weekly Visual Inspections:
- Control Valves – Position (sealed only)
- Backflow Prevention Assemblies – Unsupervised Isolation Valves
- Fire Pumps – Pumps, Motors, Engines, Controllers, Batteries, Fuel Systems, Switches, Gauges, Lubricants, Coolant, Piping, Isolation Valves, Relief Valves, and Pump House
- Sprinkler Systems – Heated Valve Enclosures (with temperature alarm – during cold weather)
Monthly Visual Inspections:
- Control Valves – Position (locked or electronically supervised)
- Backflow Prevention Assemblies – Electronically Supervised Isolation Valves
- Fire Pumps – Battery Charging System
- Sprinkler Systems – Dry Pipe and Alarm Check Valves
Quarterly Visual Inspections:
- Fire Department Connections – Condition and Accessibility
- Pressure Relief Valves – Condition
- Standpipe and Hose Systems – Pressure Regulating Devices, Piping and Hose Connections
- Fire Pumps – Batteries (terminals)
- Sprinkler Systems – Pressure Regulating Devices
Semiannual Visual Inspections:
- Fire Pumps – Engine Exhaust Insulation
Annual Visual Inspections:
- Piping Systems – Leaks/Corrosion/Damage/Restraints (exposed outdoor)
- Standpipe and Hose Systems – Nozzles, Hose Storage Devices, and Cabinets
- Sprinkler Systems – Sprinkler Heads, Piping, Hangers, and Seismic Braces
It is critical for organizations to maintain fire system operational reliability and minimize the risk for property damage. Maintaining fire sprinkler systems in accordance with NFPA standards, including following the mandated inspection, testing, and maintenance schedules, will help organizations control the risk of a system malfunction or failure.
Facilities may have skilled and knowledgeable electricians, mechanics, and other trade specialists on staff; however, fire protection systems have some unique attributes that in-house personnel may not have experience with or adequately understand. It is recommended that organizations utilize an outside contractor that specializes in fire protection systems whenever their internal knowledge and experience is insufficient.
Self-Inspection Quick Reference Table | This document provides an overview of NFPA standards for recommended test activities and testing frequencies.
National Fire Protection Association | The NFPA website provides information and resources on fire, electrical and related hazards, including related codes and standards.
National Fire Protection Association (NFPA). (2017). Standard for the inspection, testing, and maintenance of water-based fire protection systems (Standard No. 25). Retrieved from https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=25