Skilled Nursing Bulletins: Fire Safety Scrutiny, Anti-Psychs in Kansas

Fires Bring New Scrutiny to SNF Safety

In a year that has already brought significant national attention to the way nursing homes handle natural disasters, concerns about fire risk are springing up across the country in the wake of a Pennsylvania fire that killed four long-term care residents.

That blaze, at the Barclay Friends Senior Living Community in West Chester, Pa., also displaced 133 residents, according to the Associated Press, and brought headlines such as “Nursing Home Inferno” — as used by ABC’s “World News Tonight” — into American living rooms. (Barclay Friends provides memory care, skilled nursing, and short-term rehab, per the AP.)


Just last week, Idaho’s fire marshal called for a complete federal overhaul of fire codes after a blaze destroyed the Safe Haven Health Care facility, which specializes in behavioral care, in Pocatello earlier this month. No one died, according to the AP, but eight residents were treated for smoke inhalation, and the fire caused $2 million in property damage.

“I would find it very hard to believe the codes aren’t going to be reviewed on a national basis,” state fire marshal Knute Sandahl told the AP, citing both the fire in his state and the Pennsylvania incident.

The nursing home met all necessary fire safety requirements as laid out by the International Fire Code and the National Fire Protection Association, and yet the facility’s sprinkler system still couldn’t fight the blaze, which started due to an electrical problem.


“We’ll be making recommendations that the code be reviewed for possible changes on a national basis,” he said. “Are we keeping people as safe as we can, or do we need to modify his particular section of code?”

Skilled nursing home operators must consider fires and all other potential disasters when developing emergency plans, as mandated by new prep rules from the Centers for Medicare and Medicaid Services (CMS). Those regulations went into effect earlier this month.

Anti-psychotic use stubbornly high in Kansas

Kansas has consistently ranked near the top of states with the highest rates of anti-psychotic drug use in nursing homes, according to a new in-depth report from the Kansas City Star, and some advocates are raising the alarm about the issue.

In 2016, 20% of Kansas skilled nursing residents took an anti-psychotic drug, giving it the top spot alongside Oklahoma and Mississippi. Still, that’s down from a high of 26% in 2011, the Star reported, but other states have logged more impressive reductions over that span.

Cutting the use of drugs such as Haldol to control residents’ moods has been a top priority for CMS, and on a nationwide basis, those efforts have worked: By the first quarter of 2017, long-term care facilities had slashed anti-psychotic drug prescriptions to 15.7%, for a six-year decline of 34.1%. That’s below the agency’s 2011 goal of reducing usage by 30% by the end of 2016.

Rates remain particularly high in Kansas, which has a significant quantity of mental health-focused nursing facilities; still, even if those specialty SNFs are removed from the equation, Kansas rises from 51st in the nation (including Washington, D.C.) to only 42nd.

“A ranking of 42 is nothing to jump up and down about, but it is proof that our nursing homes have made steady and significant progress in reducing anti-psychotic use, including in relation to other states,” LeadingAge Kansas vice president for government affairs Rachel Monger told the Star.

Written by Alex Spanko

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