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Jul 26, 2021

This Episode is sponsored by Wachter.

Welcome to episode 33 of Fire Code Tech! In this episode we talk to Stan Szpytek a former deputy fire chief and fire marshal of a Chicago metropolitan area fire protection district. In this episode, we discuss disaster preparedness, life safety compliance and codes and standards for center for Medicaid facilities.

Would you speak about your career and how you got started in fire and life safety?

What further bit of information would you give about your background and the different roles you have held?

What kind of services are you involved with as a consultant?

Would you speak about the codes and standards around Center for Medicaid Services facilities?

How do the international building code and NFPA 101 interface for CMS facilities?

What is the difference between disaster preparedness and conventional fire protection engineering?

What resources would you recommend to professionals?



Hello, all welcome to the show. I'm Gus Gagliardi, and this is fire code tech on fire code tech. We interview fire protection professionals from all different careers and backgrounds in order to provide insight and a resource for those in the field. My goal is to help you become a more informed fire protection.

Professional fire code tech has interviews with engineers and researchers, fire marshals, and insurance professionals, and highlights topics like codes and standards, engineering systems, professional development, and trending topics in the industry. So if you're someone who wants to know more about fire protection or the fascinating stories of those who are in the field, you're in the right place.

Hello, all welcome to episode 33, your fire code tech. Wanna give a big thanks to our sponsor for this episode. Walk. But we'll hear more from them later on in the show. On this episode, we have Stan spit tech. Stan is the president of the fire and life safety, Inc. Stan has been in the fire and life safety industry for over 35 years.

Stan runs his consulting practice now in which his specialty lies in risk analysis and disaster preparedness for board and care and skilled nursing facilities. I was compelled to have Stan on the podcast because I found him while watching a presentation online. Uh, center for Medicare facilities and common fire and life safety issues.

I'd never had a person before on the podcast who had a specialty in disaster preparedness. So I really enjoyed getting a different perspective from Stan on this episode. And we talked about some topics that, uh, I had never discussed before on the pod. Don't forget to give us a follow on LinkedIn and subscribe.

So you never miss an episode. So if you could give us a five star review on apple podcast, there would be huge. Well, Stan, thanks so much for coming on the podcast. I'm so happy to have you today. Welcome to fire code tech. It's great to be here. GU awesome. Awesome Stan. Well, uh, you know, um, we were speaking a little bit before and having a lot of good conversation, but uh, yeah, I'm excited to have you on.

And um, you know, I always kind of like to get started with a little bit. Of your background and how you found your way into fire and life safety. If you wouldn't mind telling the listeners stand. Sure. Well, it's great to be here and, you know, with a last name like mine, uh, through the years I've been, uh, Given a nickname that nickname is Stan, the fireman.

Nobody can say those seven letters of my last name. S Z P Y T E K. You know, if I ever get a chance to go on wheel of fortune, the first thing I think I'll say is pat, I'd like to buy a VA, but I'm Stan the fireman because I had a wise old nursing home administrator about 20 years ago when I started consulting while I was still active.

In the fire service as a deputy fire chief in a fire marshal in a suburban Chicago, um, fire district, uh, she looked at me and she looked at my business, uh, card and she said, I'll never be able to say that last name. She says, I officially w stand the fireman. And at first. It felt a little corny, but you know what, if people can remember you by a nickname or a moniker like Stan, the fireman, and if it's not a bad thing, uh, I think it's probably a good thing, but I'm staying the fireman because I started in the fire service.

Now this is, what's a little frightening to me when I do the simple math I've been involved with emergency response, fire safety, education, uh, consult. For 44 years, I started in the fire service in 1977 as a Cade. On a fire district in the Chicago metropolitan area that had a, um, a fire department that was volunteer, paid on call kind of a combination department, like many of the departments in the Metro area, uh, through the years to present date, most of those fire departments are now either full career or combination departments, fully staffed.

But, you know, I think about the origins and my desire to get involved with the fire service. You know, we all know about the influence that, um, um, role models have on us. Now, my role model when I was a little kid, wasn't, uh, an athlete, wasn't a movie star or a person on a TV show. I remember being in first grade in Burbank, Illinois.

I remember the fire department coming to my. During fire prevention week. I still remember that firefighter putting me up on the side of that old, I think it was a 1956 Mac pumper and, um, putting that scary air mask up to my face. And I just remember what my response was. I'm like, I wanna be one of them.

And at 16 years old, I was able to, um, to kind of realize that dream because the community that I lived in had a cadet program, you needed to be 15 and a half actually. Uh, when I knocked on the door, the fire. Fire station in pay park, Illinois. And the next thing I know, I'm on a vocational path that led me to a career that gave me a, a wonderful experience in the fire service that ultimately allowed me to retire from the fire service at a relatively LA young age.

Uh, I did my 26 years. Part of those years were as, uh, a cadet and then as a volunteer, then as a paid on call. And then I was one of the communities first. Six full-time firefighter paramedics that were hired, uh, in 1983 and in a blink of an eye, a 20 year career on the fire department kind of came and went.

And at the rip old age of 42, In 2003, I did. I retired from the fire department and I did what all good Chicago area firefighters do. I moved to Mesa, Arizona. So I really didn't retire at all. Guys. What I did was kind of, um, shift gears and I started to follow a passion that I have, and that was to be a fire and life safety consultant.

Awesome. Well, I appreciate that bit of exposition on your background, Stan, and, and, uh, kind of the, the first formative years of your career and your, your background in the fire service. That's, that's very interesting. Um, I wanted to transition to, uh, you know, speaking, uh, broadly about your career. Um, you talked about a couple of the roles that you've held so far, but I also, um, wanted to, uh, you know, dig a little bit deeper into, um, More specifically what, how many, you know, the kind of hats that you've worn during your time mm-hmm um, in the fire service and kind of segue into?

Sure. Well, that's, that's a good question because that's, that's what I often, um, promote and project to people when I'm explaining my background is that. Being on a smaller suburban fire district or fire department. Uh, a fire district is a separate taxing body, similar to a school district. And in that district, um, there was a couple of different municipal and county jurisdictions, but the hats that I wore, you know, started from being a fire cadet to becoming an EMT, to becoming a paid on call firefighter.

But in my official professional capacity as an employee of the district, when I was first hired in 1983, I was a paramedic. I was an engineer. And in the fire service, an engineer is a, is a person that operates. The apparatus drives the fire equipment, operates the pump. So not to the level of engineer as you and many of your peers are, but a fire service engineer, meaning the chauffeur or.

Operator of the equipment. I was also a certified fire investigator, a certified paramedic. I was the shift commander on my shift. I moved up through the ranks from Lieutenant to captain, to fire marshal, to deputy chief and fire marshal. So not only was I responsible for the, uh, response. Components of the fire department and administrative functions, but I was also a bureau chief, meaning that I was in charge of the fire prevention bureau.

So with the hats that I wore in the fire prevention bureau, I did plan review. I did public education. I did building inspection. Um, Major incidents were kind of bubbling to the surface. And this is even before nine 11, but think about what it was like in emergency response or the safety sectors or emergency preparedness prior to the year 2000, a lot of people remember the anxiety and, um, apprehension that we had.

As a world when it comes to, or when it came to Y two K, which was a non-event that never occurred. But then there was a need in communities to have someone that would deal with the emergency preparedness or emergency management elements of operations. So suffice to Sega, I wore a lot of hats and it was really kind of the launching pad for me to get involved with consult.

On my watch and in my jurisdiction, uh, it was primarily a bedroom community, meaning that we didn't have any industrial areas. The jurisdiction was a mix of residential properties, kind of an affluent area. Bigger houses, bigger lots. Uh, I had some houses in my jurisdiction, um, that were built on my watch that were as, as big as, uh, 20,000 square feet for a single family private residence.

Um, but I had mostly, uh, you know, Schools. I had some churches, but I had three nursing homes that were built on my watch along with an assisted living facility, a senior retirement community, along with, uh, a memory care building and an assisted living facility and all of these long-term care type facilities that were within my jurisdiction that I was involved with from concept.

To design, to inspection, to build out, to signing the, um, you know, the certificate of occupancy to conducting inspections in those buildings, to responding to emergencies in those buildings. I remember one such emergency happened in the late 1980s at one of my nursing homes on college drive. And I entitled the article that I wrote about a fire that happened in that facility, nursing home fire.

A success story. And in that article, that. Published in fire engineering magazine, I compared and contrast the elements of my fire to several serious fatal fires that occurred around the nation in skilled nursing facilities, where dozens of people were killed. Whereas in our fire, everything went right.

Sprinkler system activation, fire alarm system activation, proper staff response, horizontal evacuation. It was a page six blurb in the local newspaper instead of being a front page or front cover of the NFPA journal because dozens of people died. So maybe you're picking up on my proactive perspective on the fire service.

I loved being a responder. Couldn't wait to be one, but I started as a consultant to refocus my efforts and probably more appropriately my passion on. The proactive side of fire and life safety, the, of trying to prevent those events that, uh, we hope never make the newspaper. I like that. I like that there was a lot of great points there.

Stan. I liked hearing about, you know, you, I feel like you started to touch on a little bit of your, um, specialty in fire and life safety. I always liked to get a sense of individuals and kind of. Where their experiences, uh, created a niche or a wealth of experience. And to me, it sounds like, uh, it was kind of the dipping, the toe in the waters of the, uh, more residential facilities or like some of the institutional occupancies, but yeah.

But, uh, I appreciate that. And, you know, um, yeah, maybe, um, for those who don't know, you, you could speak, uh, more directly at, um, the kind of consulting work that you're involved with now. And when I moved to Arizona, uh, I knew that my business model and my, my consulting business was gonna focus, focus on a couple of different silos.

Um, we. Um, fire and life safety, uh, surveys and evaluations of all types of occupancies. We've got connections. My company, fire and life safety incorporated, or FLS, um, has relationships with many, um, insurance companies where we do safety surveys of schools within school districts. We work with several different arch diocese around the country, connected with different, uh, insurance groups.

And I. Pools, but my main. Element of consulting is the principle of the company is, um, healthcare, uh, and senior services. And within that umbrella of specialty, I'm really focused on, um, long term care. I'm the life safety and disaster planning consultant for a couple of different, or a few different state associations, including the Arizona healthcare Associa.

The California association of health facilities and the Utah healthcare association. In addition to that, uh, I've been able to really modify and maximize my niche with long term care associations around the country. And I'd say I'd probably have been connected to at least half of the states. Healthcare associations, where I, uh, get engaged to do breakout sessions on emergency preparedness life safety.

One of my true areas of specialty are the CMS, which is Medicare Medicaid requirements for healthcare facilities, both on life safety. and emergency preparedness. Uh, I design and conduct tabletop exercises. I facilitate discussion based exercises and you know, I've had to do probably what you and others have done when it comes to the educational venues during a pandemic.

Uh, I've done a lot of webinars on life safety, one in particular life safety considerations. Uh, or, or life safety in consideration of COVID 19, you know, what were the life safety or what are the life safety consequences of transforming buildings with strong focus on infection, control and management. So even though I've worked with many different types of occupancies through my connections with insurance companies or stand.

Clients that we've been able to, uh, engage with, which includes general industry, public assembly, uh, board and care, um, Merck and teal. I'd say my sweet spot is the work that I do with long-term care and healthcare facilities around the country. That's great. I, I appreciate that. A little bit of added information about, you know, kind of the services you provide and some of the different types of work that you're involved in.

I mean, I guess, uh, this next question may be obvious, but, um, as somebody who, you know, uh, works as a consultant or somebody who gets into specialized work, I just have a fascination with, um, you know, somebody like yourself to go out and, and start a business of your own. You know, I, it appears to me that your specialty and your experience has kind of, um, dictated, you know, what kind of services that you've offered as a consultant.

But I wondered if you haven't had any more exposition on like how you determined what services to offer as a consultant. I just think it's, uh, you kind of had a, a wide open space. You could have put your time into you. You had to have some, some passion behind these to, to get into 'em. Yeah. You know, there, there was definitely a Genesis to this and it already goes, I mean, it goes directly to the article that I spoke to you about.

So there was an admissions director that was at the facility that had the fire, um, that I wrote about the success story fire. And you know, one thing that I prided myself on in my jurisdiction was that I made a connect. With these long-term care facilities, the occupants within the jurisdiction, whether it was the owner of a strip mall, the occupants at the strip mall, the operators of a nursing home, the community hospital that was in my jurisdiction, the churches, the schools, I was that fire marshal, um, that had a partner.

With those types of agencies so that when the fire came that day at seven 15 in the morning at that facility on college drive, we weren't meeting each other for the first time we had a relationship and we managed the problem. Uh, Together. Well, it was this admissions director that was at this nursing facility who went on to become an executive director.

So the, the leader of a, of an assisted living facility in another nearby jurisdiction, she came to me and said, Stan, listen, you know, all that great stuff that you did at my facility when I was the admissions director, the community that my new building is based in. Doesn't have those kinds of resources and, you know, can you come to my building and teach the people how to evacuate, how to use a fire extinguisher, how to shelter in place.

And vis-a-vie, you know, I had an entrepreneurial thought she said, and I'll even pay you to come and do this for me. So I remember staying up. Into the wee hours of the morning at the fire station when I was on duty or when I was off duty at home, putting together a business plan, coming up with the business that was really focused on just doing fire safety kind of stuff.

But through the years, just like my career in the fire service evolved at first. You know, going back to the fifties and sixties and seventies and all points before that the fire service really was all about what you get response. You put the wet stuff on the red stuff, and it was really all about putting out fires.

But then in the seventies, we became more involved with. You know, emergency medical services. We had EMTs. Then we had paramedics. Then in the eighties, it was all about hazardous material response. Then it was technical re rescue. Then it was being responders to weapons of mass destruction. You know, you think about your firefighters today.

It's all about an all hazards approach to emergency preparedness response, recovery and continuity of services. And I just took all those elements. And kind of incorporated them into a business where again, it started out on a fire safety focus, then it expanded to emergency preparedness. And today it's gone.

Even beyond that, I've gone into risk management loss control. Infection, uh, measures. I've got a relationship with an industrial hygienist. You can only imagine the kind of work that we've been doing in the midst of a pandemic, but it's kind of been a dovetail of services that really, you know, focus. At the foundational level of life, safety and preparedness, but there are so many elements of that.

You know, I think one client that I had characterized what I do for my clients, uh, in a very simple phrase, he said to me, do you know why I hire someone like you? Cuz I'm not an engineer? Uh, I'm not a PhD. I'm a technician. I'm a fire marshal that can work to the advantage. Of my clients, uh, and their operations.

He said, I hire guys like you, or I hire you specifically because I need you to be my conscience. I wanna make sure that we're meeting code, that we're doing things to the level of best practices. And when it comes to long-term care or senior services, like a retirement community, which I work with, many of them around the country coast to coast, uh, the net product.

Are the clients, the people, the customers that they serve, they're not, um, producing a widget or a gadget they're providing. And this is what I say in many of the presentations that I make to staff to educate, inspire and motivate them. You're not just selling a beautiful environment of care or service.

You're not, um, providing simply a wonderful. Culinary experience and activities. The, the basic thing that you're providing is life safety and security. And that's what I kind of enhance my clients when, when I get involved with them. I see. Yeah, I like that. That's a, that's a good point. You know, um, I was offered this, uh, you know, piece of, um, advice or somebody.

We had a salesperson come in to speak with us about, um, they were trying to sell their product and they were saying, you know, how they had trouble, um, conveying, you know, how they add to the Bo bottom line, cuz they are a, uh, something that's in fire and life safety. And you know, I had issued a piece of advice that I had heard on, uh, one of the previous episodes of this podcast.

It was, uh, you know, as, as fire and life safety professionals, we. Maintain the. Companies, you know, right. To do business in the eyes of the loss. So I love that point that you're talking about, about how, you know, you are providing a safe environment for people. When, you know, if the fire and life safety is, uh, Paramount to that.

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They don't have to hire someone like this, but the clients that do to me, they're the ones that, that get it. They are kind of hedging their bet by not only meeting minimal compliance, but they wanna provide optimal safety for the people. You know, that generally. Occupy their buildings. Now, when I talk about regulated healthcare, such as a nursing home that might receive funding from a funding agency, like Medicare or Medicaid, they do have regulatory requirements.

And, uh, I'm the person and my, my team or my company comes in and we kind of are the objective observers. We're the conscience of the facility. Um, we let them know what they're. Right. What they're doing, uh, wrong. Where are there opportunities for improvement? So when that. Or federal surveyor or local inspector comes in.

They're not gonna find the penetrations in a firewall. They're not gonna see that the provider had missed a quarterly sprinkler test. We find these things. So we do a lot of mock survey, mock life safety tours, um, mock emergency preparedness tours to make sure that the providers are meeting their codes.

And in many cases, they're exceeding them and that's, that's the kind of environment and that's the ki kind of client we like to work with. That's great. Yeah. It's always nice to see good maintenance records and to be involved with clients who are concerned with. Not just meeting the minimum requirements of code, which that's what they are, minimum requirements, but, you know, providing, going above and beyond.

But yeah, you touched on, uh, you touched on it a couple times, this, uh, CMS center for, uh, Medicaid and Medicare and, um, kind of the codes and standards around it. You know, how I found you, Stan was, um, looking on YouTube and I was working for a, uh, hospital and I was trying to. You know, navigate the codes and standards around, um, CMS facilities.

And I found a great presentation on, on YouTube, uh, that you were doing about some of these common fire and life safety features. And speaking about the codes to, you know, to some extent around these facilities, uh, I'd love to hear you speak a little bit on, um, the codes and standard structure around these kind of occupancies.

It's confusing because, uh, CMS. Obviously as a federal agency and they are going to, uh, they needed to adopt, you know, consistent codes and standards that are applicable and enforceable, uh, around the country. Um, CMS typically engages contractors to, uh, provide the enforcement. Leg of, of the regulatory requirements and in many cases, uh, the enforcement body or the contractor in an individual state is a state's department of health or similarly titled, uh, agency in Arizona.

It's the Arizona department of health services in Illinois. It's the Illinois department of health in California. It's the California department of health, but. There's a breakout in California where the county of Los Angeles is the CMS. Contractor. So state surveyors working as, um, a representative of the federal government, um, come in from a life safety and emergency preparedness perspective, and they, um, make sure that these buildings are up to a specific code.

Now, the addition. Of the code or the main code that they are focused on and are re regulating is the life safety code and FPA 1 0 1. But present. The addition of NFPA 1 0 1, uh, is the 2012 addition of the life safety code. This is often in conflict with other jurisdictions that may not enforce the life safety code or have a different, more commonly, a more current addition of the life safety code.

But. Getting down to the brass tax of enforcement, CMS enforces the 2012 edition of the life safety code. The 2012 edition of NFPA 99, the healthcare facilities code and in chapter two of the life safety code. As most code officials and, and code officianados know chapter two and NFPA 1 0 1 is the reference publications, codes and standards.

So whatever chapter two of the 2012 addition of the code references. Those are the other applicable additions, I believe. Um, the 2012 edition of the life safety code references, the 2010 or the 2011 edition of an FPA 13, the same for 72 for fire alarms. And a lot of folks will say, wait a second. It's 20, 21.

Why are they using such. Uh, an older addition of the code in codes and standards in publications. Well, it's the federal government and they've gotta come up with some standard. And in my experience, it's about every five to seven years. They'll go through, um, the. Process of Congress updating a, a more frequent or I'm, I'm sorry, a newer edition of the code, but right now we're in the 2012 edition of the life safety code.

And I would imagine at some point in the coming years, we're gonna see. Um, CMS adopt, uh, a more, a newer addition of the life safety code. And one of the things that that leads to GU is a lot of frustration. You know, I can only imagine, uh, in your practice when you're trying to figure out the codes and standards for one of your clients, you know, you've gotta look for those conflicts.

You've gotta look for those incongruencies and. In my experience with healthcare, uh, facilities, particularly long term care or skilled nursing facilities. Um, there's a ton of frustration when it comes to navigating all the different AJS that are out there. Yeah. Stan, it's definitely a struggle. It feels like, um, operating in a, in a very, uh, specific or a different state.

And like, you know, I I'd compare it to like the difference between. Traditional code and then like working on a department of defense job it's you gotta throw the book out the window and, uh, uh, assume a whole new, uh, rules of engagement and operations. Uh, one part, one part, uh, that was confusing for me.

And, and maybe you could touch on this a little bit was, um, you know, the. International building code is generally what's adopted in, uh, most of the jurisdictions that I work in. You know, how does this, how does NFPA 1 0 1 and how you know, uh, CMS, um, and how they adopt NFPA 1 0 1 and N F P 99. You know, how do these two documents, uh, play with each other because, um, you know, the state or the, one of the jurisdictions, that's not the, the Medicare, uh, facility, um, might, uh, adopt I B, C or IM C.

And so how do these two documents, uh, cohabitate, I guess, Well, they, they really don't because the CMS doesn't really dabble into building codes. They defer to the, uh, appropriate jurisdiction that has authority. And sometimes there's multiple jurisdictions. Uh, I go back to my experience w working with the fire district, I had three different municipalities within my district, along with unincorporated cook county.

Each of those jurisdictions had their own building code, their own electric code. And then if you factored in a school, the school was exempt from our particular authority. They had their own code. And even in the seventies, eighties and nineties, they were still using, I believe the 1967 edition. Of the AIA code.

So there's a lot of conflict, a lot of consternation, a lot of frustration. And that's when I would have to tap in my third party, reviewer my fire protection engineering company from a local, uh, fire protection engineer that was in the Chicago area to, to navigate some of these things. But CMS really does not address, um, The building codes at all, they defer to the ones that are applicable.

And then if, if, uh, any of our, our, our listeners, um, are thinking about an assisted living facility, you know, to the. Common person on the street, you know, you're, you're, you're driving by a Manor care facility, a sunrise facility, a Genesis facility. The assumption can't be, if there's elderly folks in there, that must be a nursing home because there's different levels of care and licensure that's out there that comes with different requirements.

But just to compare and contrast. Assisted living facilities are regulated by state regulations on board and care or assisted living. They are not regulated by CMS, nor do they receive CMS or funding from Medicare or Mary Medicaid. It's all private pay. So it's extreme. I don't know if convoluted is the right word, but it's cons it's very confusing when it comes to peeling back, you know, the depth of, of the different authorities that have jurisdiction on, on these types of facilities.

Yeah. I think that's where, uh, a lot of my confusion comes from too. Stan is working for, uh, uh, a hospital with a myriad of different authority, having jurisdictions and. You know, stakeholders at hand, um, kind of makes the issue, uh, not so clear. So I appreciate that. Um, some more insight on, um, these kind of occupancies I'm, I'm fascinated with, uh, any little, you know, or it's not little by any means, but any different, um, kind of, uh, pond or, you know, different place in fire and life safety, where there is a lot of value to be added.

And, um, these occupancies, uh, obviously are one of those, but. Uh, well, lemme tell you this, when it comes to healthcare facilities, you know, anyone familiar with the life safety code and in particular, the 2012 edition of the code, they know that chapters 18 for new construction and chapter 19 for existing, you know, that's, that's the main area that we're going to when it comes to life safety compliance, uh, uh, in, in these facilities.

But like I said, there. The focus is the means of egress. The focus is, um, those life safety provisions. It doesn't really acknowledge a whole lot on building construction. Certainly building construction and construction type minimally is required for these types of buildings. But then if you factor in I B C or Boca or AIA, there's gonna be conflict.

And, and, and that's usually where it becomes a pretty. Pretty dicey, uh, proposition for many of these types of properties. Yeah, definitely. I, I, you know, the other thing too, the point that I wanted to make was when it comes particularly to the D the domain that I work with, skilled nursing facilities. I don't know if this is a badge of honor, or if it's a cross to bear, but skilled nursing facilities are the most highly regulated type of occupancy in the country.

Only second to the nuclear power industry. GU you mentioned that you do work, um, with hospitals, even hospitals, aren't regulated to the point that a nursing home is, and maybe rightfully so, but here's an example, you know, when you design or review a system, you know that there are certain areas within a hospital, maybe it's a closet.

Patient room that's less than 12 square feet may not require a sprinkler head, but in a nursing home, if you had a one by one square foot, um, closet, and it was, it met the definition of a closet or a space, you're gonna see a sprinkler head in there. These facilities are fully sprinkled sometimes.

Completely consistent with local jurisdictions that are proactive and, uh, up to speed with modern codes and standards. But you know, there is no standard across the country when it comes to individual jurisdictions, but. Nursing homes are put through the ringer, uh, in a hospital, you only have to, um, test and evaluate your smoke and fire dampers every six years in a nursing home it's every four years.

So it it's things like that. That help me kind of clarify the niche of. Health services that I wanted to focus on from a fire and life safety perspective. Whereas in a hospital, they might engage in engineering firm like yours to, um, support their in-house fire and life safety folks. But when it comes to a nursing home, It's usually the maintenance director who is also responsible for turning rooms, painting rooms, taking temperatures, who's responsible for life safety and emergency preparedness as well.

So I just saw an opportunity to be a third party supporter and provider for these kinds of facilities that just don't have those in-house resources. I see. I see. That makes a lot of sense. I, uh, that's an, I appreciate you illustrating the, the differences between the two, uh, you know, occupancies and their similarities and differences, but mm-hmm, , uh, I wanted to move on to, you know, you have a specialty in emergency preparedness and kind of, uh, planning.

Uh, different events, uh, like this, and I've never had the opportunity to speak with anyone with, um, an area of expertise, uh, in this, uh, field, if you will. And so I wanted to, uh, talk to you about, you know, like, Kind of what emergency preparedness is and, um, you know, uh, maybe contrast that to the kind of, um, traditional, uh, fire and life safety for, for buildings that I'm used to, or that you're, you know, aware of.

That's kind of more the fire protection engineer specialty T well, like I said earlier, it it's kind of all dovetailed together. One of the things that I. Stress when I'm presenting either on life safety or emergency preparedness, um, is that compliance for compliance sake is something that a provider should never focus on.

They should never just focus on checking the Bo the boxes and meeting minimal compliance, subsequent to some major. Disasters that have happened in our country since nine 11 through Katrina, through major wildfires, uh, and the impact those disasters have had on healthcare and particularly long term care.

Um, CMS again, along with many other states, um, have put a lot of focus on regulatory compliance for emergency preparedness. Uh, in California, a few years ago, they passed a bill that made assisted living. Um, that required assisted living facilities to be better prepared for all the different disasters and emergencies that can happen in a state like California.

One of the reasons that life safety compliance and emergency preparedness has kind of aligned in my practice or my scope of practice is because when CMS comes in and regulates a facility and assesses their life safety, they issue K tags or diff deficiencies. If something is, is out of compliance, but.

In 2016, CMS adopted some very stringent emergency preparedness requirements for skilled nursing facilities, hospitals, and 17 different CMS provider type recipients that receive federal funding to operate healthcare facilities. And this includes inpatient hospice, dialysis centers, behavioral care facilities, and so forth.

Um, they put some. Very specific requirements. Uh, and they developed, what's known as E tags that, um, identify the different levels of preparedness that are required to be in these facilities. Typically in most states, it's the life safety surveyors that now also look at the emergency preparedness elements of an operation.

So it was kind of a natural pairing that my. Focus evolved from just life safety to emergency preparedness. And some of the main elements of emergency preparedness in healthcare facilities is the same as emergency preparedness from a community based perspective. Emergency preparedness needs to have an all hazards approach, meaning facilities need to know what the hazards and perils are.

so that they can appropriately, uh, prepare for those types of events to occur. Now, in my experience, Emergency preparedness was very geocentric prior to these regulations. Meaning if I was working with the facility in the Midwest, their emergency plan typically focused on the obvious fire flood power failure, but then a lot of focus on severe weather when I'm working in the bay area or a seismically active area.

The plan seems to be. All about seismic activity. If it's a coastal region, it's tropical depression or hurricane, I know you'll feel sorry for me, GU, but I've even had to go to Hawaii and do work with some of the nursing homes, uh, around Pearl Harbor in Pearl city. And their plan was all about tsunami and title search.

So the shift has been a focus on an all hazards approach. It's regard. Of what the type of emergency occurring facilities need to have a plan to deal or manage these types of emergencies with an all hazards approach. What typically equates to hazard vulnerability assessment and the implementation and integration of the incident command system into their operations.

Very interesting. Wow. I like that. Uh, your take on that it has become, uh, more holistic in nature, emergency preparedness. I think that's a very, uh, very cool insight on, uh, the field, you know, uh, it's, uh, not always very, um, Uh, apparent to me how all that works. I do. I've seen people who are employed is like that's their entire job function is, uh, emergency preparedness and, you know, facilitating this kind of, um, uh, these services.

Where, you know, you're helping communities, or sometimes I'm sure that I've seen it for people who specialize for schools or college campuses. So I really think it's a, a big emerging field. I think, uh, fire and life safety and safety in general is kind of gaining steam all the time. So it's, uh, very interesting for me to hear you speak about, uh, this, uh, subsect of, uh, safety and, um, more like, uh, I don't know, it's a safety and, uh, more, uh, broad sense than, uh, just the building.

I guess it's more of, uh, safety, maybe on a similar level, like you were saying, you've had experience with, uh, insurance companies and how they evaluate risk. They evaluate risk, uh, more holistically in, uh, earthquake, you know, flood and some of these other factors that you're talking about, but. I'm not so involved, usually on the nature perspective of, of safety and maybe for some mass notification systems and having a button on the panel that says, Hey, there's a, you know, a weather event or a tornado or something, but that's about it.

Yeah, well, you use the word. Um, holistic. What I like to say is we, we focus on a programmatic approach to fire life safety and emergency ENVE, uh, preparedness. It's not just all about the built environment, which is clearly one of your specialties. It's not about the hydraulics or the voltage. Uh, it's about the plan.

It's about the training. It's about the drills, the exercises, um, the stuff. The supplies, the contingencies, the relationships that providers need to develop with their competitors, which might be the nursing home or the hospital down the street. And everybody under normal conditions is focused on putting heads and beds and competing with the other entities, but in a true emergency or disaster scenario, uh, it's gotta be an all in all together.

Programmatic approach, you know, just putting this into action. When I sit in my office, um, doing, uh, reports and paperwork and research, uh, in the background, uh, Go on a, an app. And I will listen to my department, my old department back in Illinois, running out on calls all day. Well, yesterday while I was in my, uh, office, I heard them dispatch to what came in as an smell of gas in the area when units got on the scene.

They discovered that they had a high pressure underground, uh, gas leak. Uh, the situation was caused by a cable crew that was trying to bury some TV cable. They punctured this high pressure gas line. And one of those nursing homes that I talked to you about earlier that were built on my watch was a hundred yards down wind from.

This high pressure gas leak that was gonna take up to six hours to remediate. Uh, the gas company said it's gonna take us till about this came, the call came in around 10 or 11 in the morning. They didn't think that they would have the situation rectified until about five or six that evening. Um, I heard the response upgraded from just a simple single engine response for a gas leak to what we call a.

Still in box alarm where multiple fire units and ambulances were dispatched to that nursing home to initiate, uh, relocation and potentially evacuation of the facility, because that natural gas was, you know, Right there. So it never got to the point where they had to evacuate, but they had to relocate people from the closest area of the building.

This multistory nursing home to the furthest area, crews were on standby for several hours. But the point I'm trying to make is that that nursing home. Identified, um, you know, things like that as part of their emergency plan. And when the fire crews showed up, it wasn't a foreign operation to anyone. It was.

Kind of business as usual. Uh, the incident commander within the care center likely worked seamlessly with the incident commander from the fire department, uh, and they were able to deal with the operation in a proactive way where, um, you know, the. Maybe saying business as usual is a little bit of a stretch, but it was a well orchestrated operation where no one was hurt.

Uh, the people of the facility were safeguarded. The operators of the facility knew about pipelines and hazmat trucks that, um, drive right down the street. So it didn't come as a huge surprise that they had to go into the emergency operation. I like that. That's interesting. I always enjoy it when people give, uh, real world accounts of, you know, when these plans are, you know, when pieces of their projects or operations are, are put into practice, I think it really drives home the, the meaning of what we do and.

You know, real world example, which all sounds kind of nebulous when you're speaking about, you know, uh, this, uh, these lofty ideals of, you know, having being prepared and having everybody know their role. But when you explain it, like, uh, you know, people being able to protect their, their facility and, and the, and those who are, uh, part of the building, um, in a real world application, I think that always helps drive the message home of why we do what we do.

So I like. Well, you know, this is what I've always said. It's a normal day at your facility until it's not. And yesterday at about 11 o'clock in the morning, it was a normal day at that nursing home until they got a knock on the door from a local police officer saying prepare to either evacuate a. Or relocate because this incident had just occurred, you know, the same is true with whatever the peril might be.

The process of hazard vulnerability assessment is a specific process that all healthcare providers under CMS regulations are required to go through. There are some tools that are out there. One such tool that's commonly used was produced by Kaiser Permanente in California. And it's a simple spreadsheet that lists 85 different perils from technological failure to mechanical failure to systems, failure to fire, to flood, to active shooter, to.

Civil unrest. Uh, it even includes zombie apocalypse as the final peril that, um, the facility, uh, as a team would rate, what is the probability. What are our levels of preparedness so we can determine what is our risk. And now these facilities are no longer arbitrarily speculating. What could happen. They know that there is, uh, an underground gas line within a quarter mile of their facility.

They understand that tornadoes could be a threat in a place like Oklahoma or Kansas or Illinois, or just about anywhere in the country, but to what. And that's what the HVA process does. Is it scales, you know, with an algorithm after you input the data, what is your probability of these things? And then what CMS says is that facilities, whether it's a hospital.

A nursing home, a hospice, or when it comes to best practices, any kind of business, you need to focus on your high probability of threats and perils. So if you are in the Midwest, yeah, you should focus a lot on tornadoes, but if you've got that gas line, you need to focus on evacuation. Uh, you know, it just can go on and on figuratively speaking that way, but you need to know what you don't know, so that you can plan.

Appropriately and it comes to, no, it comes as no surprise. When the officer knocks on the door and says, there's a gas line leaking down the street and you say to yourselves, what, what gas line or, you know, whatever scenario you can think of. Yeah. That's a great piece about, uh, probability and severity and yeah.

Doing a risk analysis. I like that. That's, that's essentially what it is. It's a risk analysis and that's what CMS says in its regulations. Facilities are required to do a risk analysis. Their plan needs to be. Based on that risk analysis. And they also have to develop continuity of operation plans or business continuity plans to continue their service and their operations through a disaster.

Cuz you know, when it comes right down to it in any healthcare facility or maybe any occupancy for that matter, it comes down to, you know, two questions. Should I stay or should I go, are we gonna shelter in place or are we gonna evacuate? . Yeah, that's great. Well, Stan, I always like to, uh, kind of wrap up my interviews with, um, you know, professional development questions.

Um, and I just always like to ask from people who are really plugged in, um, you know, what kind of resources or, uh, professional societies, um, would you recommend to professionals that are interested about, uh, uh, your area of expertise? Well, certainly, you know, being a member of, uh, the national fire protection association is something that, that I would recommend.

And I would assume that many folks with an interest in this field are already connected to, uh, state fire, marshal, or fire. Uh, inspector associations, fire chiefs, associations, um, other professional organizations that are out there even though I'm retired 18 years now, you know, I stay connected with the international association of fire chiefs, uh, the fire marshals associations, uh, and different.

Um, you know, organizations and agencies that can provide me with educational updates and things that I can stay connected to the industry without just always focusing on, you know, my own clients and what their needs are. Um, I like to be aware of, um, you know, one of the parts of my practice is that I do now a lot of.

Shooter training, armed, intruder, active shooter, uh, work with many schools. I work with people who've experienced these shootings. So as much experience as you can get to help you drive your passion. And I gotta really focus on passion because GU I get the impression you not an impression. I know that you've got a passion for what you do.

I hope it's clear that I have a passion for what I do. You know, you've gotta follow your passion. With professional development, don't get stuck in your own silo. It would be easy for me to, uh, just focus on healthcare. But as an example, uh, I'm gonna go to right here in Arizona next week, the Arizona fire chief's association conference, and sit in on a few sessions that are, are, uh, that, that they'll be presenting.

So it's like, you know, you can never learn enough when it comes to this stuff. And when it comes to emergency preparedness, You always learn something new after every event, after reviewing every after action report, reading every critique, every article that's out there. Uh, it's a continuous process.

Awesome. Well, I think, uh, I can't think of any other better way to wrap things up. Stan. I just want to thank you so much for your time and, um, yeah, I really enjoyed, uh, speaking with you today. Um, thank. Gus. It's been my pleasure and I hope we get to talk again. Sure. We will. Thanks for listening. Everybody.

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