[Federal Register Volume 70, Number 226 (Friday, November 25, 2005)]
[Rules and Regulations]
[Pages 71006-71008]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-23289]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Part 403

[CMS-1428-F3]
RIN-0938-AM80


Medicare Program; Changes to the Hospital Inpatient Prospective 
Payment System and Fiscal Year 2005 Rates: Fire Safety Requirements for 
Religious Non-Medical Health Care Institutions: Correction To Reinstate 
Requirements for Written Fire Control Plans and Maintenance of 
Documentation

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final rule; correcting amendment.

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SUMMARY: In the August 11, 2004 issue of the Federal Register (69 FR 
48916), we published the Hospital Inpatient Prospective Payment System 
final rule. This correcting amendment reinstates paragraphs (a)(2) and 
(a)(3) in 42 CFR 403.744 (Condition of participation: Life safety from 
fire), which were accidentally deleted by that rule. Those paragraphs 
relate to requirements for fire control plans and maintenance of 
documentation in religious non-medical health care institutions. The 
effective date was October 1, 2004.

EFFECTIVE DATE: This correcting amendment is effective November 25, 
2005.

FOR FURTHER INFORMATION CONTACT: Janice Graham, (410) 786-8020; 
Danielle

[[Page 71007]]

Shearer, (410) 786-6617; or Jeannie Miller, (410) 786-3164.

SUPPLEMENTARY INFORMATION:

Need for Corrections

    On November 30, 1999, we published an interim final rule with 
comment period titled ``Religious Nonmedical Health Care Institutions 
and Advance Directives'' (64 FR 67028) to adopt the 1997 edition of the 
Life Safety Code (LSC) for religious non-medical health care 
institutions (RNHCIs). We adopted the 1997 edition of the LSC because 
we believed that it provided the highest available level of protection 
for patients, staff, and the public at that time. The regulation also 
permitted a RNHCI to meet a fire and safety code imposed by State law 
if we found that the State-imposed code adequately protected patients. 
This interim final rule also added paragraphs (a)(2) and (a)(3) to the 
Life Safety from Fire Condition of Participation at 42 CFR 403.744. 
These paragraphs were added in order to ensure that RNHCIs had adequate 
fire plans in case of a fire emergency and to ensure that RNHCIs 
documented the fire safety inspections and approvals related to their 
State or local fire control agencies.
    On January 10, 2003, we issued a final rule titled ``Fire Safety 
Requirements for Certain Health Care Facilities'' (68 FR 1374) amending 
the fire safety standards for RNHCIs that adopted, with certain 
exceptions, the 2000 edition of the LSC published by the National Fire 
Protection Association (NFPA). One of the exceptions to the 2000 
edition of the LSC concerned the use of roller latches in health care 
facilities, including RNHCIs. In the 2003 final rule, we prohibited 
health care facilities, including RNHCIs, from having roller latches. 
The final rule provided a 3-year phase-in period to allow facilities 
time to replace their roller latches.
    On August 11, 2004, we published the Hospital Inpatient Prospective 
Payment System (IPPS) final rule (69 FR 48916). In this final rule, we 
clarified the phase-in date of the roller latch provision, and 
accidentally deleted paragraphs (a)(2) and (a)(3), which stated:
     (a)(2) The religious non-medical health care institution 
(RNHCI) must have written fire control plans that contain provisions 
for prompt reporting of fires; extinguishing fires; protection of 
patients, staff, and the public; evacuation; and cooperation with fire 
fighting authorities.
     (a)(3) The RNHCI must maintain written evidence of regular 
inspection and approval by State or local fire control agencies.
    This correcting amendment re-incorporates paragraphs (a)(2) and 
(3), which were inadvertently deleted from the regulations by the 2004 
IPPS rule.

Collection of Information Requirements

    This document does contain information collection requirements as 
summarized below. However, we believe the burden associated with these 
requirements is exempt from the requirements of the Paperwork Reduction 
Act of 1995 (PRA) as defined in 5 CFR 1320.3(b)(2) because the time, 
effort, and financial resources necessary to comply with the 
requirement would be incurred by persons in the normal course of their 
activities.
    Section 403.744(a)(2) states that the RNHCI must have written fire 
control plans that contain provisions for prompt reporting of fires; 
extinguishing fires; protection of patients, staff and the public; 
evacuation; and cooperation with fire fighting authorities.
    Section 403.744(a)(3) states that the RNHCI must maintain written 
evidence of regular inspection and approval by State or local fire 
control agencies.

Waiver of Proposed Rulemaking and Delayed Effective Date

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register and invite public comment on the proposed rule. We 
also ordinarily provide a 30-day delay in the effective date of the 
provisions of a rule. The notice of proposed rulemaking includes a 
reference to the legal authority under which the rule is proposed, and 
the terms and substances of the proposed rule or a description of the 
subjects and issues involved. We can waive both the notice of proposed 
rulemaking and the 30-day delay in effective date, however, if the 
Secretary finds good cause that a notice-and-comment procedure and a 
30-day delay in the effective date are impracticable, or contrary to 
the public interest and incorporates a statement of the finding and the 
reasons in the rule issued.
    We believe that proceeding with notice and comment procedures and 
delaying the effective date are impracticable, and contrary to the 
public interest.
    The notice and comment procedures and delay in the effective date 
are impracticable because delaying implementation of these provisions 
would hinder our ability to provide continuous safety standards for 
RNHCI patients. These requirements were established in order to protect 
the patients, facility staff, and the public, and they continue to be 
necessary in order to ensure that RNHCIs provide safe care.
    Proceeding with notice and comment rulemaking and delaying the 
effective date would delay the restoration of these two paragraphs. 
During this delay, fire safety could be compromised because providers 
would not be required to maintain their written fire control plans or 
document their inspection and approval by State or local fire control 
agencies, two requirements that are key to ensuring patient safety. In 
addition, our ability to ensure compliance with Sec.  403.738 would be 
impeded if facilities did not maintain documentation of their 
compliance with State or local inspections and approval processes, as 
required by applicable State or local laws, regulations, and codes.
    Publishing a proposed rule and delaying the effective date are 
contrary to the public interest because of the imminent danger to life 
posed by failing to enforce the requirements of Sec.  403.744(a)(2) and 
(a)(3). One of the major responsibilities of a RNHCI is to provide an 
environment for their patients, staff, and the public that includes 
safety measures as outlined in its fire safety plan. These requirements 
re-enforce the importance of continually providing and maintaining a 
safe environment for RNHCI patients.
    Therefore, we find good cause to waive the notice of proposed 
rulemaking and delayed effective date and to issue this correcting 
amendment.

Corrections to Regulations Text

List of Subjects in 42 CFR Part 403

    Grant programs-health, Health insurance, Hospitals, 
Intergovernmental relations, Medicare, Reporting and recordkeeping 
requirements.


0
Accordingly, 42 CFR chapter IV is corrected by making the following 
correcting amendments:

PART 403--SPECIAL PROGRAMS AND PROJECTS

0
1. The authority citations for part 403 continues to read as follows:

    Authority: 42 U.S.C. 1395b-3 and Secs. 1102 and 1871 of the 
Social Security Act (42 U.S.C. 1302 and 1395hh).


0
2. Section 403.744 is corrected by adding paragraphs (a)(2) and (a)(3) 
to read as follows:


Sec.  403.744  Condition of participation: Life safety from fire.

    (a) * * *
    (2) The RNHCI must have written fire control plans that contain 
provisions for prompt reporting of fires; extinguishing

[[Page 71008]]

fires; protection of patients, staff, and the public; evacuation; and 
cooperation with fire fighting authorities.
    (3) The RNHCI must maintain written evidence of regular inspection 
and approval by State or local fire control agencies.
* * * * *
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical 
Assistance Program)

(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: November 21, 2005.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 05-23289 Filed 11-23-05; 8:45 am]
BILLING CODE 4120-01-P