Healthcare facility code updates reflect evidence-based findings: life safety expert

Dive Brief:

New requirements for internal communication networks, smoke and carbon monoxide detection equipment, fire alarms, sprinkler systems and lithium-ion batteries are included in the most recent updates to the International Code Council and National Fire Protection Association model codes for healthcare facilities, a Honeywell life safety expert said at a healthcare facilities conference in Minneapolis last week.
Alex Schick, a senior Upper Midwest regional business development manager with Honeywell Enterprise Fire, told attendees at the ASHE 2026 Health Care Facilities Innovation Conference that while some of the 2024 model code updates are “too prescriptive” and will likely see modifications in future update rounds, the code-setting organizations’ intent is to develop evidence-based standards that keep pace with present-day technology.
For example, more than two decades of research has shown that fire alarms with low-frequency tones — around 520 hZ — are more effective at rousing people who are intoxicated, under sedation, have hearing loss or are otherwise impaired, according to the NFPA.

Dive Insight:

Though it “will change again” due to stakeholder concerns about its prescriptiveness, the updated ICC standards on interior wireless communications networks known as Emergency Responder Communication Enhancement Systems, or ERCES, also aims to incorporate the latest technology, said Schick, who stressed he was speaking in his personal capacity and not on Honeywell’s behalf.

ERCES use bidirectional antennas or signal amplifiers to improve the performance of first responders’ two-way radios inside buildings, where walls, pipes and other built forms can impede radio waves, according to the NFPA.

Schick said the model codes are evolving to accommodate data transfers, text-based messaging, video relay and other communication media that weren’t widely available when the standards were first conceived.

The ICC model code contains flexibility for some new and existing buildings, so they won’t apply to every healthcare facility, Schick said. For example, facilities aren’t required to install ERCES if radio coverage is poor outside the building, he said.

Another exemption concerns buildings under 12,000 square feet without any subterranean spaces. Such buildings tend not to interfere with radio signals, Schick said.

The code also gives local fire officials discretion to allow wired first-responder communications systems in place of ERCES, though plugging a portable handset into a wall jack “is a very impractical way for a firefighter or police officer to communicate with their team,” Schick said.

The latest ICC model code adds functional requirements for certain fire safety equipment and expands the settings where they should be used, Schick said. For new construction, he said the changes include:

Low-frequency sounders should be placed in “I-1 occupancies,” such as “apartment-style nursing homes where there are people on staff but residents are expected to be able to self-rescue.”
Sprinkler systems in new buildings must now be able to send unique alarm signals that alert a supervising station to the presence of flowing water.
Carbon monoxide detectors must “annunciate at the control unit” and provide audio-visual alerts such as horns or strobes throughout the building unless the CO source can be contained to a confined area like a boiler room (though CO alarms must still send an alert to a continuously staffed station).
New buildings cannot rely on duct detectors alone to monitor CO levels because duct detectors provide no information about the gas’s source.
Testing and recordkeeping requirements for area-of-refuge smoke detection and emergency communications systems — typically placed in stairwells to support people who cannot self-rescue — have been brought in line with the stronger standards for fire alarms and other life safety equipment.

Some of these requirements, such as for carbon monoxide detectors, also apply to existing buildings that undergo significant renovations, Schick said.

One notable exception, he added: Existing hospital buildings are not required to have CO detectors in every sleeping area as long as the alarm transmits to an approved location.