Mandating Nursing Home A/C

But what happens when temperatures drop below or exceed the comfortable range? While I would have to assume that every nursing home has a heating system, I tend to think that many nursing homes do not have mechanical air conditioning. Fair assumptions? I think so.

I contacted several state agencies to find out what the written rules were regarding mechanical equipment. I was surprised to learn of the “vagueness” of the rules. For example, here is a reply from Laine Lucenti, director of the Vermont Division of Licensing & Protection: “The temperature range [71 to 81 degrees] is required of facilities that were certified after 1990. For facilities certified prior to 1990, they must still maintain comfortable and safe temperatures, but there may be times when brief episodes of unseasonably hot weather may exceed, or be below, desired ranges. In those instances, facilities are expected to take extra and precautionary measures to assure residents are comfortable, and receive plenty of fluids in hot weather.”

Dana Blanton, who is with the office of the Texas Secretary of State, sent provisions of the Texas Department of Social Services Rule 19.321. “The cooling system must be capable of maintaining a temperature suitable for the comfort of the residents in resident-use areas. The facility must be well ventilated through the use of windows, mechanical ventilation, or a combination of both.”

“The Illinois long-term care facility licensing regulations do not mandate mechanical air conditioning,” stated Rick Dees of the Illinois Department of Public Health. “The regulations do require that all facilities have emergency procedures in place to assure the health, safety, and comfort of residents if the internal building temperature/humidity exceeds a heat index of 80.

“The federal regulations require that long-term care facilities maintain a comfortable environment. The federal interpretive guidelines establish a comfort range of 71 to 81 degrees. There are a relatively small number of Illinois nursing homes without some level of mechanical air conditioning.”

Dees paints a hopeful picture, although he did say that mechanical air conditioning is not mandated. Herein lies my “cause.”

Dependable Systems

I believe that all nursing homes should be mandated to install mechanical air conditioning. I have heard many stories of residents who have died from heat stroke, in spite of “emergency measures” that the staff may have taken.

Some elderly residents, because of their diminished capacity to reason, may not have the ability to use common sense and sit in front of a fan or window air conditioner. I’m not being cruel; I’m just stating a fact. They need help. And if a staff member cannot offer assistance, there should at least be a mechanical system they can depend on — one that keeps them in the comfortable range.

At least New Hampshire is getting it right. A spokesperson for the Health Department e-mailed me with this message: “For any New Hampshire construction project submitted after 7/1/90, the plans would have required A/C. For those facilities built prior to that date, they are required to have a ‘comfortable and safe temperature level.’

Detroit contractor Kelly O’Brien of Guardian Environmental Services Inc. in Livonia, Mich., summed up the situation very well.

“Unfortunately this subject boils down to ‘dollars and no sense,’” he said. “I feel that it is a crime how the residents of many of these institutions are living with extremely poor IAQ 365 days a year.”

Please let me know your thoughts on this subject.

John Hall is business management editor. He can be reached at 248-244-1294, 248-362-0317 (fax), or johnhall@achrnews.com.

Publication date: 08/18/2003