NFPA is a nonprofit membership organization that was founded in 1896 as the National Fire Protection Association. More than 300 NFPA codes and standards have an influence on every building, process, service, design, and installation in the United States as well as many other countries where it is used. The NFPA codes and standards of interest to clinical engineers and BMETs include NFPA 99, Standard for Health Care Facilities; NFPA 70, National Electrical Code; and NFPA 101, Life Safety Code. This article and forthcoming articles will review the NFPA 99, 2005 edition.

NFPA 99

NFPA 99 is a voluntary consensus standard and not a regulation. However, it is referenced or adopted by many authorities. Many private and government agencies reference and enforce NFPA 99. Examples include the Arizona Administrative Code, Title 9, Chapter 1, Section R9-1-412, “Physical Plant Health and Safety Codes and Standards”; Healthcare Facilities Accreditation Requirements for the American Osteopathic Association; and The Joint Commission. This makes it binding on many health care facilities in the United States.

NFPA 99 provides requirements on electrical systems; gas and vacuum systems; environmental systems; materials; electrical equipment; gas equipment; laboratories; manufacturer requirements for equipment used in patient care; and requirements for hospitals, nursing homes, and other health care facilities.

When using NFPA 99, it is important to know which edition of the standard the Authority Having Jurisdiction (AHJ) has adopted. For example, The Joint Commission has adopted the 1999 edition of NFPA 99. For interpretation purposes only, The Joint Commission has adopted a small section of the 2002 edition specific to oxygen volumes—see sections 9.4.1, 9.4.2, and 9.4.3; 5.1.3.3.2, 5.1.3.3.3, 5.1.3.3.3.2, and 5.1.3.3.3.3.

The most current edition of NFPA 99 available is the 2005 edition. Currently, NFPA 99 is going through a major revision that will change it to NFPA 99 Healthcare Facilities Code. It is being rewritten as a code so that it can be adopted into law by reference by the local authorities.

The NFPA Report on Proposals (available at www.nfpa.org/Assets/Files/PDF/ROP/99-A2009-ROP.pdf ) lists all the public proposals received for changing the existing NFPA 99, NFPA technical committee responses to those proposals, and the committee’s proposed changes. The public comment deadline ended on August 29, after which the NFPA hospital committee will discuss any comments that have been received. On February 20, 2009, a report on those comments will be published, and the final document will be adopted in June 2009 at the NFPA annual meeting. The next edition of NFPA 99 will come out in 2010.

The Scope and Intent of NFPA 99

The origin of NFPA 99 can be traced to a series of explosions in operating rooms in the 1930s. Since then, the concerns have grown to encompass other fire and fire-related hazards in health care. According to Section 1.1.1, “the scope of this document is to establish criteria to minimize the hazards of fire, explosion, and electricity in health care facilities.”

It is intended “for use by those persons involved in the design, construction, inspection, and operation of health care facilities and in the design, manufacture, and testing of appliances and equipment used in patient care areas of health care facilities” (Section 1.3.4).

Chapter 2 of NFPA 99 references different publications that are considered part of the requirements of this standard. The references of interest to clinical engineers and BMETs include NFPA 70, 2002 edition; NFPA 101, 2003 edition; and IEC 60601-1-2, Medical electrical equipment – Part 1-2: General requirements for basic safety and essential performance— Collateral standard: Electromagnetic compatibility— Requirements and tests, 2004.

Chapter 3 defines the terms used in this standard. More than 185 terms are defined in this chapter. Two of the terms commonly used are:

  • Patient Care Area: “Any portion of a health care facility wherein patients are intended to be examined or treated” (Section 3.3.138).
  • Patient Care Vicinity: “A space, within a location intended for the examination and treatment of patients, extending 6 ft
  • beyond the normal location of bed or device that supports the patient during examination and extending vertically 7 ft 6 in above the floor” (Section 3.3.140).

Review Questions

  1. The Joint Commission has adapted the ____ edition of NFPA 99.
    1. 1999
    2. 1996
    3. 2005
    4. 2008
    5. None of the above

  2. Patient care vicinity is a space, within a location intended for the examination and treatment of patients, extending ____ beyond the normal location of bed or device that supports the patient during examination and extending vertically ____ above the floor.
    1. 6 feet, 6 feet
    2. 6 feet, 7 feet 6 inches
    3. 6 feet, 7 feet
    4. None of the above

  3. The following organizations reference and enforce NFPA 99: ____.
    1. Arizona Administrative Code
    2. American Osteopathic Association
    3. The Joint Commission
    4. All of the above

  4. The most current available edition of NFPA 99 is the ____ edition.
    1. 2005
    2. 2008
    3. 2002
    4. 1999

  5. According to NFPA 99, any portion of a health care facility wherein patients are intended to be examined or treated is called ____.
    1. Examination Room
    2. Intensive Care Area
    3. Patient Care Area
    4. Treatment Room

See the answers


Arif Subhan, MS, CCE, is a senior clinical engineer, Masterplan, Chatsworth, Calif; chair, education committee, ACCE; and a member of 24×7’s editorial advisory board. For more information, contact .