Ever wonder why some doctors’ offices and ambulatory clinics don’t have to meet the stringent requirements of The Life Safety Code (NFPA 101) for Healthcare Occupancies (Chapters 18 and 19)? For example, why aren’t the corridors in an outpatient MRI facility 8 feet wide, or why doesn’t my primary care doctor have fire suppression systems (sprinklers) in his or her exam rooms? After all, aren’t they healthcare facilities where treatment is given to patients?

It’s really because these types of buildings don’t meet the definition of “healthcare occupancies” as established by the National Fire Prevention Association (NFPA), and the NFPA makes a distinction between the types of patients being treated. Specifically, if any medical facility treats fewer than four outpatients at the same time it normally qualifies as a “business occupancy,” which means the life safety requirements are much less severe. Thus, that self-standing structure in your community that has one MRI owned by the independent doctors’ group is really a business, not a medical facility in the eyes of the code enforcement people.

Same thing applies to a doctor’s office that has only one “treatment space” and does not use anesthesia on its patients. Don’t expect to see over-sized corridor widths in the means of egress or sprinklers throughout these facilities because they just aren’t required. When a clinic or treatment facility has four or more patients present and those patients are incapable of taking action for self preservation without the assistance of others, then it is a different story. If those patients are under the effects of anesthesia, have a mental or physical disability, or are subject to security measures not under their control, then the building classification will change to “Ambulatory Health Care Occupancy” for outpatients or simply “Healthcare Occupancy” for inpatients. These occupancies have very strict requirements for preventing and fighting fires because of the type of patients who are present.

Bottom line: The final interpretation about these definitions of occupancies rests with the local Authority Having Jurisdiction who needs to be consulted early on during the design process to make sure the occupancy designation is correct and the appropriate Chapter of NFPA 101 is consulted for code requirements.