PSM-11520-505936模块备件

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E0R05-2661-505896

满足
获得E分数的要求。
•填写F-2A（第4页），通过列出每一项来计算住院总得分
评分表（F-2A）中居民的姓名和分数，以及个人总数
分数。在“总计”一词右侧的方框底部输入总计
•通过列出每个人的姓名，完成F-2B，找到员工轮班分数（第4页）
要求工作人员留在设施内接受评估。
评估E分数高（员工数量少）的班次，通常是
夜班。输入报警系统有效性的适当等级
（由左下表决定）适用于每位工作人员。条款
报警等级中使用“有保证”和“无保证”。“有保证”是指
警报在允许员工进入的所有位置都“容易察觉”，
不管评分对反应的及时性。“不确定”是指
警报不满足“已确定”的条件然后添加分数并输入
盒子里的总数标有“总计”
•完成F-2C，通过完成
第5页顶部的图表。表示卧室的垂直距离（即
故事）从出口。转至第F-2C节计算E分数。进来
疏散援助总分（F-2A）和垂直距离得分
这两个盒子组成这个分数的分子，并将它们乘以
彼此在分母中输入员工轮班总数（F-2B），并将其除以
转化为分子的乘积。这是E分数。
•使用页面底部的图表可以找到疏散难度分数
5并在右下角的框中输入疏散难度级别。A.
分数等于或小于1.5表示提示。分数大于1.5但不超过
比5慢。分数大于5是不切实际的。将分数转移到
调查报告表CMS-2786的封面。作为额外的保障，
卫生设施测量员，在消防局的
访问时，应完成工作表上的项目I至VI，以便对住院医师进行评估
卫生设施调查样本中包括的每位客户。这将有助于
证实消防局通过访谈获得的调查结果
与工作人员讨论住户。这样做是为了确定是否有任何原因导致
质疑员工报告预测客户行为的有效性。健康
设施测量师无需填写所有表格或计算
评估难度指数，除非国家法规要求，但仅限于
完成项目I至VI。
消防局应从国家调查机构健康调查师处获得
完成“居民评级工作表”，并比较从
两次调查。如果一个或多个项目的任何一项至六项中存在差异模式
在样本中的客户中，国家机构无法证明贷款，直到这些差异得到调和。消防局和国家调查局必须
对EDI分数代表客户能力感到满意。
ICFs/IID调查程序
确定设施的大小和疏散难度后，对
建筑物有两种可选的建筑物评级方法。
•使用第32/33章适当章节中的规定性要求，
迅速、缓慢或不切实际；或
•使用NFPA 101A，《生命安全替代方法指南》，2001年版，
第7章，食宿和看护占用的消防安全评估系统
（FSES/BC）。
设施竣工和认证有两个单独的表格系列
取决于采用上述哪种方法。如果调查是使用
第32/33章规定性要求方法然后填写消防安全报告第32/33章，以及对居民、员工进行评级和确定
NFPA 101A第6章中团体的E分数。此外，请填写以下声明：
缺陷和纠正计划（CMS-2567），如果缺陷
建立
如果设施已通过或将通过FSES/BC第7章NFPA 101A认证
您已经确定了设施的疏散难度分数，并完成了
对设施的规定性调查您可以应用FSES/BC（NFPA 101A第7章），
确定合规性。请注意，整个消防安全调查报告必须
在应用FSES/BC时完成。这与通常的调查没有什么不同
医疗保健设施的程序。填写表格CMS-2786以及
FSES/BC工作表，作为表格的一部分，用于认证为
居住膳宿和护理入住。
校园内的多个建筑物或建筑物的一部分有时被一个设施用于
房屋客户。在这种情况下，分别对每栋建筑进行评级。在大型校园，例如
州立精神病学校

E0R05-2661-505896

E0R05-2661-505896
satisfy the
requirements for obtaining the E-score.
• Complete F-2A (page 4) Finding the Total Resident Score by listing each
resident’s name and score in the Score sheet (F-2A) and total the individual
scores. Enter the total at the bottom in the box to the right of the word “Total.”
• Complete F-2B Finding the Staff Shift Score (page 4) by listing the names of each
staff member required to remain in the facility for the shift being evaluated.
Evaluate the shift with the highest E-Score (least amount of staff), usually the
night shift. Enter the appropriate rating for the effectiveness of the alarm system
(as determined by the table on the lower left) for each staff member. The terms
“assured” and “not assured” are used in the alarm rating. “Assured” means that
the alarm is “easily noticeable” in all locations where staff is allowed to go,
regardless of the ratings on the promptness of response. “Not assured” means the
alarm does not satisfy the conditions of “assured.” Then add the scores and enter
the total in the box marked “Total.”
• Complete F-2C finding the Home’s Evacuation Difficulty Score by completing
the chart at the top of page 5. Indicate the vertical distance of bedrooms (that is
the stories) from the exits. Proceed to section F-2C Calculation of E-score. Enter
the Evacuation Assistance Total (F-2A) score and the vertical distance score in
the 2 boxes, which compose the numerator of this fraction and multiply them by
each other. Enter the Staff Shift Total (F-2B) in the denominator and divide them
into the product of the numerator. This is the E-Score.
• The Evacuation Difficulty Score is found by using the chart at the bottom of page
5 and entering the level of evacuation difficulty in the box at the bottom right. A
score equal to or less than 1.5 is Prompt. A score greater than 1.5 but not more
than 5 is Slow. A score of greater than 5 is Impractical. Transfer the score to the
cover page of the Survey Report Form CMS-2786. As an additional safeguard,
the health facilities surveyor, who visits the facility before the fire authority’s
visit, should complete Items I thru VI on the Worksheet for Rating Residents for
each client included in the health facility survey sample. This will help to
corroborate the findings of the fire authority obtained through their interviews
with staff about residents. This is done to determine if there is any cause to
question the validity of staff reports of predicted client behavior. The health
facilities surveyor is not required to complete all of the forms or calculate the
Evaluation Difficulty Index unless required to by State regulations, but simply
completes item I to VI.
The fire authority should obtain from the state survey agency health surveyors the
completed “Worksheet for Rating Residents” and compare the results obtained from the
two surveys. If there is a pattern of discrepancies in any of items I to VI for one or more
of the clients in the sample, the state agency cannot certify the facility until thesediscrepancies are reconciled. Both the Fire Authority and the State Survey Agency must
be satisfied that the EDI score is representative of client capability.
ICFs/IID Survey Procedures
After you determine the size of the facility and level of evacuation difficulty, rate the
building. There are two alternative methods of rating the building.
• Use the prescriptive requirements in the appropriate section of Chapter 32/33,
Prompt, Slow or Impractical; or
• Use NFPA 101A, Guide on Alternative Approaches to Life Safety, 2001 Edition,
Chapter 7, A Fire Safety Evaluation System for Board and Care Occupancies
(FSES/BC).
There are two separate series of forms for completion and certification of the facility
depending on which method above was followed. If the survey was completed using
chapter 32/33 the prescriptive requirements method then complete the fire safety reportchapter 32/33, as well as the Worksheets for Rating Residents, Staff and Determining the
E-Score of the group from Chapter 6, NFPA 101A. In addition, complete a Statement of
Deficiencies and Plan of Correction (CMS-2567), in the usual manner if deficiencies are
found.
If the facility is certified or is to be certified using the FSES/BC, Chapter 7, NFPA 101A
and you have determined an Evacuation Difficulty Score for the facility, and completed a
prescriptive survey of the facility you may apply the FSES/BC (Chapter 7, NFPA 101A),
to determine compliance. Please note that the entire Fire Safety Survey Report must be
completed when applying the FSES/BC. This is no different from the usual survey
procedure for health care facilities. Complete a Form CMS-2786 along with the
FSES/BC worksheets, which are part of the form, for each facility certified as a
Residential Board and Care Occupancy.
Multiple buildings or parts of buildings on a campus are sometimes used by a facility to
house clients. In such cases, rate each building separately. On a large campus, such as a
State School for the Mentally Disabled or State Developmental Center, a large building
may be surveyed under Chapter 18/19 Health Care and a small building may be surveyed
as a Residential Board and Care Facility under Chapter 32/33. In some cases, buildings
may be divided into separate wings, with one wing housing Residential Board and Care
occupants and the other wing housing Health Care patients. You may use different
chapters for different wings only if there is a 2-hour fire wall separating the two parts.
Large buildings previously meeting health care requirements such as a facility with 17
beds or more, which currently meets the health care provisions of the LSC, can continue
to be surveyed either under the Health Care Chapter or the FSES/Health Care. If the
large facility qualifies as Residential Board and Care occupancy, it may elect to be
surveyed under Health Care.
If the facility is to be certified based upon achieving a passing score on the FSES/BC,
complete a Statement of Deficiencies, Form CMS-2567, for both the regular Survey
Report and the FSES/BC for any deficiencies found. The provider will indicate whether
it chooses to correct the deficiencies on the Form CMS-2786, or the deficiencies on the
FSES/BC.
There are no provisions for the granting of waivers when using the prescriptive
requirements under the Residential Board and Care Occupancies Chapters 32/33.
Providers may elect to be surveyed under the Health Care chapters to take advantage of
the ability to obtain waivers.
Only surveyors that have completed CMS’s basic Life Safety Code and the FSES/HC and
if appropriate the FSES/BC training courses may apply the FSES in Medicare/Medicaid
facilities.
TABLE 1
SAMPLE SIZE OF RESIDENT/PATIENT ROOMS
The table below gives the sample size (number of patient/resident rooms to be checked)
needed.