Basics of Suites in Health Care Occupancies
The use of suites in health care occupancies can provide significant flexibility in the design, construction, and functional daily use of a space. The term suites can be heard frequently when speaking with health care professionals and often very casually being tossed around. “Is it a suite? Can it be a suite? Have you designated it as a suite?” All of this is with great intentions but can certainly be overwhelming for someone just getting into their field or simply without experience in some more advanced life safety concepts. In terms of the Life Safety Code, a suite must meet very specific criteria. A quick google search for healthcare suite or hospital suite returns images of patient rooms that are much nicer than any hotel I’ve ever stayed in; not quite what we’re talking about here. This blog discusses the definition of suites, the different types of suites, the benefits of a suite, and the requirements for their application. What is a suite? For some life safety and fire protection topics a quick reference to a definition can give a user a good idea of what a code is talking about. This is not quite the case with suites. While there is a definition in NFPA 101 and it has been recently tweaked for the 2021 edition it’s not truly painting a full picture of all that encompasses a suite. Health Care Suite: A room or rooms sharing a means of egress separated from the remainder of the building by walls, doors, floors, and ceilings. (NFPA 101, 2021) While this gives an indication of what the concept is, it leaves a lot for a user to figure out beyond the simple definition. Instead of jumping directly to the requirements for suites, we need to first start by looking at the context that exists around their use. Without suites, what does the code require? The primary requirement to consider is that every habitable room in a health care occupancy is required to have an exit access door leading directly to an exit access corridor. This is demonstrated by the sleeping rooms in the bottom left of the image below. In providing life safety, corridors are protected spaces that come with their own set of requirements including a minimum width of 8 ft (2440 mm) in new health care occupancies, door operational requirements, and limited amounts of projections (more on these below). One exception to this rule for rooms opening directly to the corridor is for rooms within suites. A common description of a suite that is often used is “rooms within a room.” This is because instead of requiring every room to open directly into an exit access the main door(s) from the corridor into or out of the suite is considered the exit access door(s) for that ‘room.’ Even if the suite is subdivided into more rooms, those are then permitted to open into a passageway within the suite. A further benefit of the suite provisions is that the passageway within the suite is not required to meet the requirements for a corridor, such as the minimum width requirements. Key Point: Suites allow larger areas to be treated as a single room permitting a single exit access door leading to an exit access corridor even if that space is subdivided into more rooms. Key Point: Suites are not easily described by a simple definition. Understanding the context in which they play a role in life safety is key to understanding what they are. What are the benefits of suites? In framing the context of suites within NFPA 101 one of the main benefits of utilizing the suite provisions has already been mentioned. The fact that there are no corridors within a suite provides multiple benefits. The first of these being added flexibility of the use of the space in between rooms that looks and feels like a corridor but is not subject to those requirements and should be referred to as “circulating space,” “passages” “halls” or some similar term to avoid confusion on life safety drawings. Where a corridor in new health care occupancies must have a minimum width 8 ft (2440 mm) and can only have a very limited amount of projections or wheeled equipment in them, the halls within a suite are only subject to minimum widths of exit access which is 36 in (915 mm) per NFPA 101, although it should be sized to be able to readily evacuate or relocate patients in the event of a fire and plans should be in place for prompt removal of any equipment reducing widths. Another benefit to not being considered a corridor is that patient rooms inside the suite can be open to the space and/or use a variety of different doors. If located directly off a corridor the requirements for the patient room door are much more prescriptive and include requirements for maximum clearances, and latching, among others. The doors, or lack thereof in some cases, that can be used in suites have the potential to improve clinical staff efficiency and patient care. Within suites there is no limit on the number of intervening rooms permitted provided minimum travel distances are met. In patient rooms not located within a suite exit access is permitted only through a single intervening room and only where the room has no more than eight patient beds. Key Point: The space within a suite is not considered a corridor. This allows more flexibility with patient care equipment permitted outside of the rooms, permitting rooms open to the space, and opportunity to use different door types. What are the different types of suites? There are three subcategories of health care suites. Non-patient care suite - A health care suite that is not intended for patient sleeping or care. Patient care non-sleeping suite - A health care suite providing care for one or more patients not intended for overnight patient sleeping. Patient care sleeping suite - A health care suite containing one or more beds intended for overnight patient sleeping. Key Point: Suites are designated by whether or not patient care is intended for the space and whether or not it is intended for overnight patient sleeping. Construction Considerations In order to take advantage of the benefits that suites offer they must meet a number of requirements including separation from the remainder of the building, size limitations, construction materials for internal walls, and adequate levels of staff supervision. Separation - Separated from the remainder of the building and from other suites by walls and doors meeting the requirements for those of corridor separation. Maximum Size Varies by suite type and some variables: Non-patient-care suite: in accordance with primary use/occupancy Patient care non-sleeping suite: 10,000 ft2, 12,500 ft2, or 15,000 ft2 (930 m2, 1160 m2, or 1394 m2) Patient care sleeping suite: 7500 ft2 or 10,000 ft2 (700 m2 or 930 m2) Internal walls - The subdivision of suites must be by means of noncombustible or limited-combustible partitions or partitions constructed with fire-retardant-treated wood enclosed with noncombustible or limited-combustible materials. The partitions are not required to be fire rated. Staff supervision - Patient care sleeping suites only must be provided with constant staff supervision within the suite. Direct supervision of patient sleeping rooms is required if smoke detection is not provided in individual rooms or throughout the suite with total (complete) coverage automatic smoke detection. Key Point: Suites must be separated from the remainder of the building and from other suites by walls and doors meeting the requirements for those of corridor separation. Egress Considerations In addition to the requirements listed above there are a number of requirements that must be met in relation to the means of egress for a suite to be compliant. All patient care suites, whether sleeping or non-sleeping, must have at least one exit access to a corridor or to a horizontal exit directly from the suite. This allows for horizontal evacuation from the suite if needed. A second exit access door is required for patient care sleeping suites more than 1000 ft2 (93 m2) gross floor area and for patient care nonsleeping suites of more than 2500 ft2 (230 m2) gross floor area. Exit Access - All patient care suites require exit access directly to a corridor or to a horizontal exit directly from the suites Additional Exit Access - An additional remotely located exit access door must be provided for patient sleeping suites more than 1000 ft2 (93 m2) and patient care nonsleeping suites more than 2500 ft2 (230 m2). Second exit access doors are permitted to be to one of the following: An exit stair An exit passageway An exit door to the exterior Another suite provided separation between suites is equivalent to corridor Travel distance - Not to exceed 100 ft (30 m) to an exit access door or horizontal exit door from any point in a patient care suite Not to exceed 200 ft (61 m) between any point in patient care suite and an exit [150 (46 m) in existing construction not protected throughout by approved electrically supervised sprinkler system. Key Point: All suites must have at least one exit access directly to a corridor or a horizontal exit from within the suite. Larger suites require at least a second exit access door. Second exit access doors can be to a larger variety of exits/exit access. Key Point: The maximum travel distance to an exit access door or horizontal exit door is 100 ft. The maximum overall travel distance to an exit is 200 ft for sprinklered buildings and 150 ft for those without complete sprinkler coverage. Suites get a lot of attention in the life safety approach to health care occupancies for good reasons. While not a requirement, these provide a useful design option. They offer an approach that has appeals to architects and designers as well as health care engineers and clinicians. Understanding the context of suites within the overall fire protection and life safety scheme for a facility helps to ensure that the appropriate precautions are applied to ensure that the increased flexibility provided by their use is supported with compliance to the code provisions in place to make sure the environment remains safe.