Infusion Center as Business or Ambulatory Care?

4/27/2022

I have an existing business that is approximately 4,000 sqft. It's a single-story building being renovated into an infusion center with (14) IV patient rooms.

I would consider this type of occupancy to be an Ambulatory Care occupancy because of (4) or more care recipients to be incapable of self preservation at any time. Under Ambulatory Care, this building would need to be sprinkler protected under the International Fire Code.

Are these type of centers considered to fall under Ambulatory Care, or just a doctor's out patient Business occupancy?

Thanks in advance.

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10 Comments

Alex

4/27/2022 06:57:49 am

Hi,

This is an awesome question. When do you deem someone incapable of self-preservation? If I’m giving blood and I’m good with needles, am I incapable? I know if I’m in that seat and see a true emergency, I’m taking the needle out myself!

In your case, since you have (14) rooms, I would say that you have a minimum of have (4) incapable. Workers will require time to check each of the (14) rooms and assist as needed.

I don’t see this building falling under a Group B.

Thanks,
Alex

Todd E Wyatt

4/27/2022 08:15:22 am

I concur with Alex.

2021 IBC defines an AMBULATORY CARE FACILITY as follows:

Buildings or portions thereof used to provide medical, surgical, psychiatric, nursing or similar care on a less than 24-hour basis to persons who are rendered incapable of self-preservation by the services provided or staff has accepted responsibility for care recipients already incapable.

2021 IBC defines INCAPABLE OF SELF-PRESERVATION as follows :

Persons who, because of age, physical limitations, mental limitations, chemical dependency or medical treatment, cannot respond as an individual to an emergency situation.

While the AHJ has the final say as to the Occupancy Classification (OC), the scenario you describe seems to meet the intent of these (2) definitions.

Derek

4/27/2022 08:17:22 am

Agree with Alex here (as we all normally do, lol) twofold.....great question and definitely not a Group B.

Reggie

4/27/2022 08:54:37 am

What if the Infusion Center states in letter head with to the Fire Marshal Office that their services are therapies that consists of vitamins, etc. that combat auto-immune conditions that is delivered by IV due to patients unable to take oral by mouth and the patients are mobile and are never rendered incapable of self-preservation as a result of their services.

Terry

5/12/2025 11:56:04 am

Reggie

I would question the statement of being mobile. Since the patient will be confined to the chair or bed for the time frame that the medication is running. Also what effect does the medication have on the patient? Are they weak and need time to recover or are they fully capable or disconnecting themselves and evacuating the building?

Alex

4/27/2022 02:31:17 pm

Sorry about replying with the wrong name but this response was directed to Alex and Dan Wilder. What if the Infusion Center states in letter head with to the Fire Marshal Office that their services are therapies that consists of vitamins, etc. that combat auto-immune conditions that is delivered by IV due to patients unable to take oral by mouth and the patients are mobile and are never rendered incapable of self-preservation as a result of their services.

Udo Ammon

4/28/2022 08:31:47 am

As a former AHJ, it is classified as business occupancy. Also, CMS does not recognize the less than four patients. Doesn't matter how many patients.

Refer to CFR 24, part D483

Dan Wilder

4/27/2022 08:22:21 am

This opens the door to much more than a requirement for a fire sprinkler system. While a good question and I'm not sure your role in the process (contractor, arch, code consultant, AHJ) there is a little grey area here as to if people are incapable of self preservation or not. Looking at a couple of my local AHJ's, there isn't a clear path between them. As Alex said, if I'm giving blood (my donation center has 14 beds in a communal space and 3 private rooms) guess whos going to leave a path for others to follow me out the building...

Some things to consider if not a business...
All ratings to comply with an AHC vs business for both internal and shared walls with adjacent tenants?
Egress pathing distances, corridor & room door widths?
Smoke barriers, dedicated electrical, emergency lighting?
Will the fire alarm system be upgraded as well for detection and notification?

Anthony

4/27/2022 08:44:35 am

If its chemotherapy or another significant medication being administered then patients probably will need help exiting. I think some medications are administered under sedation?

If this is one of those "hydration" "clinics" where they basically offer Gatorade pumped right into your blood then most (all) of the individuals will be able to self exit following Alex's blood trail.

Craig M

4/27/2022 09:03:37 am

So this one becomes tricky because you likely have more than one AHJ and if CMS Medicare and Medicare funding used at this site you likely have to follow 2012 NFPA 101 Life Safety Code.

CMS has even more strict requirements than the ICC and the NFPA codes and does not consider the number of patients when using Chapter 20 Ambulatory Health Care so if you have one or 14 patients incapable of self preservation they still consider it a Ambulatory Health Care. I would suggest to reach out to the AHJ before this design starts and nail down exactly what the occupancy type will be as this is going to affect your entire design of this building. Also ensure to ask if there will be any additional licensing requirements that may come from the State Agencies such as the Department of Health or State Fire.

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Infusion Center as Business or Ambulatory Care?

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