Egress Door Magnetic Locks Failed to Release Within Required Timeframe
Penalty
Summary
During a Life Safety Survey at Pines Nursing Home, surveyors observed that the facility failed to maintain egress doors in accordance with NFPA 101 requirements. Specifically, two exit doors—one located by the Dialysis Room and another by Resident Room 20—were found to have magnetic locking mechanisms that did not release within the required 15 seconds. These observations were made during a walkthrough of the facility with the Maintenance Director present. The deficiency was confirmed through direct observation and was acknowledged by both the Maintenance Director and the Administrator during the exit conference. The report details that the doors in question are part of the required means of egress and are subject to strict standards regarding locking mechanisms, especially those that may delay or prevent rapid exit in an emergency. The delayed release of the magnetic locks did not comply with the standards set forth in NFPA 101, which stipulate that delayed-egress locking systems must release within 15 seconds to ensure safe evacuation. No specific residents or patients were directly involved or affected at the time of the survey, and there is no mention of any medical history or condition related to the deficiency. The findings are based solely on the physical inspection of the egress doors and staff interviews, with no additional incidents or adverse outcomes reported in connection with the deficiency.
Plan Of Correction
1. All occupants had the potential of risk but no one was harmed. Corrective action taken was designee from Maintenance or Housekeeping checked door for proper functioning upon daily exit until repair completed. 2. Upon discussion failure in the system was identified and intervention to address the deficit was implemented. During monthly QAPI meeting door check audit meant to track and monitor will be collected by Administrator for three months. Any adverse finding discovered through monitoring will be analyzed amongst the interdisciplinary team during QAPI gatherings. Audit presented to the committee is for recommendations purposes and to ensure department heads practice processes in applicable locations. 3. Facility obtained company on May 6, 2025 to inspect and service the door. 4. Magnet on each deficient door was replaced on May 20, 2025. 5. Maintenance Director or designee will review to assess if any additional task is needed to ensure compliance according to state and federal guidelines. 6. Maintenance team will perform daily scheduled door check. 7. Any identified deficiency will be reported to Administrator. Maintenance Director or Administrator will ensure proper party is secured to perform repair. 8. Maintenance team will perform preventive maintenance monthly. 9. On May 15 the Maintenance team was re-educated by the administrator on the proper procedure to check the door equipment.