All nursing facilities are required to develop and maintain policies and procedures relating to a variety of natural and man-made disasters.  To have a comprehensive plan that is specific to the risks encountered by each provider, an “all-hazards” approach must be taken:  every reasonable hazard must have a corresponding disaster plan.  For example, a nursing facility in Kansas should have Tornado and Wild Fire disaster plans while a facility in Hawaii will more likely have Volcanic Eruption and Tsunami plans.


One plan every nursing facility will have is a Fire Plan because every facility has at least some risk for experiencing a fire.  Fires are a chemical reaction (rapid oxidation through exothermic process of combustion) and result when the three elements of the “fire triangle” are present and reach critical levels  The three elements required are:


  • Heat sufficient to ignite a fire

  • Oxygen in a quantity to sustain combustion

  • Fuel to support the combustion


While each facility will have a fire plan it is almost certain they will be slightly different at each location you may work and highly likely they will be different from shift to shift even in the same setting.  Many facilities’ Fire Plans are based on the R.A.C.E. principle.  R.A.C.E. stands for:

  • R=Rescue

  • A=Alarm

  • C=Contain or Confine

  • E=Extinguish




Begin moving residents and visitors to safety by moving them past two smoke barriers.  People are more likely to be harmed by smoke than by fire so it is important to limit exposure to smoke.  Barriers include resident room doors and corridor fire doors.  Key elements to rescuing include:

  • Move away from the source of the fire/smoke

  • If moving residents from their rooms, close the door as you leave so staff know the room has been evacuated; if the facility has a system (door sign, doorknob hanger, door frame magnets) to verify a room has been evacuated, implement that system, too

  • Assist ambulatory individuals first

  • Assist those with assistive devices next

  • Assist those in wheelchairs next

  • Assist bedfast residents last

  • Evacuate past at least two Fire/Smoke barrier doors—and not simply past the fire doors in the hallway




Alert other staff to the smoke/fire so they may follow their standard procedure for sounding the alarm.  If directed, pull the manual pull station to sound the alarm.  If you are made aware of the situation by the alarm sounding, report to the nurses’ station for directions.


Contain or Confine


Close all smoke, fire, resident room, utility room, laundry, kitchen office and support area doors to “seal” the exit corridors.  Close windows and shut off oxygen concentrators/tanks that could contribute to the spread of fire.




Small fires, such as those in trashcans or ash trays that result from smoking materials igniting other materials, can be extinguished with small, hand held fire extinguishers.  There are several types of fire extinguishers that are to be used for specific classes of fires:


  • Water and Foam—an older category of fire extinguisher, these should be used only for Class A fires and will be labeled as Class A only

  • Carbon Dioxide—should be used for Class B and C fires only

  • Dry Chemical—the most common type of fire extinguisher, may be used on Class A, B and C fires unless labeled otherwise

  • Wet Chemical—generally used for Class K fires but may be effective against Class A (if so labeled) in commercial kitchens

  • Clean Agent—larger models are effective against Class A, B and C fires; smaller handhelds may be labeled for only Class B and C due to the small amount of firefighting material contained in the cannister

  • Dry Powder—used only for Class D fires

  • Water Mist—generally effective only against Class A fires though some are labeled for use on Class C fires

  • Cartridge Operated Dry Chemical—a newer version of the Dry Chemical extinguisher, may be used on Class A, B and C fires unless labeled otherwise


As a general rule, the nursing home you will be working will have hand-held fire extinguishers mounted on the walls or in cabinets installed on or in the walls.  By regulation, fire extinguishers must be stationed in common areas or large rooms so that a person must travel 75 feet or less to reach an extinguisher and the extinguisher must be clearly labeled as to the type of fire for which it is intended.  They are only intended for use against small, contained fires.  Do not attempt to use a portable extinguisher against large or growing fires or in a room that is filling with smoke!


If a fire is small, in a trashcan for example, you may be able to extinguish it with a portable extinguisher.  If you are confident you can put out the fire, position yourself so that you can face the fire and have an exit route behind you.  A portable extinguisher contains about 10 seconds worth of extinguishing material.  If the fire is not out when you exhaust the contents, back away from the fire toward the exit and pull the door shut as you leave the area. 


Using a Fire Extinguisher is very simple and is made even easier by remembering the acronym P.A.S.S. which stands for:


  • P=Pull the pin—portable extinguishers have a handle and triggering mechanism that is prevented from accidental discharge by a pin with a ring in it; pulling the pin makes it possible to squeeze the trigger and release the contents of the extinguisher

  • A=Aim the nozzle—stand 6-8 feet from the fire and aim at the base of the fire; you can move closer as fire gets smaller

  • S=Squeeze the trigger—most extinguishers have a pair of levers—the bottom is the handle and the top is the trigger—that you squeeze together to discharge the extinguisher

  • S=Sweep side to side—while aiming at the base of the fire and squeezing the trigger, sweep back and forth across the fire; continue discharging until the fire and any glowing embers are extinguished


Nursing home fires are uncommon.  However, when they occur, they are usually the result of one of the following:

  • Cooking equipment (66% of nursing home fires)

  • Clothes dryer (7%)

  • Heating equipment (5%)

  • Electrical panels or lighting equipment (5%)

  • Smoking materials (4%)

  • Intentionally set fires (4%)


As an agency employee, your responsibilities include:

  • Assure you and others follow the facility’s smoking policy regarding where smoking is permitted and how to safely dispose of smoking materials

  • Ask the person in charge on your shift to educate you on what to do in the event the fire alarms sound

  • In your work area, note the location of Fire Extinguishers and Fire Alarm Pull stations—ask for help locating them if you don’t see them

  • If you discover a fire, sound the alarm

  • Remain calm and provide reassurance to residents when alarms are sounding

  • Follow the directions of the person in charge regarding possible evacuation of the area or entire facility


When asked by a surveyor, be able to explain your responsibilities in the event of a fire

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