Power Strips in SNF Resident Rooms: What the CMS Waiver Allows

Walk through almost any skilled nursing facility and you'll find power strips: behind a resident's recliner, powering a TV and phone charger, or under a bed next to an air mattress pump. They're convenient, and they're also one of the most common things a Life Safety Code surveyor notices on a walk-through.

Why Power Strips Get Facilities in Trouble

A power strip (the codes call it a relocatable power tap, or RPT) multiplies what can be plugged into one receptacle. In a resident room that can mean medical equipment and personal electronics sharing an overloaded strip, strips plugged into other strips, or a cheap consumer strip powering an air mattress. Each of these is a fire and shock risk in a building full of people who may not be able to evacuate on their own.

The CMS Power Strip Waiver

For years, the older code edition CMS enforced made power strips in patient care areas very hard to use. In 2014, CMS issued a categorical waiver (Survey & Certification letter S&C 14-46-LSC) that lets facilities use power strips in patient care rooms if they follow the newer NFPA 99 (2012) requirements. As summarized by the American Society for Health Care Engineering, the key conditions are:

• Medical equipment powered from a strip must use a special-purpose relocatable power tap listed to UL 1363A or UL 60601-1, not a hardware-store strip.
• Non-medical equipment (TVs, lamps, chargers) may use a power strip listed to UL 1363.
• The facility must have written documentation that it has elected to use the waiver.
• Staff must tell the surveyors at the entrance conference that the facility is using the waiver and meets its conditions.

Since 2016 CMS has enforced the 2012 editions of NFPA 99 and NFPA 101 directly. Many facilities still keep their waiver election on file, and surveyors still check the underlying conditions. Confirm the current expectations with your state survey agency or Life Safety Code consultant.

Practical Rules for Resident Rooms

• Never mix medical equipment and personal electronics on the same consumer power strip.
• No daisy-chaining: a power strip should never be plugged into another strip or an extension cord.
• Keep strips off the floor where they can be rolled over, kicked or soaked, and out from under bedding.
• Don't use strips for high-draw items such as space heaters, refrigerators or microwaves.
• Inspect strips and cords on rounds, and replace any with damaged housings, scorch marks or loose receptacles.
• Check resident-owned items at admission. See resident-owned equipment and PCREE.

How This Connects to PCREE Testing

Power strips that are part of a medical equipment setup (for example, a strip mounted to a cart or bed system that powers several devices) are part of that system. NFPA 99 expects a system of several electrical appliances to be compliant as a complete system. That means your PCREE technician should test it as installed, not just the individual devices. When you schedule testing, tell the technician where medical-grade strips are in use so they're included in the scope and listed on the report.