PCREE Testing for Assisted Living Facilities: When It's Required and When It's Smart Practice

Does PCREE Testing Apply to Assisted Living Facilities?

The short answer: it depends on your state and your facility's license type. PCREE testing as defined by NFPA 99 Chapter 10 is a federal requirement for skilled nursing facilities (SNFs) certified for Medicare and Medicaid under CMS Conditions of Participation at 42 CFR 483.70(a). Assisted living facilities (ALFs) are not federally regulated in the same way — they are licensed and regulated at the state level, and requirements vary significantly by state.

However, many assisted living facilities — particularly those with memory care units, skilled nursing wings, or residents receiving skilled care services — are subject to electrical safety testing requirements that parallel or exceed PCREE standards. And facilities that do not have a federal PCREE obligation often choose to implement PCREE testing voluntarily as a risk management and quality assurance practice.

When Assisted Living Facilities Are Subject to PCREE-Equivalent Requirements

ALFs typically face PCREE or PCREE-equivalent electrical safety testing requirements in the following situations:

• ALF with a licensed SNF wing: If your assisted living campus includes a separately licensed skilled nursing facility, that SNF wing is subject to full CMS PCREE requirements under 42 CFR 483.70(a). The ALF portions of the building may or may not be separately regulated.
• Memory care units in states with specific regulations: Some states have adopted NFPA 99 or equivalent electrical safety standards for licensed memory care or dementia care units. Check with your state health department or licensing board.
• ALFs that accept Medicaid waiver residents: Facilities participating in Medicaid HCBS (Home and Community-Based Services) waiver programs may be subject to state health department oversight that includes electrical safety standards.
• Joint Commission–accredited ALFs: ALFs pursuing Joint Commission accreditation under their Home Care or Assisted Living accreditation programs face EC standards that include equipment maintenance requirements consistent with NFPA 99.
• States with explicit electrical safety testing requirements for ALFs: A growing number of states have incorporated NFPA 99 or equivalent requirements into their ALF licensing regulations. States with active Life Safety Code enforcement for ALFs include (but are not limited to) Florida, California, Texas, New York, and Ohio.

Voluntary PCREE Testing for Assisted Living: Why It Makes Sense

Even when not required, many assisted living facilities implement PCREE testing voluntarily for three reasons:

• Resident safety: ALF residents are a vulnerable population — many have the same cardiovascular conditions, implanted devices, and neurological vulnerabilities that make SNF residents susceptible to electrical safety hazards. The safety rationale for PCREE testing applies equally in ALF settings.
• Liability risk management: A documented PCREE testing program demonstrates that the facility met a recognized standard of care for electrical equipment safety. In the event of a patient safety incident involving electrical equipment, this documentation is valuable.
• Pre-emptive compliance: State licensing requirements for ALFs are evolving, and more states are incorporating Life Safety Code requirements. Facilities that already have a functioning PCREE program are ahead of any regulatory change.

Equipment in Assisted Living That Typically Requires Testing

In an ALF setting, the equipment categories that warrant electrical safety testing include:

• Electric beds and adjustable sleeping surfaces in resident rooms
• Patient/resident lift equipment (ceiling-mounted, portable floor lifts)
• Vital signs monitoring equipment used by nursing or care staff
• Wound care and medical treatment equipment if skilled nursing services are provided on-site
• Physical and occupational therapy electrical equipment in on-site therapy programs
• Equipment in any licensed skilled nursing or memory care wing

State-Specific Guidance for Assisted Living PCREE

Because ALF requirements are state-driven, the best source of specific guidance is your state licensing agency. PCREE Test can provide state-specific information for facilities in all 50 states. When you submit a quote request, mention that you operate an assisted living facility and we will clarify the applicable requirements in your state and design an inspection program accordingly.

Request a free quote — we serve both SNFs and ALFs and can structure an inspection program appropriate for your facility type and state.

Frequently Asked Questions