NFPA 99 Medical

Gas for Healthcare

Facilities
2021 Code

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 1

Introduction
As with most healthcare aspects, medical gas systems continue to evolve
to provide a safer, more effective patient experience. NFPA 99 Health Care
Facilities Code is no exception, and the 2021 edition has some noteworthy
changes and additions with which facility managers should be aware.

This most recent edition was published in October of 2020. While there
is no current indication the 2021 edition will be adopted by CMS, some of
the updates highlight the importance of qualified individuals managing and
maintaining medical gas systems.

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 2

New Additions to the NFPA 99 2021 C ode

Going back to the 2012 edition of NFPA 99, the document addressed the
importance of medical gas systems’ operation and management. This portion
of the code continued to evolve in 2012, 2015, and 2018 editions, and 2021
follows suit.

One of the most significant additions to the 2021 code is the Responsible
Facility Authority role and the Permit to Work system’s evolution. While the
wording of a responsible facility authority has been part of previous editions,
the role was never really defined as to the qualifications and responsibilities
required.

Responsible Facility Authority Role

This position shall be a person or persons responsible for implementing NFPA

99 medical gas requirements within the facility.

Among the responsibilities, they shall be involved in:

• Advising on the facility’s assessment to determine risk categories of

various spaces

• Interpretations of the code

• A medical gas emergency plan

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 3

• Development and enforcement of a permit-to-work system

• Evaluation and acceptance of medical gas verification reports

• And maintaining all inspection, testing, & maintenance (ITM) reports

The individual(s) designated as the Responsible Facility Authority is required

to demonstrate a level of competency. This can be achieved through meeting
the requirements of an ASSE 6010 Medical Gas Systems Installer, 6020
Medical Gas Systems Inspector, 6030 Medical Gas Systems Verifier, or 6040
Medical Gas Systems Maintenance Personnel. Instead of attaining one of
these credentials, the individual can also qualify by completing an educational
program equivalent or superior to the ASSE credentials noted above.

Permit-to-Work System

The inclusion of a documented Permit-to-Work system in the code is a step

forward in providing a safe and efficient method of performing routine
maintenance, repairs, and medical gas system installations by ensuring proper
communication and protocols are being adhered to by facility staff.

In addition to shutdown procedures, the permit-to-work system shall require

proper testing on affected portions of the medical gas system after any work
is performed to effectively “close the loop”.

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 4

New Requirements for the Emergency
Oxygen Supply Connection (EOSC)

From a design perspective, the Emergency Oxygen Supply Connection (EOSC)

is now required to include master alarm connection points to monitor the
temporary supply of oxygen. NFPA 99 has always applied to all medical gas
installations, including temporary installations.

However, monitoring a temporary supply of oxygen has previously been

difficult since additional, often temporary, wiring was needed to be installed
prior to connection to the EOSC. In a real emergency, installing this wiring was
unlikely, and unfortunately, the system was not adequately monitored. This
addition rectifies this condition moving forward.

Installation Process Requires a System

Inspectionm

A notable inclusion in the installation process is the requirement of a system

inspection following the installer performed tests required in 5.1.12.2 but
before the final system verification.

The primary goals of this system inspection are to identify any system leaks
and ensure proper component labeling prior to any piping being concealed
behind walls, ceilings, etc. This inspection is to be performed by a qualified
ASSE 6030 Verifier or an ASSE 6020 Inspector. That individual is also required
to witness the initial pressure tests required by the installer.

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 5

Decommissioning Portions of Medical
Gas Systems

Aside from installation requirements, for the first time, NFPA 99 now
addresses the issue of decommissioning portions of medical gas systems.
While not an extensive explanation within the code itself, Annex A does
provide the user some basic recommendations.

However, it is essential to remember that information in the annexes are

recommendations and not requirements of the code.

Conclusion
While these are just a few of the changes and updates to NFPA 99, the
document continues to evolve with the ever-changing world of healthcare to
provide a safe environment for patients, staff, and visitors.

And as previously noted, those individuals’ expertise and qualifications

maintaining these critical utility systems remain paramount to an effective
management program.

As these changes develop, CHT will keep you informed.

For help in determining how to apply NFPA 99 to your facility, contact your
CHT representative today. Our knowledgeable staff can assist in navigating
through NFPA 99.

NFPA 99 Medical Gas for Healthcare Facilities [2021 Code] Page 6

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