BCAB #1791 - Occupancy Classification of Long Term Residential Care Facility

January 11, 2017

BCAB #1791

Re: Occupancy Classification of Long Term Residential Care Facility, Article 3.1.2.1.

Project Description

The project is a Long Term Residential Care Facility licensed under the Community Care and Assisted Living Act. The facility will provide 24 hour “Complex Care” to 73 residents.

The client profile of residents in a Long Term Residential Care Facility, as described by the provincial Ministry of Health, persons:

• have severe behavioural problems on a continuous basis;
• are cognitively impaired, ranging from moderate to severe;
• are physically dependent, with medical needs that require professional nursing care, and a planned program to retain or improve functional ability; or
• are clinically complex, with multiple disabilities and/or complex medical conditions that require professional nursing care, monitoring and/or specialized skilled care

Reason for Appeal

The local authority has determined that the occupancy classification of the proposed facility is Group B, Division 2, Treatment Occupancy.

Appellant's Position

The appellant contends that the proposed facility’s occupancy classification should be Group B, Division 3, Care Occupancy. The appellant acknowledges that some or all of the residents may be incapable of evacuating to a safe location without the assistance of another person. However self-evacuation is not a stated criteria in the definition of Care Occupancy and therefore should not preclude the facility from the Care Occupancy classification. The appellant indicates “…., the ability of the residents to evacuate without assistance is irrelevant in determining the occupancy classification of care facilities. If the inability to evacuate unaided is caused by natural factors such as disease or illness, and the facility provides only care services without treatment, then the occupancy classification is B-3. If the inability to evacuate unaided is caused by a treatment provided by (the) facility, then the occupancy classification is B-2.”

“Given that facility name will not provide treatment as defined by the 2012 BC Building Code, it is our assessment that the project is a Group B, Division 3 major occupancy.”

Local Authority’s Position

The local authority maintains that, based on the Ministry of Health guidelines and the Community Care and Assisted Living Act, residents of a long term care facility may be fully dependent on care-givers and may be incapable of self-preservation. The local authority considers the Code’s definition of 'treatment' to be broad with respect to the administration of "medical or other health related interventions to persons" but is specific in the criteria for occupants to be incapable of self-preservation. The local authority has also used the direction of the provincial Building and Safety Standards Branch, NFPA 101 Life Safety Code, and the International Building Code to support its position.

Appeal Board Decision #1791

It is the determination of the Board the building occupancy classification for the Long Term Residential Care Facility licensed under the Community Care and Assisted Living Act is Group B Division 2, Treatment Occupancy.

Reason for Decision

The Board acknowledges the definition of Treatment appears to be limited to only those health or medical related interventions, or lack thereof, that would result in the resident being unable to evacuate unassisted. The definition of Care includes all services other than Treatment. The Residential Care regulations permit, with conditions, the use of restraint, either physically or chemically (sedation). The Board considers this restraint to be a “medical or health related intervention” by the facility that would render the person incapable of evacuation without assistance per the definition of Treatment.

The Board has consulted with staff of the Canadian Code Center for background related to development of the Code’s differentiation between B2 Treatment and B3 Care occupancy classification and their definitions. The Board was informed the Standing Committee responsible was sensitive to regulations that the Provinces and Territories may have had already in place and the Code’s definitions for Treatment and Care were written broadly to be accommodating. There was also some expectations that the Provinces and Territories would make amendments to suit their individual circumstances, and this has occurred in some jurisdictions. Further, the Board was informed that, although not explicit, the definitions were worded with the intent to reflect the scale of persons unable to evacuate without assistance, that being a Care occupancy having fewer than that of a Treatment occupancy. In the subject under appeal, there is the potential that many of the occupants may be unable to evacuate without assistance.

The Board has found that the Building Code’s differentiation by its definition of Care and Treatment occupancies to be ambiguous, and a clearer definition and /or an appendix note expanding on the definitions and their intended applications would be of benefit to code users. It has taken a conservative perspective in its decision based both on the historical approach and the direction of other jurisdictions. The Board will bring this matter to the attention of the provincial regulators.

Lyle Kuhnert
Chair, Building Code Appeal Board