CMS has issued a proposed rule that would require certain dialysis facilities participating in Medicare or Medicaid to meet updated fire safety standards. The proposed fire safety rule, published November 4, 2016, would apply only to dialysis facilities that do not provide one or more exits to the outside at grade level from the treatment area level. CMS notes that it updated fire safety standards for numerous provider types in a May 2016 rule, but CMS “inadvertently neglected to include updated provisions for dialysis facilities.” The November fire safety rule will require covered facilities to meet the National Fire Protection Association’s (NFPA) 2012 edition of the Life Safety Code (LSC), as well as provisions of the NFPA’s 2012 edition of the Health Care Facilities Code. Significant requirements of the proposed rule address the use of alcohol based hand rubs; use of a fire watch or building evacuation if a sprinkler system is out of service for more than 10 hours; and a requirement that all doors to hazardous areas be self-closing or close automatically. Furthermore, the rule would prohibit Medicare-approved dialysis facilities from being located adjacent to industrial high hazard facilities. CMS will accept comments on the proposed rule until January 3, 2017.