In January 1976 a Chicago nursing home fire killed 23 people. Within a week, another nursing home fire just outside Chicago claimed the lives of eight people. In his letter of February 20, 1976, the Chairman, Subcommittee on Health and Long-Term Care, House Select Committee on Aging, asked us to investigate reasons for the severity of the fires and to suggest possible actions to avoid similar situations. He also asked us to investigate: 1)The fires and determine if automatic sprinkler systems would have put out the fires or lessened their severity in these facilities. 2) The facilities in Chicago and determine if they met the Life Safety Code requirements for participation in federally financed health programs. 3) The Department of Health, Education, and Welfare's (HEW's) enforcement of fire safety standards in Chicago and elsewhere. 4) The State inspections of the Chicago facilities in question and HEW's validation of those inspections. 5) The State inspection procedures including the qualifications of the inspectors. 6) The quality of trained personnel assisting patients during the fires. 7) The implementation of Public Law 93-204, approved December 28, 1973, which authorized federally insured loans to provide fire safety equipment for nursing homes and intermediate care facilities.

In 2003, 31 residents died in nursing home fire in Hartford, CT, & Nashville, TN. Federal fire safety standards enforced by the Centers for Medicare & Medicaid Services (CMS) did not require either home to have automatic sprinklers even though they have proven very effective in reducing the number of multiple deaths from fires. The GAO was asked to report on: (1) the rationale for not requiring all homes to be sprinkled, (2) the adequacy of federal fire safety standards for nursing homes that lack automatic sprinklers, & (3) the effectiveness of state & federal oversight of nursing home fire safety. GAO makes several recommendations to the Administration of CMS. Charts & tables.