The US Centers for Medicare and Medicaid Services (CMS) published a new 7-page Categorical Waiver – Health Care Microgrid Systems (HCMSs) [Ref: QSO-23-11-LSC] on March 31, 2023.

Although CMS continues to invoke the 2012 editions of NFPA 99 (Health Care Facilities Code) and NFPA 101 (Life Safety Code), this new Categorical Waiver also invokes specific portions of NFPA 99-2021, specific portions of the National Electrical Code (NFPA 70-2023), and their associated references.

Whereas NFPA 99-2012 requires emergency power for an Essential Electric System (EES) to be supplied by a generator or battery system, NFPA 99-2021 also permits emergency power for an EES to be supplied by sources other than a generator or battery system, including a Health Care Microgrid System (HCMS).  This Categorical Waiver specifically permits HCMSs provided that all requirements of the Categorical Waiver are followed.

CMS described HCMSs as “small-scale electrical grids where the sources of electricity can be provided by clean energy technologies (e.g., fuel cells, solar, wind, energy storage, etc.).”

This new CMS Categorical Waiver allows HCMSs in all new and existing healthcare facilities except where it “excludes long-term care (LTC) facilities that provide life support as the LTC requirements at 42 CFR 483.90(c)(2) requires these facilities to have an emergency generator without exception.”

As further background, the CMS Categorical Waiver also states “The 2021 edition of NFPA 99 now permits normal and emergency power to be supplied by sources other than a generator or battery system, including a health care microgrid system (HCMS). HCMSs are small-scale personalized electrical networks with intelligent controls that can operate independently, or in tandem with a large-scale electric grid. The power sources for an HCMS can be provided or supplemented by a combination of clean energy technologies such as fuel cells, solar panels, wind turbines, energy storage systems, and other alternate energy sources.”

The CMS “Categorical Waiver Process” on pages 2 and 3 has strict requirements for using this categorical waiver.  Pages 4 to 7 provide detailed “Health Care Microgrid System Requirements & Survey Guidance” with specific references to the portions of NFPA 99-2021 and NFPA 70-2023, as well as the survey guidance that must be followed.  We can also expect Accrediting Organizations to roll this Categorical Waiver into their processes shortly.