The Centers for Medicare & Medicaid Services nursing home sprinkler mandate (CMS mandate) has raised multiple jurisdictional code conflicts that significantly complicate compliance, particularly inside the City of New York.

When most "older nursing homes" (pre-1990) were first built, the governing codes required that "hazardous" areas such as kitchens and large storage areas be sprinklered. The balance of these pre-1990 facilities did not require sprinkler protection. Interestingly enough, most people would consider electric service rooms, emergency generator spaces, and elevator machine rooms to be at least somewhat "hazardous". However, in most pre-1990's nursing homes, these electrical spaces are not sprinklered (nor were they required to be).

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