The tragic Anderson Guest House fire in November that killed 11 people has spawned a series of recommendations for safer long-term residential care facilities. But the recommendations raise some nagging questions. Suppose the Anderson Guest House had a high-quality sprinkler system…..Suppose it had better smoke, fire, and heat detection….Suppose the state defined the phrase “qualified electrician” and required people installing and inspecting wiring in those facilities to meet that standard…Suppose there had been better evacuation and emergency plans, limits on client smoking, and prohibited staff from sleeping during overnight hours…. Would there have been a fire? Would there have been 11 deaths? The health department’s Nanci Gonder says it’s “pure speculation” whether there would have been a fire, or whether more people could have gotten out safely. She says the goal from this point forward is to do everything possible to prevent fires in those faclities and to get residents out as safely as possible if there is a fire. Governor Blunt, who is considering legislation on those and other issues thinks the new policies would have helped control the fire and kept it from spreading throughout the building, if they had been in effect November 27th. The health department and the mental health department has spent a month intensively studying shortcomings in current practices…and listing possible changes. Some can be done with new regulations. Others will mean changes in laws. Some will cost money….but money isn’t the only cost to consider.The recommendations the departments have made to the governor are in the report on the website of the Missouri Department of Health and Senior Services: http://www.dhss.mo.gov/SeniorServices/FireSafetyReport/ConsolidatedReport12-29.pdf