Updated

A Nashville nursing home where a fire killed eight women and critically injured 16 residents was exempt from a state law requiring sprinklers (search) -- and more lives would probably have been saved had the devices been present, firefighters said.

As smoke spread through the four-story NHC Healthcare Center (search) late Thursday night, bedridden patients screamed for help, and others banged on their windows. Firefighters carried the elderly and disabled patients down ladders and stairs.

"Definitely, sprinklers would have subdued the fire quicker," said Assistant Fire Chief Lee Bergeron. "It would have eliminated the smoke that we generated, and it would have made a difference in this fire."

"We can't be soothsayers and tell you exactly how much difference, but we do know that we would probably have more people survive this fire."

Of the 343 licensed nursing homes in Tennessee, 52 either have no sprinklers or just a partial system, said Diane Denton, state Health Department spokeswoman.

The only sprinkler in the building was over the grill in the kitchen, as required by law, said Gerald Coggin, a spokesman for National Healthcare Corp., the company that owns the center.

When Tennessee adopted a national building code in 1994 that requires sprinklers in residential areas of nursing homes, the center, built in the 1960s, was grandfathered in, meaning sprinklers would be required only if the brick-and-steel building was extensively renovated, Denton said.

Democratic state Sen. Roy Herron, who has pushed for nursing home reform laws, was sharply critical of the exemption of older nursing homes from the sprinkler requirement.

"The cost of grandfathering in those nursing homes has been paid for by the grandfathers and grandmothers who were killed," Herron said. "I'm sure a number of the families think the cost of providing safe nursing homes would have been worth it."

The cause remains under investigation. Officials said there was no immediate evidence of arson.

The hospital-style bed in the room where the fire broke out was removed by investigators for analysis, officials said. The bed had an electrical mechanism that raised and lowered it.

Most of the 116 residents were carried out by firefighters or rolled in wheelchairs to safety. Eighty-two residents and one nursing home employee were treated for burns and smoke inhalation at four Nashville hospitals.

Hettie May Akin, 96, said she was awakened by screams. She could not get out of bed because she is paralyzed from the waist down.

"The smoke was so thick, you could cut it with a knife," she said. "I saw a light, and it was a fireman coming to get me out. I began screaming when I saw that light."

It took firefighters about an hour to contain the blaze, which was confined largely to one end of the building but spread smoke throughout the place. It took about two more hours to evacuate the home.

Among the victims was Thelma Connelly, the 96-year-old mother of District Fire Chief Bobby Connelly, who was off duty but went to the scene, said Deputy Fire Chief Kim Lawson.

"You can imagine what he's going through," District Chief David Warman said. "She was a really sweet lady -- a feisty lady. When you met her, you never forgot her."

The dead were all women: Connelly; Margaret H. Dilbeck, 80; Alma I. Gordy, 85; Dorothy M. Lee, 76; Isabel Lollar, 85; Priscilla B. Polk, 82; and Anna Tolston, 86; and Lydia Bodnar, 86.

In February, 16 patients were killed in a fire at a Hartford, Conn., nursing home, and fire officials there also said there was no sprinkler system in the building, even though it was up to code.

The Nashville fire was the deadliest nursing home fire in Tennessee since 1989, when a smoldering cigarette caused a blaze on Christmas Eve that killed 16 people in a Johnson City retirement home.

National Healthcare, which operates 87 long-term health care centers, mostly in Tennessee and elsewhere in the South, bought the building in 1976.