NASHVILLE, Tenn. -- Monday marked the three-year anniversary of the deadly NHC nursing home fire that killed 16 elderly Nashvillians.

Smoke and flames consumed the four-story building on Patterson Street.

The years since the fire have been filled with lawsuits and court battles between victims’ families and the company that owned the facility.

While there has never been a definitive cause, many things have been learned in the investigation.

David Randolph Smith and his law firm represented nine families who lost loved ones.

Since the fire, state and federal laws have changed dramatically.

"The most important thing to come out of that fire was the need for smoke detectors in every room," said Smith.

Smoke detectors in every room became a federal law after the NHC fire.

Now, every nursing home in the country that does not have a sprinkler system must have a smoke detector in every room.

Also, Tennessee now requires every nursing home to have a sprinkler system, even if they have to retrofit their building to add it.

The Tennessee Health Department said all but six nursing homes in the state now have sprinklers.

Of those six, four of them have submitted plans to the state to add sprinklers. One of them is building a new facility and is being excused, and the sixth, General Care Convalescent, in Clarksville has been cited by the state.

Smith said that families who are looking to choose a nursing home should “look for smoke alarms in every room, a central fire alarm system, a location to the stairs and the reputation of the nursing home.”

The state Department of Health told Channel 4 that there has not been a single fire death in a Tennessee nursing home since the NHC fire.

Thousands of pages of documents related to these civil cases are still sealed from the public.

But they may be opened as early as next month, for a hearing on the two remaining cases.

Firefighters were able to pull 120 survivors from the blaze in 2003.

Click on the link below to read the latest inspection records of nursing homes across the United States:

Search for detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.