We went around and around with this question for several hospital projects that I worked on.
The NEC only tells you HOW you need install this...not whether or not you need it.
Reviewing the rest of the 'tons' of Codes that apply to Health Care, the end result is that they aren't required by the letter of the law, although having them (IMHO) is an excellent idea.
Like with most things in this world...it always came down to the money. If it wasn't "required", the folks with the checkbooks saw no need to "waste good money" on them; no matter if they were recommended or not.
