# Medical Alert Devices After Copper: A 90X1 Use Case

> Keep medical alert systems (PERS) reaching the monitoring center after copper retirement: the 90X1 replaces the POTS line, not the base unit. Setup, test, PDF.

- Published: November 4, 2026
- Author: DataRemote
- Topics: Use Cases, Life Safety, POTS Replacement, Copper Retirement
- Primary entity: endpoint:medical-alert-system
- Related entities: family:pots-in-a-box, platform:ara, product:90x1, product:90x2, product:vab-1, solution:pots-line-replacement, solution:analog-telephone-connectivity, endpoint:nurse-call-system, topic:life-safety-communications, topic:pots-line-replacement, topic:copper-retirement, standard:fcc-copper-retirement-rules, definition:alarm-communicator, definition:dtmf, definition:line-seizure, definition:central-station, definition:battery-backup, definition:calling-party-control, definition:enhanced-911
**Direct Answer:**
Medical alert systems, also called personal emergency response systems (PERS), give seniors and at-risk residents a wearable pendant or fall detector. A press of the button, or a detected fall, triggers the base unit to dial a 24/7 monitoring center over an analog POTS line, send the subscriber's account data, and open a two-way speakerphone call so help can be sent. When that copper line is retired, the [DataRemote 90X1](https://dataremote.com/pots-in-a-box/90x1) replaces the line, not the medical alert system. The base unit's phone cord plugs into a 90X1 FXS port, the call goes out over 5G/LTE with wired WAN failover, and residents keep the pendants and base units they already know. This post covers how a base unit uses the line, what to check before you order, and how to test each pendant. The one-page summary is available as a [PDF white paper](https://dataremote.com/documentation/marketing/dataremote-90x1-medical-alert-devices.pdf).

## Key Takeaways

- **Replace the line, not the system.** The pendant talks to the base unit over its own short-range wireless link. Only the base unit's phone line moves, and the 90X1 presents one that behaves like copper.
- **Two things travel on that line, and both are supported.** The account data goes out as in-band tones; the operator's conversation with the resident follows as two-way voice. The 90X1 provides automatic pulse and DTMF detection, in-band alarm signaling, G.711 audio, and G.168 echo cancellation.
- **The monitoring center sees no change.** With the caller ID set in Ara, the same account data arrives on the same receiver, and the response procedure stays as written.
- **Outages are covered on the line side.** An integrated 18-cell lithium battery keeps the line live when power fails, and a 12 V UPS output can power an approved device. The base unit's own battery still needs its own plan.
- **Lines are supervised.** Ara line-status monitoring and alerts let a community, a PERS provider, or a home care agency confirm a line is ready without a visit, which a copper pair never offered.
- **Test every pendant.** The acceptance test is a real press of each pendant and a real two-way conversation, confirmed by the monitoring center, with the center told in advance that test alarms are coming.

## The use case at a glance

| Detail | This use case |
|---|---|
| **Endpoints** | Medical alert base units, with their wearable pendants, wrist buttons, and automatic fall detectors |
| **Where found** | Independent and assisted living communities, senior apartments, group homes, continuing care campuses, and the homes of subscribers served by a PERS provider or home care agency |
| **Line today** | One analog POTS line per base unit, carrying the subscriber's account data as tones and then a two-way speakerphone call to the monitoring center |
| **Product** | DataRemote [90X1](https://dataremote.com/pots-in-a-box/90x1) 5G POTS IN A BOX®, up to eight base units per appliance |
| **Transport** | 5G/LTE, with wired WAN failover where the site has a wired internet connection |
| **Answer point** | The 24/7 monitoring center, unchanged, which talks to the resident and dispatches help or 911 |
| **What stays the same** | The pendant, the base unit, the account data it sends, the monitoring center, and the response procedure |
| **Management** | [Ara](https://dataremote.com/ara): caller ID and pulse dialing per line, line-status monitoring, alerts, remote management |

## How a medical alert system uses its POTS line

A medical alert system has two halves, and only one of them touches the phone line. The pendant, wrist button, or fall detector talks to the base unit over a short-range wireless link inside the home or apartment, and copper retirement does not affect that part at all. The base unit is the half that depends on the line: it is a speakerphone and an [alarm communicator](https://dataremote.com/newsroom/definitions/alarm-communicator) in one box, plugged into a phone jack and a power outlet. When the pendant is pressed or a fall is detected:

1. **The base unit seizes the line.** It goes off-hook, draws [loop current](https://dataremote.com/newsroom/definitions/loop-current), and, where a telephone shares the jack through the base unit's pass-through port, uses [line seizure](https://dataremote.com/newsroom/definitions/line-seizure) to take the line ahead of the handset.
2. **It dials the monitoring center.** Most base units send [DTMF](https://dataremote.com/newsroom/definitions/dtmf) digits; some older units pulse the number.
3. **It sends the account data.** The subscriber's account number and the event type go out as tones in an alarm format such as Contact ID, and the monitoring center's receiver answers with a handshake and an acknowledgement.
4. **It opens two-way voice.** The base unit switches its speakerphone on, and the operator talks with the resident across the room to find out what happened.
5. **The monitoring center responds.** The operator follows the subscriber's care plan: calling a family member or neighbor, or dispatching emergency services to the address on file.

### What the replacement line must preserve

| Phase | What travels on the line | What the replacement line must preserve |
|---|---|---|
| **Account data** | DTMF tones that encode the account number and the event, plus the receiver's handshake and acknowledgement tones | In-band DTMF that arrives undistorted, with the timing the receiver expects, so the alarm is decoded on the first attempt |
| **Two-way voice** | A speakerphone conversation between an operator and a resident who may be on the floor several feet from the base unit | Clear G.711 audio and effective echo cancellation, so the operator can hear a quiet voice and the resident can hear reassurance |
| **Supervisory test** | A timed test call that many base units place daily or weekly to confirm the path | Reliable dialing and answer detection, so the test arrives on schedule and a missed test means something |
| **Disconnect** | The far-end hang-up that tells the base unit the call is over | [Calling Party Control](https://dataremote.com/newsroom/definitions/calling-party-control) or an equivalent disconnect signal, so the base unit releases the line and is ready for the next alarm |

The first row is where a generic VoIP adapter most often fails. Alarm formats are tones inside the audio path, and anything that compresses or smooths that audio can corrupt them, which the monitoring center sees as a garbled signal and the resident sees as a base unit that keeps redialing. Our guide to [POTS replacement for fire and burglar alarm panels](https://dataremote.com/blog/pots-replacement-for-fire-and-burglar-alarm-panels) covers the same signaling in detail, because a medical alert base unit reports to its monitoring center the way a burglar alarm panel does.

### A failed line looks like a quiet day

A copper line gives no warning when it fails, and a base unit rarely tells anyone either. The pendant still blinks, the base unit still answers a test press with a reassuring tone, and the unit dutifully seizes a dead line when it is needed. Base units that place a timed supervisory call give the monitoring center a chance to notice a missed test, but a unit configured for a weekly test can be silent for up to a week before anyone looks. That silent-failure mode is the strongest reason to pair the replacement line with supervision, not only with a new carrier.

## Why copper retirement reaches the base unit

The copper line under a base unit is not being repriced. It is being withdrawn. The FCC's [guidance for government officials on network modernization](https://www.fcc.gov/modernizing-telecommunications-networks-what-government-officials-need-know) explains that carriers are retiring copper and the legacy time-division multiplexing (TDM) switching behind it in favor of IP and wireless service, and that an incumbent carrier owes a non-residential customer at least 180 days' notice before replacing that customer's copper connection with fiber. The same guidance makes the point that matters most for a medical alert line: copper landline service typically keeps working through a power outage, and the services that replace it usually need backup power of their own.

Those notices are already arriving. On January 12, 2026, AT&T's application to discontinue legacy POTS in portions of 18 states was deemed granted under the FCC's streamlined process, with discontinuance authorized on or after November 15, 2026; the dated record is in our newsroom: [FCC grants AT&T applications to discontinue POTS in portions of 18 states](https://dataremote.com/newsroom/news/fcc-grants-att-pots-discontinuance-18-states-november-15-2026). Verizon followed with a [Section 214 application covering copper POTS in nine states and D.C.](https://dataremote.com/newsroom/news/verizon-section-214-application-discontinue-copper-pots-nine-states-dc) A base unit on either carrier's copper has a date attached to it, whether or not the resident, the family, or the community's management has read the letter.

### The people on the other end of the pendant

The population that relies on these devices is growing, and so is the share of it living at home. The CDC's [facts about older adult falls](https://www.cdc.gov/falls/data-research/facts-stats/index.html) report that more than one in four adults aged 65 and older falls each year, that fewer than half tell their doctor, and that falls lead to about 4.5 million emergency department visits a year. The University of Michigan's [National Poll on Healthy Aging](https://ihpi.umich.edu/national-poll-healthy-aging/national-findings/older-adults-preparedness-age-place) found in 2022 that 88 percent of adults aged 50 to 80 felt it important to remain in their homes as long as possible, while fewer than one in ten reported having an emergency response system. A medical alert device is often the one piece of equipment that lets a resident stay, and its phone line is the part nobody thinks about until it is gone.

### The cellular swap and the lesson of 3G

The usual alternative to replacing the line is replacing the device: the PERS provider ships a cellular base unit or a mobile pendant with its own radio. That is the right answer for a subscriber who needs GPS and coverage away from home. For a resident whose base unit works and whose pendant they know, it means a new device to learn, a new installation visit, and, for a provider with thousands of subscribers, a fleet of radios that each belong to a network generation. [Verizon's 3G CDMA retirement notice](https://www.verizon.com/business/support/services-and-apps/cdma-network-retire/) records that the network was decommissioned in January 2023, and devices built for it lost service. With the 90X1, the radio lives in the appliance, where a 5G/LTE module serves up to eight base units and Ara manages the fleet, rather than in each subscriber's device.

### The rules these calls sit under

None of the rules below says how the alarm must travel. Each one addresses the equipment or the people answering, which is why the migration owes them the same proof: a documented test showing the alarm reached an operator and the resident could be heard.

| Area | What applies, and where it says so |
|---|---|
| **The medical alert equipment** | UL 1637 is the UL standard for home health care signaling equipment. It addresses the equipment itself, not the phone line it uses, so a listing on the base unit says nothing about the path its dialer takes. Source: [UL 1637](https://www.shopulstandards.com/ProductDetail.aspx?productId=UL1637). |
| **The monitoring center** | A [central station](https://dataremote.com/newsroom/definitions/central-station) receives the alarm and dispatches response under its own standards and certifications. Ask yours which it holds and what it needs from you at cutover. |
| **Backup power** | The FCC's network-modernization guidance notes that copper landlines typically work during a power outage while modern alternatives usually require backup power. Source: [FCC, what government officials need to know](https://www.fcc.gov/modernizing-telecommunications-networks-what-government-officials-need-know). |
| **The setting** | Assisted living and senior housing are licensed state by state, and a Medicaid waiver contract or an insurer may set requirements for resident emergency response. Confirm with your licensing agency or surveyor which apply. |

The requirements that govern emergency communication circuits in buildings more broadly, including the elevator phones and fire panels that share a community's telecom closet, are summarized on our [emergency communication requirements](https://dataremote.com/newsroom/standards/emergency-communication-requirements) page.

## How the 90X1 connects to a medical alert base unit

To the base unit, the 90X1 looks like a standard phone line, so the medical alert system does not need to change. The appliance sits where the copper lines terminate, usually the community's telecom closet or, in a single home, beside the base unit, and the base unit's phone cord plugs into one of the 90X1's eight RJ-11 [FXS](https://dataremote.com/newsroom/definitions/fxs) ports. The alarm and the voice call leave over 5G/LTE. If the site has a wired internet connection on the 90X1's WAN port, it serves as failover.

Three parts of the base unit's behavior deserve a closer look, because they are where a replacement either preserves the workflow or breaks it.

### Works with existing base units

The 90X1 provides automatic pulse and DTMF detection and in-band alarm signaling, which let the base unit send its account data to the monitoring center unchanged. In practice:

- **A DTMF base unit** sends its account data through the audio path as it does on copper and receives the handshake and acknowledgement tones from the monitoring center's receiver. Most base units need no line configuration at all.
- **A pulse-dialing base unit** from an earlier decade keeps its stored numbers. Pulse dialing can be enabled for that line in Ara where the unit needs it. Automatic pulse and DTMF detection is available on the 90X1, 90X2, 90X5, and VAB-1, so a base unit that pulses needs one of those models.
- **The caller ID** the monitoring center expects is set for the line in Ara, so an alarm arrives from the number on the subscriber's account rather than from an unknown one.

If a telephone shares the jack with the base unit today, keep that arrangement on the 90X1 line: [line seizure](https://dataremote.com/newsroom/definitions/line-seizure) is performed by the base unit itself, so it behaves the same way on an FXS line that supplies loop current.

### Clear two-way voice

The second half of every alarm is a conversation, and it is a hard one for a phone line: a speakerphone in one room, a resident who may be on the floor, and an operator who needs to hear whether the answer is "I'm fine" or silence. The 90X1 carries the call as G.711 audio with G.168 echo cancellation, so the speakerphone's own output does not come back to the operator as echo and a quiet voice across the room is not lost. Our [nurse call and panic button use case](https://dataremote.com/blog/nurse-call-panic-buttons-pots-replacement) covers the same two-way voice requirement for a facility's call stations.

### Ready during outages

Copper carried its own power from the central office. A replacement line does not, which is why the FCC's note about backup power matters here. The 90X1 keeps the line live from an integrated 18-cell, 15 Ah lithium-ion battery rated for up to 48 hours of standby (actual runtime varies with usage), and its 12 VDC, 3.0 A UPS output can power an approved connected device. When the battery runs low, the appliance sends a battery alert and shuts down gracefully.

The base unit is the other half of the outage question. Base units typically carry their own backup battery, sized by the manufacturer for the hours they expect to run without power. Check both before cutover: a line that stays up for two days behind a base unit that stops after a few hours has not solved the problem, and neither has the reverse. Our definition page on [battery backup](https://dataremote.com/newsroom/definitions/battery-backup) covers how to turn a standby rating into a runtime plan.

### Monitored from Ara

The 90X1 is managed through [Ara](https://dataremote.com/ara), DataRemote's device management platform. For a medical alert deployment, two Ara functions carry the weight:

- **Line-status monitoring with alerts.** Each 90X1 line reports its status, so a base unit that drops off the line raises an alert to the community or the provider instead of waiting for the next supervisory call.
- **Remote management.** Caller ID and pulse dialing are set from the portal, and a line can be checked by a provider's support desk without a visit to the resident.

Ara watches the line. It does not watch the base unit, the pendant, or the pendant's battery, so keep the base unit's supervisory test call running where it sends one, and keep the resident's scheduled test press on the calendar.

## Where the 90X1 fits, and where a smaller appliance does

How a 90X1 is deployed depends on who provides the line today.

| Deployment | How it works | Notes |
|---|---|---|
| **A community that provides the lines** | Assisted living, memory care, group homes, and campuses whose phone system delivers an analog line to each resident's base unit terminate those lines in a telecom closet. A 90X1 in that closet replaces up to eight copper pairs; a closet with more lines gets a second appliance. | The community owns the migration and the test. Elevator phones and fire panels in the same closet usually move in the same project. |
| **A PERS provider or home care agency** | The provider manages base units in many homes and buildings and wants one supervised line per unit without swapping the device. | Ara gives the provider's support desk line status for every appliance in the fleet. |
| **A single home with one base unit** | One or two analog lines in a residence call for a smaller appliance. The [CDS-9010](https://dataremote.com/pots-in-a-box/cds-9010) presents two FXS ports in a compact unit with up to 24 hours of battery standby. | The connect, configure, test sequence is the same for a DTMF base unit. A base unit that pulses needs a 90X1, 90X2, 90X5, or VAB-1, the models with automatic pulse and DTMF detection. |

Where a resident holds their own carrier account, the carrier's replacement service decides what the base unit sees. The FCC guidance quoted above is the reason to ask that carrier about backup power before the switch, and to test the pendant afterward.

## Before you order: six questions for each base unit

Most of the work in this migration is in the inventory, not the installation. Answer these for every base unit before sizing the order.

| Question | Why it matters |
|---|---|
| **Does the base unit actually use a phone line?** | Cellular base units and mobile pendants have no POTS dependency. Look at the back of the unit: a phone cord into a wall jack means a line to migrate. |
| **How does it dial, and what format does it send?** | Pulse or DTMF, and the alarm format the monitoring center's receiver is programmed for. This sets the line configuration in Ara and the pass condition for the test. |
| **What caller ID does the monitoring center expect?** | Many centers match alarms to accounts by the calling number. Get the number on file, set it in Ara, and tell the center the cutover date. |
| **Does it place a supervisory test call?** | Note the interval, daily or weekly, so a missed test after cutover is caught, not ignored. |
| **How is the base unit powered?** | Whether it has its own backup battery and for how long. This decides whether the 90X1's UPS output or a separate supply is part of the plan. |
| **What is the cellular signal where the line terminates?** | Measure signal at the closet or the spot in the home where the 90X1 will sit. A basement telecom room or an interior apartment may need an external antenna. |

A community will usually find a mix: some residents on community-provided lines, some on their own carrier accounts, some already on cellular units. A PERS provider will find the same mix across its subscriber base, plus a monitoring center that needs the cutover schedule. The inventory tells you which lines exist; the test tells you whether the replacement works.

## Installation and testing, pendant by pendant

The installation itself is short. The white paper reduces it to three steps, and the third is the one that matters.

1. **Connect.** Plug the base unit's phone cord into any of the 90X1's eight RJ-11 FXS ports. Label the port with the resident or unit it serves.
2. **Configure.** In Ara, set the caller ID for that line and, if the base unit needs it, enable pulse dialing.
3. **Test.** Press the pendant and confirm the alarm is received and two-way voice is clear.

Notify the monitoring center before placing test alarms, so the operator logs them as tests and no one is dispatched. Complete an end-to-end test from each pendant after installation, with the monitoring center confirming what it received, and record the result per base unit. The acceptance checklist below is a starting point; the community's licensing agency, the monitoring center, or an insurer may add to it.

| Acceptance check | Pass condition |
|---|---|
| Each pendant type | A neck pendant, a wrist button, and a fall detector each trigger the base unit |
| Account data | The monitoring center receives and decodes the correct account and event, and the base unit receives the acknowledgement on the first attempt |
| Caller ID | The call arrives from the number on the subscriber's account |
| Two-way voice | The operator hears a resident speaking at a normal volume from across the room, and the resident hears the operator, without echo |
| Disconnect | The base unit releases the line when the operator hangs up and is ready for a second alarm |
| Supervisory test | The next scheduled test call arrives at the monitoring center on time |
| Battery | Remove AC power from the 90X1 and repeat an alarm on battery |
| Supervision | Disconnect the base unit's line and confirm Ara raises the alert |
| Procedure | The monitoring center handles the test exactly as the subscriber's care plan says, with no new steps |

The final installation must meet the site's applicable healthcare, emergency communication, and life-safety requirements, which is why the test, not the connection, is the finish line. Keep the old copper in service until each base unit has passed, and tell the monitoring center which accounts are moving and when, so a changed caller ID during cutover is understood rather than treated as a fault.

## Planning across a portfolio

A single community is a day's work. An operator with forty communities or a PERS provider with thousands of subscribers runs this as a program:

1. **Inventory every base unit** using the six questions above, including units in independent living apartments whose residents may not have mentioned them.
2. **Group by closet.** Each closet or equipment room with base unit lines becomes a 90X1 site; a room with more than eight lines gets a second appliance. Single homes with a DTMF base unit get a CDS-9010.
3. **Pilot one site** with a mix of base unit makes, migrate it, and run the full acceptance checklist with the monitoring center.
4. **Sequence by risk.** Residents who live alone and residents with a fall history go first, then the rest.
5. **Document the result.** A per-base-unit record of the test, the Ara configuration, and the closet location is what the operator will hand to a surveyor, an insurer, and the next facilities team.

The same inventory serves the other analog lines on the property. Elevator phones, fire panels, and nurse call dialers in a community share the closets these base units use, so a portfolio migration usually moves them together. Our [nurse call and panic button use case](https://dataremote.com/blog/nurse-call-panic-buttons-pots-replacement) follows the same station-by-station pattern for a facility's call systems, and our [guide to POTS line replacement cost](https://dataremote.com/blog/pots-line-replacement-cost) covers how the per-line economics change when a closet of copper pairs becomes one appliance.

**Plan your medical alert migration:**
Start with the base unit inventory: does it use a phone line, how does it dial, what caller ID does the monitoring center expect, does it place a supervisory call, how is it powered, and where does the line terminate. Share it with DataRemote and we will help you size the 90X1 deployment and build the pendant-by-pendant test plan. [Talk to a DataRemote engineer](https://dataremote.com/contact).

## How DataRemote helps

DataRemote builds [POTS line replacement](https://dataremote.com/solutions/pots-line-replacement) around the equipment a resident already has: the base unit keeps its analog line, and only the carrier underneath changes. For medical alert systems, that means:

- **The 90X1**, a 5G POTS IN A BOX® appliance with eight RJ-11 FXS ports with surge protection, automatic pulse and DTMF detection, in-band alarm signaling, G.711 audio with G.168 echo cancellation, caller ID, an integrated 18-cell lithium battery rated for up to 48 hours of standby, a 12 VDC UPS output for approved devices, and a wired WAN port for failover.
- **Ara**, for caller ID and pulse dialing configuration, line-status monitoring with alerts, and remote management across every appliance in the portfolio.
- **Alarm signaling experience** from the same platform that carries [fire and burglar alarm communication](https://dataremote.com/solutions/fire-burglar-alarm-communication), which is the path a medical alert base unit's account data uses.
- **The one-page white paper**, [90X1 Medical Alert Devices (PDF)](https://dataremote.com/documentation/marketing/dataremote-90x1-medical-alert-devices.pdf), for the administrator, the PERS provider, or the family member who needs the summary.

Every system is different. Base unit make and age, the alarm format it sends, the monitoring center's requirements, base unit power, and cellular coverage at the closet all affect the design, so each site should be tested on its own before cutover.

## Frequently asked questions

**Do residents have to replace their medical alert devices when the copper line is retired?**

Not if the base unit reports over an analog phone line. The DataRemote 90X1 presents a standard analog line on each of its eight FXS ports, so the base unit's existing phone cord plugs into the appliance and the pendant, the fall detector, the base unit, and the monitoring center account stay as they are. Units that already report over their own cellular radio have no POTS line to replace.

**What does a medical alert base unit actually send over the phone line?**

When the pendant is pressed or a fall is detected, the base unit seizes the line, dials the monitoring center, and sends the subscriber's account data as a series of tones, often in an alarm format such as Contact ID. Once the receiver acknowledges the signal, the base unit switches to two-way voice so the operator can talk with the resident over the speakerphone. The 90X1 supports both halves through automatic pulse and DTMF detection, in-band alarm signaling, G.711 audio, and G.168 echo cancellation.

**Why does caller ID matter for a medical alert line?**

Many monitoring centers use the caller ID of the incoming call to match the alarm to a subscriber account or to confirm that the base unit is calling from where it should be. The white paper's second installation step is to set the caller ID for the line in Ara so the monitoring center sees the number it expects. Tell the monitoring center before cutover so a changed number is understood rather than treated as a fault.

**What happens to a medical alert system during a power outage?**

The 90X1 keeps the line live from an integrated 18-cell, 15 Ah lithium-ion battery rated for up to 48 hours of standby (actual runtime varies with usage), and its 12 VDC UPS output can power an approved connected device. The base unit usually has its own backup battery, sized by its manufacturer, so an outage plan covers both. The FCC notes that traditional copper landlines typically work during power outages while modern alternatives usually need backup power.

**Is a cellular medical alert device a better answer than replacing the line?**

It can be the right answer for a mobile subscriber who needs GPS and coverage away from home. For a resident whose base unit works and whose pendant they know, replacing the line keeps the equipment and the account unchanged. Cellular units are also tied to a network generation: Verizon decommissioned its 3G CDMA network in January 2023, and devices built for it lost service. With the 90X1, the radio lives in the appliance, which Ara manages for the whole fleet, rather than in each subscriber's base unit.

**Which rules apply to medical alert equipment and its phone line?**

UL 1637 is the UL standard for home health care signaling equipment, which addresses the medical alert equipment itself rather than the phone line it uses. Monitoring centers operate under their own standards and certifications. Assisted living and senior housing are licensed state by state, and a Medicaid waiver contract or an insurer may add requirements of its own. None of these rules says how the alarm must travel; each says it must get through, which is what the pendant-by-pendant test proves. Confirm which apply with your licensing agency, monitoring center, or insurer.

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Canonical page: https://dataremote.com/blog/medical-alert-systems-pots-replacement
Organization: DataRemote, Inc. — POTS line replacement, cellular failover, and fixed wireless access solutions. https://dataremote.com