Current through Rules and Regulations filed through March 20, 2024
Areas accessible by individuals shall meet the following requirements:
1.The CSU shall maintain an environment that is clean and in good repair;
2.The environment of the C & A CSU shall have natural light and exterior views;
3.The general architecture of the C & A CSU, along with tools and technology, shall provide for optimal line-of-sight observations from the nurses' station throughout the unit, mitigating hidden spots and blind corners;
4.The C & A CSU shall be a locked facility;
5.The C & A CSU shall have sleeping areas that are gender and age specific;
6.Interior finishes, lighting, and furnishings shall conform to applicable fire and safety codes; as classified for Health Care Occupancy/Limited Care Facilities in the current edition of National Fire Protection Association's NFPA 101 Life Safety Code Handbook, Chapter 18/19: New and Existing Health Care Occupancies;
7.Furnishings, hardware, fixtures, or protrusions must be:
a.Made of materials which mitigate the risk of use as weapons or for self- harm (hanging, cutting, etc.);
b.Intact and functional;
c.Maintained in good condition, and ;
d.Tamper resistant.
8.The ceiling and the air distribution devices, lighting fixtures, sprinkler heads, and other appurtenances shall be of the tamper-resistant type;
9.Doors of the C & A CSU must meet the following requirements:
a.Doors in seclusion and/or restraint rooms shall not be locked from within;
b.The C & A CSU shall have a policy in effect to address locking doors in bedrooms and bathrooms which will address an individual's privacy and safety and which addresses staff access at all times to supervise and monitor that individual's clinical status and safety;
c.The CSU must have written risk management protocols in place to address situations in which an attempt might be made to prevent access to any area of the C & A CSU;
d.If the C & A CSU is equipped with electronic locks on internal doors or egress doors, the C & A CSU shall ensure that such locks have manual common key mechanical override that will operate in the event of a power failure or fire;
10.Light switches and electrical outlets shall be secured with -tamper-resistant type screws;
11.For C & A CSUs which are new facilities and who apply for licensure on or after (PUBLISH DATE OF NEW RULES), sprinkler heads shall be flush mounted on ceilings lower than nine (9) feet. Sprinklers shall have institutional heads that are recessed and drop down when activated;
12.Security and safety devices shall be mounted, installed, or secured in a manner which:
a.Mitigates the risk of use as weapons or for self-harm (hanging, cutting, etc.);
b. Prevents interference; and
c. Prevents any attempt to render inoperable with its purpose as a security devise.
13.Upon request, the C & A CSU shall provide a means of locked storage for any individual's valuables or personal belongings;
14.The C & A CSU must have policies/procedures to address identification, detection, handling, and storage of individuals' belongings that are determined to be potentially harmful;
15.The C & A CSU shall maintain the environmental temperature between 65°F and 82°F(18°C to 27°C);
16.The interior and grounds of the C & A CSU shall be non-smoking;
17.Lighting fixtures shall be recessed and tamper-resistant with Lexan or other strong translucent materials;
18.Windows shall be protected with Lexan or other shatter-resistant material that will minimize breakage;
19.The C & A CSU shall be equipped and maintained so as to provide a sufficient amount of hot water for individuals' use.
a.Heated water provided for individuals' use must be maintained between 110°F and 120°F(43°C and 48°C);
b.The C & A CSU must have policies/procedures to routinely check and document hot water temperature at various outlets throughout the C & A CSU and to correct any variance from the standard temperature if needed;
20.The C & A CSU shall have consistently available drinking water for individuals' access using mechanisms which meet general expectations of infection control and procedures;
21.The pre-admission waiting area, including restroom(s), must meet all safety requirements applicable to designated individual areas;
22.The C & A CSU shall have written policies and procedures for the provision of or arrangement for, services for individuals with physical disabilities (including those with sensory impairments) in compliance with all federal rules and regulations;
23.The C & A CSU shall have facilities accessible to and usable by physically disabled individuals which meet the minimum requirements of Section 504 of the Rehabilitation Act of 1973. The C & A CSU shall install required alterations or modifications in accordance with the 1984 Law of Georgia regarding Access to and Use of Public Facilities by Physically Handicapped Persons, O.C.G.A. Sec. 30-3-1et seq;
24.The C & A CSU shall maintain safety equipment to include an Automated External Defibrillator (AED) and all other necessary medical safety supplies;
25.The C & A CSU shall provide laundry facilities on the premises for the individual's personal laundry;
26.Entrances and exits, sidewalks, and escape routes shall be constantly maintained, free of all impediments and hazards;
27.The C & A CSU shall have at least one (1) operable, non-pay telephone which is private and accessible at reasonable times for use by individuals; and
28.The C & A CSU physical environment shall provide for space that accommodates the developmental needs of the individual and shall, at a minimum, have the following designated areas within its facility which meet the following requirements:
a.A screening area with capacity to be locked where searches can be done in a private and safe manner, respecting individual rights and privacy;
b.
Exam room;
c.
Bedrooms:
i.Beds and other heavy furniture capable of use to barricade a door shall be secured to the floor or wall;
ii.The use of beds with springs, cranks, rails or wheels, including hospital beds, rollaway beds, cots, bunk beds, stacked beds, hide-a beds and studio couches is prohibited;
iii.Rooms utilized for more than one individual shall have a minimum of sixty (60) square feet per individual; a private room shall not be less than eighty (80) square feet;
iv.Windows may be textured to provide privacy without the use of curtains or blinds.
d.
Bathrooms:
i.The C & A CSU shall have gender specific bathrooms with proper ventilation;
ii.Exposed plumbing pipes shall be covered to prevent access by individuals;
iii.The C & A CSU shall have a minimum of one (1) shower for each six (6) individuals receiving services and one (1) toilet and lavatory for each six (6) individuals receiving services;
iv.Individual shower stalls and dressing areas shall be provided;
v.The C & A CSU shall have a bathroom facility that is in compliance with the American Disabilities Act (ADA) for use by individuals with physical disabilities. It shall include a toilet, lavatory, shower and flush-mounted safety grab bars;
vi.Access to a bathroom shall not be through another individual's bedroom;
vii.The shower head shall be recessed or have a smooth curve from which items cannot be hung;
viii.Overhead rods, fixtures, privacy stalls supports or protrusions must be selected and installed in a manner which mitigates the risk of use of weapons or for self- harm (hanging, cutting, etc.) If the physical plant space of the C & A CSU is prohibitive of this, there must be written policies and protocols to monitor and reduce this risk with supporting evidence of compliance to these policies and protocols;
ix.The toilet shall be secured and tamper resistant;
x. Mirrors shall not be common glass and must be fully secured and flat mounted to the wall.
e.
Seclusion and/or Restraint Room. For C & A CSUs which apply for licensure on or after (PUBLISH DATE OF NEW RULES), the privacy of the person is protected by the seclusion and/or restraint room location either being not visible from the common consumer areas, or if visible, the seclusion and/or restraint room is constructed to be offset from main thoroughfares and have restricted visibility to the interior of the room;
i.At least one (1) identified room used for seclusion and/or restraint shall have a bed commercially designed for use with restraints that is bolted to the floor and without sharp edges. The surface of the bed must be impermeable to resist penetration by body fluids;
ii.The floors and walls, up to a height of three (3) feet, shall be finished to resist penetration of body fluids or be constructed of a high impact sheetrock;
iii.For C & A CSUs which apply for licensure on or after (PUBLISH DATE OF NEW RULES), the seclusion and/or restraint room shall have a minimum of seventy (70) square feet with one wall of the room no less than nine (9) feet in length;
iv.For C & A CSUs which apply for licensure after (PUBLISH DATE OF NEW RULES), the ceiling height of seclusion and/or restraint rooms shall be at least nine (9) feet.
v.The door to the room shall open outward;
vi.The bed placement in the seclusion and/or restraint room shall provide adequate space for staff to apply restraints and shall not allow individuals to access the lights, smoke detectors or other items that may be in the ceiling of the room;
vii.Rooms used for seclusion and/or restraint must provide staff full visual access of the individual, and shall include a vision panel installed in the door;
viii.Where the interior of the seclusion and/or restraint room is padded, it is in good repair and must be fully intact.
f. Fenced Recreational Area:
i.The C & A CSU shall have an age appropriate outdoor area enclosed by a privacy fence no less than six (6) feet high, where individuals may have access to fresh air and exercise. It must provide privacy from public view and shall not provide access to contact with the public;
ii.This area shall be constructed to retain individuals inside the area and minimize elopements from the area;
iii.The fenced area shall be designed for safety without blind corners to be readily visible by one staff person standing in a central location; and designed to minimize elopement.
29.The C & A CSU shall meet rules specified in Rule 82-4-1-.21, Environment of Care or shall submit a Risk Mitigation Plan to the Department for approval addressing a particular citation and related protocols for safety management. This shall be submitted at the time of licensing review and annually thereafter.
O.C.G.A. Sec. 37-1-29.
