Current through Register Vol. 48, No. 12, March 22, 2024
a) The number of
resident beds, cribs or bassinets in a nursing unit shall not exceed
75.
b) General Requirements for
Bedrooms
1) Resident bedrooms shall have an
entrance directly off a corridor with an entrance door which swings into the
room.
2) The facility shall provide
a closet or wardrobe of at least four square feet for each resident.
3) Resident bedroom floors shall be at or
above grade level.
4) Each room
used as a resident bedroom shall have at least one outside window, with a total
window area equal to one-tenth the floor area of the room.
5) There shall be separate bedrooms for males
and females over six years of age unless the interdisciplinary team determines
that separation is not necessary due to the functional level of individual
residents.
6) A handwashing
lavatory shall be provided in each bedroom.
7) Resident bedrooms shall have adequate and
satisfactory artificial light and be equipped in accordance with Section
390.2740(d)(2).
8) Receptacles shall be provided in
accordance with Section
390.2740(e).
9) Nurses' call system shall be provided in
accordance with Section
390.2740(g).
10) Visual privacy shall be provided for each
resident in multibed rooms in accordance with Section
390.2220(a)(4).
Location of screen or curtain shall not restrict resident access to bathing
facilities, toilet or lavatory.
11)
Residents shall have access to a bathing/toilet room without entering the
general corridor area.
12) No
resident bedroom shall be located more than 120 feet from the nurses' station,
clean utility room, and soiled utility room.
13) Vision panels shall be provided in
corridor walls or room doors of each bedroom.
c) Resident Bedrooms
1) Each single bedroom used for a resident
shall have at least 100 square feet of usable net floor area, not including any
space taken up for closets, wardrobes, bathrooms, and clearly definable
entryway areas.
2) Each multiple
bedroom for residents shall have the following floor areas, exclusive of
closets, wardrobes, bathrooms, and clearly defined entryways:
A) Not less than 80 square feet per bed.
Size: 38"-40" x 75"- 84". No more than 4 beds per room.
B) Not less than 70 square feet per small
bed. Size: 37" to less than 38" x 61" to less than 75". No more than 4 beds per
room.
C) Not less than 65 square
feet per large crib. Size: 30" to less than 37" x 56" to less than
61".
D) Not less than 55 square
feet per medium crib. Size: 27" to less than 30" x 43" to less than
56".
E) Not less than 50 square
feet per small crib. Size: 19" to less than 27 x 35" to less than
43".
F) Not less than 30 square
feet per bassinet. Size: Smaller than 19" x 35". All sleeping accommodations
shall be adequate in size to allow for the resident's comfort.
3) Multiple resident bedrooms
shall not have more than four beds of any size located not more than three deep
from the outside wall.
4) Any
combination of beds, cribs and bassinets (of any size) may be placed in the
same bedroom when appropriate to the functional levels of the residents.
However, no bedroom shall contain more beds, cribs, and bassinets (of any size)
than can be contained in 390 square feet of floorspace, except that no more
than four beds of any size can be contained in one room and such rooms shall
not contain any cribs or bassinets of any size. In addition, the number of
residents in a bedroom shall not exceed eight.
5) The facility shall provide a minimum
clearance of three feet at the foot and side of all sleeping accommodations.
Clearance is not required when accommodation is not occupied, however, an exit
path must always be maintained in accordance with the requirements of the
National Fire Protection Association's Standard No. 101: Life Safety
Code.
6) The minimum dimension of
bedrooms shall be ten feet between walls or a wall and any built-in furniture
or storage space.
d)
Special Care Room
1) The facility shall
provide one special care room for each nursing unit, complying with bedroom
requirements in subsections (b) and (c) of this Section.
2) The facility shall provide one workroom
with observation windows adjacent to special care room. Space within this room
or in separate rooms shall be designed to include all or part of the following
functions:
A) Hygenic care including bathing,
complying with this Section.
B)
Separated soiled area with hampers for soiled linen, diapers and disposables.
This area shall be provided with a double compartment sink with integral
drainboard and clinical rim flush sink.
C) Separated clean area with storage
cabinets, work counter, refrigerator, formula storage-dispensing and clean
linen storage.
D) Gowning for
staff.
3) When more than
one resident is housed in this room, it may only be used to isolate residents
with the same communicable disease.
4) This room shall be located to allow direct
appropriate visual supervision from the nurses' station.
5) This room may be included in the
authorized maximum bed capacity for the facility.
6) It is permissible for the room to be
occupied by residents not in need of special care, provided the resident is
clearly informed and understands that he or she will be immediately transferred
out of the room any time of day or night, whenever the room is needed to care
for a resident requiring special care.
e) Nurses' Station (B)
1) The facility shall provide a minimum of
one nursing station for each nursing unit. The station shall have direct access
to a corridor, shall be located near the area it will serve, and shall be
designed to provide visual control of the area. It shall be separated
satisfactorily from the nurses' utility rooms.
2) One or more nursing units may be combined
with a central nursing station if sufficient space is provided for all nursing
functions.
3) A toilet room shall
be provided near each station for nursing staff. A lounge with lockers for
safekeeping of coats and personal effects shall be provided either within this
space or in a convenient central location.
f) Bathing and Toilet Rooms
1) The bathing/toilet room adjacent to
resident room shall serve no more than two resident rooms nor more than 16
beds, cribs or bassinets.
2)
Fixtures shall be provided as follows:
A)
Lavatories: One per eight.
B)
Clinical rim flush sink and water closet for residents capable of using them:
One per eight.
C) Bathing or shower
fixtures: One per ten.
3) The lavatory may be omitted from the
bathing/toilet room when installed in the resident room.
4) The facility shall provide a minimum of
one bathtub for assisted bathing per nursing unit. There shall be a clear area
at least three feet wide on one long side.
5) The facility shall provide a minimum of
one shower stall for assisted showering per nursing unit. The shower stall
shall be at least four feet square with no curb.
6) Other acceptable fixtures for bathing the
residents may be provided with Department approval.
7) All plumbing fixtures shall be designed
and installed to satisfactorily serve the residents using them.
8) There shall be separate toilet and bathing
areas on each floor for males and females over six years of age unless the
interdisciplinary team determines that separation is not necessary due to the
functional level of individual residents.
9) The facility shall provide one wheelchair
toilet room for residents residing in the nursing unit. This room shall be
accessible from the corridor and shall contain a water closet and
lavatory.
10) Wheelchair resident
toilet rooms are not required when all resident toilet rooms can accommodate
wheelchair residents.
11) Grouped
bathing and toilet facilities shall be partitioned or curtained for
privacy.
g) Utility
Rooms
1) The clean utility room shall have
direct access to a corridor or access may be through the nurses' station
entrance. This room shall contain work counters, single or double compartment
sink with integral drainboard, storage cabinets, and an autoclave. (Autoclave
may be waived in lieu of other methods if sterilization is approved by
Department.)
2) A clean linen
storage room or closet within the clean utility room shall be provided. If a
closed cart system is used, storage may be in an alcove.
3) The soiled utility room shall have direct
access to a corridor. This room shall contain work counters, double compartment
sink with integral drainboard, storage cabinets with shelves, a clinical rim
flush sink, and sanitizer (See Section
390.2230
).
4) The charging room for a linen
chute shall be large enough to unload the collecting cart with the corridor
door closed.
h) A
medicine station shall be provided for convenient and prompt 24 hour
distribution of medicine to residents.
1) The
medicine preparation room shall be under the nursing staff's visual control and
contain a work counter, refrigerator, and locked storage for biologicals and
drugs. A sink for handwashing and preparation of medication shall be provided
in the medication preparation room.
2) If medicine dispensing carts are used, a
specific space shall be provided which may be located in the nurses' station or
in an alcove or other space under the direct control of the nursing staff. A
sink for handwashing and preparation of medication shall be provided in the
nurses' station.
i) A
nourishment station shall be provided with a handwashing sink and equipment
including refrigerator, and storage cabinets for serving nourishment between
scheduled meals.
1) Commercially prepared
formulas can be stored and dispensed from this room or from the special care
workroom.
2) Ice for residents' use
shall be provided only by icemaker dispenser unit.
3) There shall be a separate room or area for
bottle and nipple washing and cleaning, equipped as necessary to carry out
proper technique.
j) A
room for examination and treatment of residents shall be provided and shall
have a minimum floor area of 100 square feet, excluding space for vestibule,
closets and work counters (whether fixed or movable). The minimum room
dimension shall be ten feet. The room shall contain a lavatory or sink equipped
for handwashing; a work counter; storage facilities; and as desk, counter, or
shelf space for writing. When this room is not being used for examination or
treatment, it may be used for other functions (such as an office).
k) Equipment storage rooms shall be provided
for storage of equipment such as I.V. stands, inhalators, air mattresses,
walkers, and wheelchairs.
l)
Parking space for wheelchairs shall be provided and located out of path of
normal traffic.