Kentucky Administrative Regulations
Title 902 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR PUBLIC HEALTH
Chapter 20 - Health Services and Facilities
Section 902 KAR 20:056 - Facility specifications; intermediate care
Universal Citation: 902 KY Admin Regs Service 20:056
Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO: KRS 216B.010-216B.130, 216B.990(1), (2)
NECESSITY, FUNCTION, AND CONFORMITY: KRS 216B.042 and 216B.105 mandate that the Kentucky Cabinet for Human Resources regulate health facilities and health services. This administrative regulation provides licensure requirements for facility specifications for the construction, alteration and maintenance of intermediate care facilities.
Section 1. Definitions.
(1) "Board" means the Commission for Health
Economics Control in Kentucky.
(2)
"License" means an authorization issued by the Board for the purpose of
operating an intermediate care facility.
(3) "Licensure agency" means the Division for
Licensing and Regulation in the Office of the Inspector General, Cabinet for
Human Resources.
Section 2. Preparation and Approval of Plans and Specifications. After receiving certificate of need approval from the board, the following procedures shall be followed:
(1) Before construction is
begun for the erection of new buildings or alterations to existing buildings or
any change in facilities for an intermediate care facility, the licensee or
applicant shall submit plans in the detail specified in Section 3 of this
administrative regulation to the licensure agency for approval.
(2) All architectural, mechanical and
electrical drawings shall bear either the seal of an architect registered in
the Commonwealth of Kentucky or the seal of a professional engineer registered
in the Commonwealth of Kentucky, or both.
(3) Drawings shall not exceed thirty-six (36)
inches by forty-six (46) inches when trimmed.
(4) All such plans and specifications must be
approved by the licensure agency prior to commencement of construction of new
buildings or alterations of existing buildings.
(5) Plans and specifications in specific
detail as required by the Kentucky Building Code shall be submitted together
with architectural and/or engineering stamps as required by KRS Chapters 322
and 323, to the Department of Housing, Buildings and Construction for
determining compliance with the Kentucky Building Code. All such plans and
specifications must be approved by the Department of Housing, Buildings and
Construction, and appropriate local building permits shall be obtained prior to
commencement of construction.
Section 3. Submission of Plans and Specifications.
(1) First stage. Schematic plans.
(a) Single line drawings of each floor shall
show the relationship of the various departments or services to each other and
the room arrangement in each department. The name of each room shall be noted.
Drawings shall include typical patient room layouts (scaled one-fourth (1/4)
inch = one (1) foot) with dimensions noted. The proposed roads and walks,
service and entrance courts, parking and orientation shall be shown in a plot
plan.
(b) If the project is an
addition, or is otherwise related to existing buildings on the site, the plans
shall show the facilities and general arrangements of those
buildings.
(2) Second
stage. Preliminary plans: preliminary sketch plans shall include the following:
(a) Architectural: plans of basement and
floors.
(b) Outline specifications.
1. General description of the construction,
including interior finishes, types and locations of acoustical material, and
special floor covering;
2.
Description of the air-conditioning, heating, and ventilation systems and their
controls, duct and piping systems; and dietary, laundry, and other special
equipment;
3. General description
of electrical service including voltage, number of feeders, and whether feeders
are overhead or underground.
(3) Third stage. Contract documents.
(a) Working drawings. Working drawings shall
be complete and adequate for bid, contract, and construction purposes. Drawings
shall be prepared for each of the following branches of the work:
architectural, structural, mechanical, and electrical. They shall include the
following:
1. Architectural drawings.
a. Approach plan showing all new topography,
newly established levels and grades, existing structures on the site (if any),
new building structures, roadways, walks, and parking areas;
b. Plan of each basement, floor and
roof;
c. Elevations of each
facade;
d. Sections through
building;
e. Required scale and
full-size details;
f. Schedule of
doors, windows, and room finishes;
g. Equipment. Location of all fixed
equipment. Layout of typical and special rooms indicating all fixed equipment
and major items of movable equipment. Equipment not included in contract shall
be so indicated;
h. Conveying
systems. Details of construction, machine and control spaces necessary, size
and type of equipment, and utility requirements for the following: dumbwaiters:
electric, hand, hydraulic; elevators: freight, passenger, patient; loading dock
devices; pneumatic tube systems.
2. Structural drawings.
a. Plans for foundations, floors, roofs, and
all intermediate levels with sizes, sections, and the relative location of the
various structural members;
b.
Dimensions of special openings;
c.
Details of all special connections, assemblies, and expansion joints.
3. Mechanical drawings.
a. Heating, steam piping, and
air-conditioning systems: radiators and steam heated equipment, such as warmers
and steam tables; heating and steam mains and branches with pipe sizes; diagram
of heating and steam risers with pipe sizes; sizes, types, and capacities of
boilers, furnaces, hot water heaters with stokers, oil burners, or gas burners;
pumps, tanks, boiler breeching, and piping and boiler room accessories;
air-conditioning systems with required equipment, water and refrigerant piping
and ducts; supply and exhaust ventilation systems with heating/cooling
connections and piping; air quantities for all room supply and exhaust
ventilating duct openings.
b.
Plumbing, drainage, and standpipe systems: size and elevation of: street sewer,
house sewer, house drains, street water main, and water service into the
building; location and size of soil, waste, and water service with connections
to house drains, clean-outs, fixtures, and equipment; size and location of hot,
cold and circulating branches, and risers from the service entrance, and tanks;
riser diagram of all plumbing stacks with vents, water risers, and fixture
connections; oxygen and vacuum systems; standpipe and sprinkler systems where
required; all fixtures and equipment that require water and drain
connections.
4.
Electrical drawings.
a. Electric service
entrance with switches and feeders to the public service feeders,
characteristics of the light and power current, transformers and their
connections if located in the building;
b. Location of main switchboard, power
panels, light panels, and equipment. Diagram of feeders and conduits (with
schedule of feeder breakers or switches);
c. Light outlets, receptacles, switches,
power outlets, and circuits;
d.
Telephone layout showing service entrance, telephone switchboard, strip boxes,
telephone outlets, and branch conduits;
e. Nurses' call systems with outlets for
beds, duty stations, door signal light, annunciators, and wiring
diagrams;
f. Emergency electrical
system with outlets, transfer switch, sources of supply, feeders, and
circuits.
(b)
Specifications. Specifications shall supplement the drawings to fully describe
types, sizes, capacities, workmanship, finishes and other characteristics of
all materials and equipment and shall include:
1. Cover or title sheet;
2. Index;
3. Sections describing materials and
workmanship in detail for each class of work.
(c) Access to the work. Representatives of
the appropriate state agencies shall have access at all reasonable times to the
work wherever it is in preparation or progress, and the contractor shall
provide proper facilities for such access and inspection.
Section 4. Compliance with Building Codes, Ordinances and Administrative Regulations.
(1) This section may be administered
independently from other sections of this administrative regulation.
(2) General. Nothing stated herein shall
relieve the sponsor from compliance with building codes, ordinances, and
administrative regulations which are enforced by city, county, or state
jurisdictions.
(3) The following
requirements shall apply where applicable and as adopted by the respective
agency authority.
(a) Requirements for safety
pursuant to 815 KAR 10:020, as amended.
(b) Requirements for plumbing pursuant to
815 KAR
20:010 through 191, as amended.
(c) Requirements for air contaminants for
incinerators pursuant to
401 KAR 59:020
and
401 KAR
61:010.
(d) Requirements for elevators pursuant to
803 KAR 4:010.
(e) Requirements for
making buildings and facilities accessible to and usable by the physically
handicapped, pursuant to
KRS
198B.260 and administrative regulations
promulgated thereunder.
(4) Prior to occupancy, facility must have
final approval from appropriate agencies.
(5) All facilities shall be currently
approved by the Fire Marshal's Office in accordance with the Life Safety Code,
before relicensure is granted by the licensure agency.
Section 5. Facility Requirements and Special Conditions.
(1) Independent facilities with a
capacity of fifty (50) beds or less present special problems. The sizes of the
various departments shall depend upon the requirements of the facilities. Some
functions allotted separate spaces or rooms in these general standards may be
combined provided that the resulting plan will not compromise the standard of
safety and of medical and nursing practices and the social needs of patients.
Otherwise, the general standards set forth herein, including the area
requirements, shall apply.
(2)
Facilities shall be available to the public, staff, and patients who may be
physically handicapped with special attention given to ramps, drinking fountain
height, mirrors, etc.
(3) The
number of beds in a nursing unit shall not exceed sixty (60) unless additional
services are provided, as deemed necessary by the board. At least sixty-six
(66) percent of the beds shall be located in rooms designed for one (1) or two
(2) beds unless health program needs indicate otherwise in intermediate care
mentally retarded/developmentally disabled facilities.
(4) Access to the facility shall be by means
of a paved or gravel roadway which shall be available for use by traffic prior
to a license being issued to the facility for occupancy.
Section 6. Nursing Unit.
(1) Patient rooms. Each patient room shall
meet the following requirements:
(a) Maximum
room capacity: four (4) patients.
(b) Patient rooms shall be designed to permit
not less than a four (4) foot space between beds, and at least three (3) foot
space between the side of a bed and the nearest wall, fixed cabinet, or
heating/cooling element. A minimum of four (4) feet is required between foot of
bed and opposite wall, or foot of opposite bed in multibed rooms.
(c) Window. All patient rooms must have
windows opening to the outside. The sill shall not be higher than three (3)
feet above the floor and shall be above grade. Window area shall be at least
eight (8) percent of patient room floor area.
(d) Lavatory. In single and two (2) bed rooms
with a private toilet room, the lavatory may be located in the toilet room.
Where two (2) patient rooms share a common toilet, a lavatory shall be provided
in each patient room;
(e) Wardrobe
or closet for each patient. Minimum clear dimensions shall be one (1) foot and
ten (10) inches deep by one (1) foot and eight (8) inches wide with full length
hanging space with a clothes rod and shelf.
(f) Cubicle curtains, or equivalent built-in
devices shall be provided for complete privacy for each patient in each
multibed patient room and in tub, shower and toilet rooms.
(g) No patient room shall be located more
than 120 feet from the nurses' station, the clean workroom, and the soiled
workroom. No room shall be used as a patient room where the access is through
another patient's room.
(2) Patient toilet rooms:
(a) Where a centralized toilet area is used,
the facility shall provide for each sex on every floor the following: one (1)
toilet for each eight (8) residents or major fraction thereof and one (1)
lavatory for each sixteen (16) residents or major fraction thereof. Toilets
must be separated by a permanent partition and at least one (1) toilet for each
sex must be designed for wheelchair use.
(b) Grab bars shall be provided at all
toilets. At least one (1) toilet shall be easily usable by wheelchair
patients.
(c) Doors to toilet rooms
shall have a minimum width of two (2) feet and ten (10) inches to admit
wheelchair.
(3) Service
areas in each nursing unit. The size of each service area will depend on the
number and types of beds within the unit and shall include:
(a) Nurses' station. For nurses' charting,
doctors' charting, communications, and storage for supplies and nurses'
personal effects.
(b) Staff lounge
area with personal storage space and a toilet room for staff.
(c) Visitors toilet room. The facility shall
provide a toilet for visitors. The staff toilet room may serve as the visitors
toilet room if marked and accessible.
(d) Clean workroom for storage and assembly
of supplies for nursing procedures with a work counter and sink.
(e) Soiled workroom with a clinical sink,
work counter with two (2) compartment sink, waste receptacles, and soiled linen
receptacles.
(f) Medication area
adjacent to nurses' station with sink, refrigerator, locked storage, and
facilities for preparation and dispensing of medication. (May be designated
area within clean workroom if a self-contained cabinet is provided.) The
controlled substances locker must be under double lock.
(g) Clean linen storage with enclosed storage
space. (May be designated area within the clean workroom.)
(h) Equipment storage room for storage of IV
stands, inhalators, air mattresses, walkers, and similar bulky
equipment.
(i) Patient baths. One
(1) shower stall or one (1) bathtub shall be required for each twelve (12) beds
not individually served. There shall be at least one (1) free standing bathtub
in each bathroom. Grab bars or patient lift with a safety device shall be
provided at all tubs. Grab bars shall be provided at all shower stalls. Each
bathtub or shower enclosure in central bathing facilities shall provide space
for private use, for dressing and for a wheelchair and attendant. At least one
(1) shower in the central bathing facilities shall not be less than four (4)
feet square, without curbs, and designed to permit use from a wheelchair. Soap
dishes in showers and bathrooms shall be recessed.
(j) Janitor's closet for storage of
housekeeping supplies and equipment with floor receptor or service
sink.
(k) Bedpan washing facilities
on each floor and located so that bedpans need not be carried through lobbies
and dining areas.
(4)
Patients' dining, TV viewing and recreation areas:
(a) The total areas set aside for these
purposes shall be not less than thirty (30) square feet per bed for the first
fifty (50) beds and twenty (20) square feet per bed for all beds in excess of
fifty (50). Additional space shall be provided for outpatients if they
participate in a day care program.
(b) Storage shall be provided for
recreational equipment and supplies. (Such as wall cabinets or
closets.)
(c) The areas set aside
for these purposes must be readily accessible to wheelchair patients and shall
be of sufficient size to accommodate equipment and permit unobstructed movement
of wheelchair patients and personnel responsible for instructing and
supervising patients.
Section 7. Dietary Department. If a commercial service will be used or meals will be provided by an adjacent hospital, dietary areas and equipment shall be designed to accommodate the requirements for sanitary, efficient, and safe storage, processing, and handling, otherwise the following shall be provided:
(1) Food preparation center with a lavatory
but no mirror.
(2) Food serving
facilities to accommodate patient and staff.
(3) Dishwashing and pot-washing facilities.
Dish and utensil washing equipment shall be used that will result in sanitized
serviceware and will prevent recontamination.
(4) Refrigerated storage which can
accommodate a three (3) day supply minimum.
(5) Dry storage which can accommodate a three
(3) day supply minimum.
(6) Food
carts. If the facility uses food carts, space shall be provided in the kitchen
or in a separate storage area for the cleaning and storage of food
carts.
(7) Janitor's closet for
storage for housekeeping supplies and equipment with a floor receptor or
service sink.
(8) A toilet room
conveniently accessible to the dietary department. If a toilet room is built
within the dietary department it must have a two (2) door separation from food
preparation area or dining areas.
Section 8. Administration Department. The facility shall have adequate administrative, public, and staff facilities (e.g., offices, lobby, toilet facilities) to accommodate the needs of the public, patients, and staff without interfering with the provision of medical care services.
Section 9. Laundry. The following shall be included:
(1) Soiled
linen room;
(2) Clean linen
room;
(3) Lavatory accessible from
soiled, clean, and processing rooms;
(4) Laundry processing room, and storage for
laundry supplies. (Need not be provided if laundry is processed outside the
facility.);
(5) Janitor's closet
with storage for housekeeping supplies and equipment and floor receptor or
service sink.
Section 10. Storage and Service Areas. The following shall be included:
(1) Sufficient storage space for general
storage requirements.
(2)
Engineering service and equipment areas. The following shall be provided where
applicable:
(a) Boiler room;
(b) Mechanical and electrical equipment
room(s) (can be combined with boiler room);
(c) Storage room for housekeeping equipment
(need not be provided if space is available in janitor's closets or
elsewhere);
(d) Refuse area for
holding trash prior to disposal which is located convenient to service
entrance.
Section 11. Details and Finishes. A high degree of safety for the occupants to minimize the incidence of accidents shall be provided. Hazards such as sharp corners shall be avoided. All details and finishes shall meet the following requirements:
(1) Details.
(a) Handrails shall be provided on both sides
of corridors used by patients in intermediate care facilities with a clear
distance of one and one-half (1 1/2) inches between handrail and
wall.
(b) All doors to patient-room
toilet rooms and patient-room bathrooms shall swing outward or shall be
equipped with hardware which will permit access in any emergency.
(c) All doors opening onto corridors shall be
swing-type except elevator doors. Alcoves and similar spaces which generally do
not require doors are excluded from this requirement.
(d) Thresholds and expansion joint covers, if
used, shall be flush with the floor.
(e) Grab bars and accessories in patient
toilet rooms, shower rooms, and bathrooms shall have sufficient strength and
anchorage to sustain a load of 250 pounds for five (5) minutes.
(f) Lavatories intended for use by patients
shall be installed to permit wheelchairs to slide under.
(g) Mirrors shall be arranged for convenient
use by patients in wheelchairs as well as by patients in standing
position.
(h) Towel rack or
dispenser shall be provided at all lavatories and sinks used for hand-washing.
(i) Ceiling heights.
1. Boiler room. Not less than two (2) feet
and six (6) inches above the main boiler header and connecting piping with
adequate headroom under piping for maintenance and access;
2. Corridors, storage rooms, patients' toilet
rooms, and other minor rooms. Not less than seven (7) feet and six (6)
inches;
3. All other rooms. Not
less than eight (8) feet.
(j) Boiler room, food preparation centers,
and laundries shall be insulated and ventilated to prevent any floor surface
above from exceeding a temperature of eighty-five (85) degrees
Fahrenheit.
(k) Noise reduction
criteria. The ceilings of the following areas shall be designed to reduce noise
transmission:
1. Corridors in patient
areas;
2. Nurses'
stations;
3. Work areas, such as
utility rooms;
4. Lobbies and
recreation areas.
(l)
Special attention shall be given to sound transmission from boiler rooms,
mechanical rooms, and kitchen, to patient bedroom areas.
(2) Finishes.
(a) Floors generally shall be easily
cleanable and shall have the wear resistance appropriate for the location
involved. Floors in kitchen and related spaces shall be waterproof and
grease-proof. In all areas where floors are subject to wetting, they shall have
a nonslip finish.
(b) Adjacent
dissimilar floor materials shall be flush with each other to provide an
unbroken surface.
(c) Walls
generally shall be washable and in the immediate area of plumbing fixtures, the
finish shall be moisture-proof. Wall bases in dietary areas shall be free of
spaces that can harbor insects.
(d)
Ceilings generally shall be washable or easily cleanable. This requirement does
not apply to boiler rooms, mechanical and building equipment rooms, shops and
similar spaces.
Section 12. Elevators. Elevators shall conform with 815 KAR 4:010. Elevators, where required. All facilities where either patient beds or inpatient facilities such as diagnostic, recreation, patient dining or therapy rooms are located on other than the first floor, shall have electric or electrohydraulic elevators as follows:
(1) Number of elevators. All facilities with
either patient beds or inpatient facilities located on any floor other than the
first floor shall have at least one (1) hospital-type elevator and such
additional elevators as determined by the licensure agency from a study of the
facility plan and the estimated vertical transportation requirements.
(2) Cars and platforms. Cars of hospital-type
elevators shall have inside dimensions that will accommodate a patient's bed
and attendants and shall be at least five (5) feet wide by seven (7) feet and
six (6) inches deep; car doors shall have a clear opening of not less than
three (3) feet and eight (8) inches. Cars of all other required elevators shall
have a clear opening of not less than three (3) feet.
(3) Leveling. Elevators shall have automatic
leveling of the two (2) way automatic maintaining type with accuracy within
plus or minus one-half (1/2) inch.
Section 13. Construction. Foundations shall rest on natural solid ground if a satisfactory soil is available at reasonable depths. Proper soil bearing values shall be established in accordance with recognized standards. If solid ground is not encountered at practical depths, the structure shall be supported on driven piles or drilled piers designed to support the intended load without detrimental settlement.
Section 14. Mechanical Requirements.
(1) Steam and hot water systems.
(a) Boilers. If boilers are used a minimum of
two (2) must be provided; the combined capacity of the boilers, based upon the
published Steel Boiler Institute or Institute of Boiler and Radiator
Manufacturer's net rating, must be able to supply 150 percent of the normal
requirements of all systems and equipment.
(b) The design and installation of boilers in
the facility shall comply with
815 KAR
15:010 through 060.
(2) Temperature and ventilating systems.
(a) Temperatures. A minimum temperature of
seventy-two (72) degrees Fahrenheit shall be provided for in occupied areas in
winter conditions. A maximum temperature of eighty-five (85) degrees Fahrenheit
shall be provided for in occupied areas in summer conditions.
(b) Ventilation systems details. All
air-supply and air-exhaust systems shall be mechanically operated. All fans
serving exhaust systems shall be located at or near the point of discharge from
the building. The ventilation rates shown in Table 1, Section 16 of this
administrative regulation, shall not be considered as precluding the use of
higher ventilation rates if they are required to meet design conditions.
1. Outdoor ventilation air-intakes, other
than for individual room units, shall be located as far away as practicable but
not less than twenty-five (25) feet from the exhausts from any ventilating
system or combustion equipment. The bottom of outdoor intakes serving central
air systems shall be located as high as possible but not less than eight (8)
feet above the ground level or if installed through the roof, three (3) feet
above roof level.
2. The
ventilation systems shall be designed and balanced to provide the general
pressure relationship to adjacent areas shown in Table 1, Section 16 of this
administrative regulation.
3. Room
supply air inlets, recirculation, and exhaust air outlets shall be located not
less than three (3) inches above the floor.
4. Corridors shall not be used to supply air
to or exhaust air from any room, except that exhaust air from corridors may be
used to ventilate rooms such as bathrooms, toilet rooms, or janitor's closets
which open directly on corridors.
(3) Plumbing and other piping systems.
(a) Lavatories and sinks required in patient
care areas shall have the water supply spout mounted so that its discharge
point is a minimum distance of five (5) inches above the rim of the fixture.
All fixtures used by medical and nursing staff, and all lavatories used by
patients and food handlers shall be trimmed with valves which can be operated
without the use of hands. Where blade handles are used for this purpose, they
shall be at a distance from the center line of the sink to be
operational.
(b) Clinical sinks
shall have an integral trap in which the upper portion of a visible trap seal
provides a water surface.
(4) Water supply system:
(a) Systems shall be designed to supply water
to the fixtures and equipment on the upper floors at a minimum pressure of
fifteen (15) pounds per square inch during maximum demand periods.
(b) Each water service main, branch main,
riser and branch to a group of fixtures shall be valved. Stop valves shall be
provided at each fixture.
(c) Hot,
cold and chilled water piping and waste piping on which condensation may occur
shall be insulated. Insulation of cold and chilled water lines shall include an
exterior vapor barrier.
(d)
Backflow preventers (vacuum breakers) shall be installed on hose bibbs and on
all fixtures to which hoses or tubing can be attached such as janitor's sinks
and bedpan flushing attachments.
(e) Hot water distribution systems shall be
arranged to provide hot water at each fixture at all times.
(f) Piping over food preparation centers,
food serving facilities, food storage areas, and other critical areas shall be
kept to a minimum and shall not be exposed. Special precautions shall be taken
to protect these areas from possible leakage of, or condensation from,
necessary overhead piping systems.
(5) Hot water heaters and tanks.
(a) The hot water heating equipment shall
have sufficient capacity to supply the water at the temperature and amounts
indicated below:
|
Use |
|||
|
Patient |
Dish- washer |
Laundry |
|
|
Gal/hr/be d |
6 1/2 |
4 |
4 1/2 |
|
Temp. F. |
100-110 |
180* |
140-180** |
*Temperature may be reduced to 140 if chloritizer is used.
**If the temperature used is below 180, the facility shall utilize detergents and other additives to insure that the linens will be adequately cleaned.
(b)
Storage tank(s) shall be provided and shall be fabricated of
corrosion-resistant metal, or have noncorrosive lining.
(6) Plumbing approval. Prior to final
approval of the plans and specifications by the licensure agency, the plumbing
plans and specifications must be approved by the Division of Plumbing,
Department of Housing, Buildings and Construction.
Section 15. Electrical Requirements.
(1) General. Electrical requirements of the
Kentucky Building Code shall apply where applicable.
(2) The wiring in each facility shall be
inspected by a certified electrical inspector and a certificate of approval
shall be issued to the facility, prior to occupancy; however, the wiring in
existing buildings shall be approved by a certified electrical inspector only
when the building has not been previously so approved for health care occupancy
or where the State Fire Marshal finds that a hazardous condition
exists.
(3) Switchboard and power
panels. All breakers and switches shall be indexed.
(4) Lighting.
(a) All spaces occupied by people, machinery,
and equipment within buildings, and the approaches thereto, and parking lots
shall have electric lighting.
(b)
Patients' bedrooms shall have general lighting. A reading light shall be
provided for each patient when appropriate. Patients' reading lights and other
fixed lights not switched at the door shall have switch controls convenient for
use at the luminaire. Fixed type night lights shall be provided in each
patient's room.
(c) Lighting levels
for the facility shall comply with the requirements of Table 2, Section 16 of
this administrative regulation.
(5) Receptacles (convenience outlets).
(a) Bedroom. Each patient bedroom shall have
duplex receptacles as follows: one (1) each side of the head of each bed (for
parallel adjacent beds, only one (1) receptacle is required between the beds),
receptacles for luminairies, television and motorized beds, if used, and one
(1) receptacle on another wall.
(b)
Corridors. Duplex receptacles for general use shall be installed approximately
fifty (50) feet apart in all corridors and within twenty-five (25) feet of ends
of corridors.
(6) Nurses'
calling system. A nurses' visible signal calling station shall be installed at
each patient bed and in each patient toilet, bath, and shower room. The nurses'
call in toilet, bath, or shower room, shall be an emergency call. All calls
shall register at the nurses' station and shall actuate a visible signal in the
corridor at the patient's door, in the clean workroom, and the soiled workroom
of the nursing unit.
(7) Emergency
electric service.
(a) General. To provide
electricity during an interruption of the normal electric supply that could
affect the nursing care, treatment, or safety of the occupants, an emergency
source of electricity shall be provided and connected to certain circuits for
lighting and power.
(b) Sources.
The source of this emergency electric service shall be an emergency generating
set, when normal service is supplied by one (1) or more central station
transmission lines.
(c) Emergency
generating set.
1. The required emergency
generating set, including the prime mover and generator, shall be located on
the premises and shall be reserved exclusively for supplying the emergency
electrical system. The emergency generator set shall be sufficient kilowatt
capacity to supply all lighting and power load demands of the emergency system.
The power factor rating of the generator shall be not less than eighty (80)
percent.
2. When the facility is
supplied by at least two (2) dedicated and separate utility service feeders, an
emergency generating set is not required.
(d) Emergency electrical connections.
Emergency electric service shall be provided to circuits as follows:
1. Lighting.
a. Exitways and all necessary ways of
approach thereto, including exit signs and exit direction signs, exterior of
exits, exit doorways, stairways, and corridors;
b. Dining and recreation rooms;
c. Nursing station and medication preparation
area;
d. Generator set location,
switch-gear location, and boiler room;
e. Elevator (if required for
emergency).
2. Equipment.
Essential to life safety and for protection of important or vital materials:
a. Nurses' calling system;
b. Sewage or sump lift pump, if
installed;
c. At least one (1)
duplex receptacle in each patient room;
d. Equipment such as burners and pumps
necessary for operation of one (1) or more boilers and their necessary
auxiliaries and controls, required for heating and sterilization;
e. Details. The emergency system shall be so
controlled that after interruption of the normal electric power supply, the
generator is brought to full voltage and frequency and connected within ten
(10) seconds through one (1) or more primary automatic transfer switches to all
emergency lighting, all alarms, nurses' call, and receptacles in patient
corridors. All other lighting and equipment required to be connected to the
emergency system shall either be connected through the above described primary
automatic transfer switching or shall be subsequently connected through other
automatic or manual transfer switching. Receptacles connected to the emergency
system shall be distinctively marked for identification.
Storage-battery-powered lights shall not be used as a substitute for the
requirement of a generator. Where fuel is normally stored on the site, the
storage capacity shall be sufficient for twenty-four (24) hour operation of
required emergency electric services. Where fuel is normally piped underground
to the site from a utility distribution system, storage facilities on the site
will not be required.
f. Emergency
heating. Where electricity is the only source of power normally used for space
heating, an alternate emergency heating system for the heating of corridors
will be required. Emergency heating of corridors will not be required in areas
where the facility is supplied by at least two (2) utility service feeders,
each supplied by separate generating sources or a network distribution system
fed by two (2) or more generators, with the facility feeders so routed,
connected, and protected so that a fault any place between the generators and
the facility will not be likely to cause an interruption of more than one (1)
of the intermediate care facility's service feeders. If there is written plan
for the transfer of patients within a reasonable time to other facilities with
which the intermediate care facility has written transfer agreements, the above
alternate emergency heating system will not be required.
Section 16. Appendix: Table 1 - Pressure Relationships and Ventilation of Certain Intermediate Care Areas. Table 2 - Lighting Levels For Intermediate Care Facilities.
|
TABLE 1. PRESSURE RELATIONSHIPS AND VENTILATION OF CERTAIN INTERMEDIATE CARE AREAS |
|||||
|
Area Designation |
Pressure Relationship to Adjacent Areas |
All Supply Air From Outdoors |
Minimum Air Changes of Outdoor Air per Hour |
Minimum Total Air Changes Per Hour |
All Air Exhausted Directly to Outdoors |
|
Patient room |
0 |
-- |
1 |
4 |
-- |
|
Patient area corridor |
0 |
-- |
2 |
4 |
-- |
|
Treatment room |
0 |
Yes |
2 |
4 |
Yes |
|
Physical therapy and hydrotherapy, if applicable |
N |
-- |
2 |
6 |
-- |
|
Dining and recreation areas |
0 |
-- |
2 |
4 |
-- |
|
Soiled workroom |
N |
-- |
2 |
4 |
Yes |
|
Clean workroom |
P |
Yes |
2 |
4 |
-- |
|
Toilet room |
N |
-- |
-- |
10 |
Yes |
|
Bedpan room if applicable |
N |
-- |
-- |
10 |
Yes |
|
Bathroom |
N |
-- |
-- |
10 |
Yes |
|
Janitor's closet |
N |
-- |
-- |
10 |
Yes |
|
Linen and trash chute rooms |
N |
-- |
-- |
10 |
Yes |
|
Food preparation center |
0 |
Yes |
2 |
10 |
Yes |
|
Dishwashing area |
N |
-- |
-- |
10 |
Yes |
|
Dietary day storage |
0 |
-- |
-- |
2 |
-- |
|
Laundry, general |
0 |
Yes |
2 |
10 |
Yes |
|
Soiled linen sorting and storage |
N |
-- |
-- |
10 |
Yes |
|
Clean linen storage |
P |
-- |
2 |
2 |
-- |
|
P = Positive N = Negative 0 = Equal -- = Optional |
|||||
|
Table 2. Lighting Levels for Intermediate Care Facilities |
|
|
Area |
Foot-candles* |
|
Administrative and lobby areas, day |
50 |
|
Administrative and lobby areas, night |
20 |
|
Barber and beautician areas, if applicable |
50 |
|
Corridors and interior ramps |
20 |
|
Corridor night lighting |
3 |
|
Dining area and kitchen |
30 |
|
Doorways |
10 |
|
Exit stairways and landings |
5 |
|
Janitor's closet |
15 |
|
Nurses' station, general, day |
50 |
|
Nurses' station, general, night |
20 |
|
Nurses' desk, for charts and records |
70 |
|
Nurses' medicine cabinet |
100 |
|
Patient care unit (or room), general |
10 |
|
Patient care room, reading |
30 |
|
Recreation area (floor level) |
50 |
|
Stairways other than exits |
30 |
|
Toilet and bathing facilities |
30 |
|
Utility room, general |
20 |
|
Utility room, work counter |
50 |
|
*Minimum on task at anytime |
|
STATUTORY AUTHORITY: KRS 216B.042, 216B.105
Disclaimer: These regulations may not be the most recent version. Kentucky may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
