Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.49 - Resident Bedroom in Nursing Home
Universal Citation: MD Code Reg 10.07.02.49
Current through Register Vol. 51, No. 19, September 20, 2024
A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home unless a waiver has been granted by the Office of Health Care Quality in accordance with Regulation .03G of this chapter.
B. Bedroom Accommodations.
(1) Bedroom.
(a) A resident's room shall have direct
access to an exit in accordance with the requirements applicable to nursing
homes specified in NFPA 101 Life Safety Code.
(b) A room that opens into the kitchen may
not be used as a resident bedroom.
(c) A room may not be used as a resident
bedroom if it can only be reached by passing through a kitchen.
(d) Residents may not occupy rooms extending
below the ground level.
(e) No more
than four individuals may occupy a multiple occupancy bedroom.
(f) Residents' beds may not be located near
radiators, registers, or sources of draft.
(g) Adequate storage space shall be provided
in each bedroom to allow each resident to keep necessary items of clothing,
including items that need to be hung.Adequate storage space shall be provided
for residents' personal possessions, including the storage of seasonal
clothing.
(h) All occupants of any
bedroom shall be of the same sex, except in the case of a two-bed room occupied
by:
(i) Siblings;
(ii) A parent and child;
(iii) A married couple; or
(iv) Consenting residents.
(2) Bedroom - New
Construction. A nursing home shall provide cubicle curtains and tracks in
multiple occupancy bedrooms between beds to ensure privacy of
residents.
(3) Bedroom - Existing
Construction. In an existing nursing home, curtains or screens shall be
acceptable.
C. Floor and Window Space.
(1) Floors.
(a) A distance of at least 3 feet shall be
maintained between each bed. Beds are to be placed so that all sides of the bed
are at least 18 inches from heating units.
(b) The following shall be considered a
minimum allowance of floor space:
(i) 100
square feet, single-bed room; and
(ii) 80 square feet, per bed, for
multiple-bed rooms.
(c)
The following floor areas may not be included in the calculation of floor
space:
(i) Toilet rooms and bathing
facilities;
(ii) Closets;
(iii) The floor area occupied by wardrobes,
bureaus, or lockers, when permanently installed as part of walls or ceilings
and as a permanent component of a bedroom;
(iv) HVAC equipment, including any steam,
water, or electrical supply or return lines that may run parallel to the floor
or interrupt the floor surface;
(v)
Support columns, pipe chases, or other structures, whether free-standing or as
an integral part of a wall; and
(vi) The arc of any doors that open into the
room, excluding closet doors.
(d) The minimum horizontal dimensions of a
bedroom shall be 10 feet to:
(i) Facilitate
the placement of beds as required in Regulation .44 of this chapter;
and
(ii) Maintain a minimum
clearance of 3 feet at the foot of the bed.
(e) In an existing nursing home, the usable
floor area for rooms having a bedroom shall have a finished ceiling height of 8
feet. For a bedroom that has sloping walls, only 50 percent of the floor area
with a ceiling height between 4 feet and 7 feet, 6 inches, shall be credited,
provided that at least 50 percent of the total area of the bedroom has a
ceiling height of 8 feet.
(2) Windows.
(a) The window area within each bedroom shall
be at least 10 square feet per bed. The window opening shall be at least 28
inches so that the total area equals 10 square feet per bed.This is to allow
entry of fire fighters, removal of smoke, and emergency evacuation.
(b) The maximum height from the floor to the
top of a window sill shall be 44 inches above the finished floor.
(c) A portable window air-conditioning unit
may not block window space. The installation of a portable air-conditioning
unit shall be approved by the:
(i) Local fire
authorities; and
(ii)
Department.
(d) If
windows cannot be opened for ventilation, a central HVAC system shall be
provided and maintained.
(e) If
windows can be opened, but the nursing home has concern over the window being
opened due to resident safety issues and elopement, the window sash may be
restricted by hardware as approved by the Department.
D. Furnishings.
(1) Furnishings.
(a) The nursing home shall provide residents
with their own bed. The bed shall be at least 36 inches wide and be
substantially constructed. Rollaway type beds, cots, or folding beds may not be
used.
(b) Bed.
(i) Each bed provided shall be in good
repair, with a clean and comfortable standard size mattress and
foundation.
(ii) To avoid injury to
the resident, the mattress and foundation shall fit the bed.
(iii) Clean linen and a clean, comfortable
pillow shall be provided. Extra pillows shall be available.
(c) Bedroom Furniture. A resident
shall be provided with the following furnishings, which shall be convenient to
the resident:
(i) Bedside stand with a
drawer;
(ii) Towel
hanger;
(iii) A comfortable
chair;
(iv) A chest of drawers with
at least one locking drawer;
(v)
Enclosed space for hanging clothing;
(vi) A wall mirror in each room, unless
contraindicated by physician's order; and
(vii) A bedside lamp, over-bed lamp, or other
directional light source for resident reading and bedside care.
(d) Resident's Personal
Furnishings.
(i) A nursing home shall develop
policies and procedures to give residents the opportunity to use the resident's
own furnishings as detailed in this chapter.
(ii) The nursing home shall make its
resident's personal furnishing policies available for review by residents and
the resident's representative.
(iii) These policies shall address the
condition of the personal furnishings, presence of insects or vermin, and
overall safety to ensure that the use of the resident's belongings does not
create any safety or health issues.
(iv) Personal furnishings that are allowed
shall be appropriate for the resident's use.
(e) Windows shall be provided with shades or
draperies adequate to control glare and maintain privacy.
(f) Each living room for residents' use shall
be provided with a sufficient number of reading lamps, tables, and comfortable
chairs or sofas.
(2)
Furnishings - New Construction. A bedroom shall be provided with a hand-washing
sink with both hot and cold running water unless a toilet or bathroom facility
with a sink is connected to the bedroom.
(3) Medication Storage Cabinets.
(a) Medication storage cabinets with locks
shall be permitted for the storage of resident medications that do not require
refrigeration within a resident bedroom.
(b) Controlled medications to be stored
within medication storage cabinets in a resident's room shall be held within a
separate compartment that is locked and inside of the larger medication storage
cabinet in that room.
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