Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 175 - HEALTH CARE FACILITIES AND SERVICES LICENSURE
Chapter 17 - INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED
Section 175-17-007 - PHYSICAL PLANT STANDARDS
Universal Citation: 175 NE Admin Rules and Regs ch 17 ยง 007
Current through March 20, 2024
The facility must be designed, constructed and maintained in a manner that is safe, clean, and functional for the type of services to be provided. The physical plant standards, which include support services, construction standards, building systems, and waivers, are set forth below.
007.01 Support Areas
The facility may share the following support service areas among detached structures, and with other licensed facilities.
17-007.01A
Dietary:
If food preparation is provided on site, the facility must dedicate space and
equipment for the preparation of meals. Facilities licensed for more than 16
individuals must comply with the Food Code.
For facilities licensed for 16 or fewer individuals or for areas of the facility used only for training or activity purposes may follow the food code or must develop policies and procedures to ensure the following:
1. Automatic dishwasher
final rinse cycle temperature of not less than 150 degrees
Fahrenheit;
2. Foods are stored,
prepared, transported, and served at proper temperatures. Temperatures of
potentially hazardous foods must be 45 degrees Fahrenheit or below or 140
degrees Fahrenheit or above at all times;
3. Food preparation and eating areas are
maintained in a sanitary manner; and
4. All equipment and utensils, including
dishes, glassware, and silverware used in the serving or preparation of food or
drink for individuals is thoroughly cleaned after each use and stored in a
manner to assure they are kept free of dust, insects, and
contamination.
17-007.01B
Laundry:
The facility must provide laundry services. Laundry service may be provided by
contract or on-site by the facility.
17-007.01B1
Contract: If contractual services are used, the facility must have
areas for soiled linen awaiting pickup and separate areas for storage and
distribution of clean linen.
17-007.01B2
On-Site: If on-site services are provided, the facility must have
areas dedicated to laundry.
17-007.01B2a
Laundry areas must be provided and equipped with a washer and dryer.
17-007.01B2b When the facility launders items
for more than one individual together, the bulk laundry area must be divided
into separate soiled (sort and washer areas) and clean (drying, folding, and
mending areas) areas. In new construction, the facility must provide a
conveniently located sink for soaking and hand washing of laundry and a
housekeeping room.
17-007.01C
Waste
Processing: The facility must provide areas to collect, contain,
process, and dispose of waste produced within the facility in a manner to
prevent the attraction of rodents, flies, and all other insects and vermin, and
to minimize the transmission of infectious diseases.
17-007.01D
Cosmetology and
Barber: When provided, cosmetology and barber services must be in
conformance with the Nebraska Cosmetology Act, Neb. Rev.
Stat.
§§ 340 to 3,238 and the Barber Act,
Neb. Rev. Stat.
§§
71-201
to
71-248.
17-007.01E
Pharmaceutical: If the facility provides pharmacy
services as defined in Neb. Rev. Stat.
§§
71-1,142 to 71-1, 147.61, the services must be provided in conformance with
that law.
007.02 Construction Standards
The facility must be designed, constructed, and maintained in a manner to provide ICF/MR services. The standards are set forth below:
17-007.02A
Codes
and Guidelines
17-007.02A1
New Construction: New construction must comply with
the following:
1.
Building: Building Construction Act, Neb.
Rev. Stat.
§§
71-6401
to
71-6407;
2.
Plumbing:
Plumbing Ordinance or Code, Neb. Rev. Stat.
§
181915;
3.
Electrical: State Electrical Act, Neb.
Rev. Stat.
§§
81-2101
to 812143;
4.
Elevators: Nebraska Elevator Code, Neb.
Rev. Stat.
§
48-418.12 and
Department of Labor Regulations, 230 NAC 1;
5.
Boiler: Boiler
Inspection Act, Neb. Rev. Stat.
§§
48-719
to
48-743;
6.
Accessibility:
Nebraska Accessibility Requirements, State Fire Marshal Regulations, 156 NAC 1
to 12; and
7.
Energy: Nebraska Energy Code, Neb. Rev.
Stat.
§§
81-1608
to
81-1626,
for construction initiated on or after July 1, 2005.
17-007.02A2
All
Facilities: All facilities must comply with the following
applicable codes and standards to provide a safe environment:
1.
Fire Codes:
Nebraska State Fire Code Regulations, State Fire Marshal, 153 NAC 1;
and
2.
The Food
Code, Neb. Rev. Stat.
§
81-2,244.01,
as published by the Nebraska Department of Agriculture, except for compliance
and enforcement provisions, and except as noted in 175 NAC
17-007.01A.
17-007.02A3
Existing
and New Facilities: Existing and new facilities must comply with
the physical plant standards contained in 175 NAC 17-007. The facility must
maintain all building materials and structural components so that total loads
imposed do not stress materials and components more than one and one-half times
the working stresses allowed in the building code for new buildings of similar
structure, purpose and location.
17-007.02B
Conflicts in
Standards: In situations where the referenced codes and guidelines
conflict with 175 NAC 17, the adopted rules and regulations of the Department
and the Nebraska State Fire Marshal will prevail.
17-007.02C
Floor
Area: Floor area is the space with ceilings at least seven feet in
height and excludes enclosed storage, toilet and bathing rooms, corridors, and
halls. The space beyond the first two feet of vestibules and alcoves less than
five feet in width is not included in the required floor area. In rooms with
sloped ceilings, at least half of the ceiling must be at least seven feet in
height. Areas less than five feet in height are not included in the required
floor area.
17-007.02D
Dining/Activity Areas: The facility must provide
adequate space for dining, socialization, and leisure activities.
17-007.02D1 The space must provide a minimum
of 15 square feet per individual in existing facilities and 20 square feet per
individual in new construction.
17-007.02D2 Dining/activity areas must not be
used for sleeping, offices, or corridors.
17-007.02E
Bathing
Rooms: The facility must provide a bathing room consisting of a
tub and/or shower equipped with hand grips or other assistive devices as needed
or desired by the individual. The facility must have one bathing fixture per 20
licensed beds in existing facilities, and one fixture per eight licensed beds
in new facilities and new construction.
17-007.02F
Toilet
Rooms: The facility must provide a room with a sink and toilet for
individuals' use with one fixture per eight licensed beds in existing
facilities, and one fixture per four licensed beds in new facilities and new
construction.
17-007.02G
Bedrooms: The facility must provide bedrooms that
provide for sleeping, afford privacy, provide reasonable access to furniture
and belongings, and accommodate the needs of the individual. All bedrooms must:
1. Not be accessed through a bathroom, food
preparation area, laundry, office, or another bedroom;
2. Be located on an outside wall with an
operable window with a minimum glass size of six square feet per individual in
new construction and new facilities;
3. Contain at least 35 cubic feet of storage
volume per individual in dressers, closets, wardrobes, or other similar types
of storage;
4. Have 80 square feet
of floor area for a single bed room and 60 square feet of floor area per
individual in a multiple bed room; and
5. Not exceed four beds per room in existing
facilities and two beds per room in new construction and new
facilities.
17-007.02H
Corridors: The facility's corridors must be wide
enough to allow passage and be equipped as needed by the individuals with
safety and assistive devices. All stairways and ramps must have
handrails.
17-007.02I
Doors: The facility's doors must be wide enough to
allow passage and be equipped as needed by the individuals for privacy and
safety.
17-007.02J
Outdoor Areas: The facility must provide an outdoor
area for individuals' use. It must be equipped and situated to provide for
safety and the abilities of the individuals.
17-007.02K
Emergency
Telephone: The facility must provide non-coin operated
telephone(s) in working order, accessible to individuals based on their needs,
located on the premises for local calls and emergencies. Emergency numbers must
be easily accessible near the telephone.
17-007.02L
Privacy:
The facility must provide window coverings to ensure visual privacy of the
individuals.
007.03 Building Systems
The facility must have building systems that are designed, installed, and that operate in a manner to provide for the safety, comfort, and well being of the individuals.
17-007.03A
Water and Sewer
Systems: The facility must have and maintain an accessible,
adequate, safe, and potable supply of water. Where an authorized public water
supply of satisfactory quantity, quality, and pressure is available, the
facility must be connected to it and its supply used exclusively.
17-007.03A1 The system for collection,
treatment, storage, and distribution of potable water of a facility that
regularly services 25 or more individuals must be constructed, maintained, and
operated in accordance with all provisions of the Nebraska Safe Drinking Water
Act and Title 179, Regulations Governing Public Water Systems.
17-007.03A2 The system for collection,
treatment, storage and distribution of potable water in a facility that serves
less than 25 individuals on a regular basis must be maintained and operated as
if it were a public water system, in accordance with 179 NAC 2-002, 3 and 4.
These facilities must report to the Department the result of all tests that
indicate the water is in violation of the standards set out in 179 NAC 2-002 or
3. These facilities must construct all water wells in accordance with 178 NAC
12, Water Well Construction, Pump Installation, and Water Well Decommissioning
Standards.
17-007.03A3 The water
distribution system must have anti-siphon devices and air-gaps to prevent
potable water system and equipment contamination.
17-007.03A4 The facility must provide
continuously circulated, filtered, and treated water systems as required for
the services provided.
17-007.03A5
The facility must maintain a sanitary and functioning sewage system.
17-007.03B
Hot Water
System: The facility must maintain hot and cold water to all
handwashing and bathing locations with water temperatures for the comfort and
safety of each individual. Hot water temperatures must not exceed 120 degrees
Fahrenheit.
17-007.03C
Heating and Cooling Systems: The facility must provide
a heating and air conditioning system for the comfort of the individuals and
capable of maintaining temperatures of at least 70 degrees Fahrenheit during
heating conditions and that does not exceed 85 degrees Fahrenheit during
cooling conditions.
17-007.03D
Ventilation System: The facility must provide exhaust
and clean air to prevent the concentrations of contaminants which impair health
or cause discomfort to individuals and employees.
17-007.03D1 Existing and new facilities must
have adequate ventilation.
17-007.03D2 New construction must provide a
mechanical exhaust ventilation system for windowless toilets, baths, and
kitchens that provides five air changes per hour.
17-007.03E
Electrical
System: The facility must have an electrical system that has
sufficient capacity to maintain the services that are provided and that
provides proper grounds.
17-007.03E1 New
construction and new facilities must have outlets that are ground fault circuit
interrupter-protected in wet areas and within six feet of sinks.
17-007.03E2 All facilities must provide the
minimum illumination levels as follows:
1.
General purpose areas - 5 foot candles;
2. General corridors and individuals' living
areas - 10 foot candles;
3.
Personal care and food preparation areas - 20 foot candles; and
4. Activity areas - 30 foot candles.
Light levels are measured at 30 inches above the floor in multiple areas in the room being evaluated and the readings are averaged.
17-007.03F
Emergency Power
System: If the facility provides services to individuals who need
electrical life support equipment, the facility must maintain an emergency
power system.
007.04 Waivers
The Department may waive any provision of 175 NAC 17 relating to construction or physical plant requirements of a licensed facility upon proof by the licensee satisfactory to the Department that:
1. The waiver would not unduly jeopardize the
health, safety, or welfare of the persons residing in the facility,
2. The provision would create an unreasonable
hardship for the facility, and
3.
The waiver would not cause the State of Nebraska to fail to comply with any
applicable requirements of Medicare or Medicaid so as to make the state
ineligible for the receipt of all funds to which it might otherwise be
entitled.
17-007.04A
Unreasonable Hardship: In evaluating the issue of
unreasonable hardship, the Department will consider the following:
1. The estimated cost of the modification or
installation;
2. The extent and
duration of the disruption of the normal use of areas used by persons residing
in the facility resulting from construction work;
3. The estimated period over which the cost
would be recovered through reduced insurance premiums and increase
reimbursement related to costs;
4.
The availability of financing; and
5. The remaining useful life of the
building.
17-007.04B
Waiver Terms and Conditions: A waiver may be granted
under terms and conditions and for a period of time as are applicable and
appropriate to the waiver. Terms and conditions and period of waiver include
but are not limited to:
1. Waivers granted to
meet the special needs of an individual remain in effect as long as required by
the individual;
2. Waivers may be
granted for a period of time that ends at the time the conditions of approval
no longer exist;
3. Waivers may be
granted to permit a facility time to come into compliance with the physical
plant standards for a period of one year. Upon submission of proof of ongoing
progress, the waiver may be continued for an additional year; and
4. An applicant or licensee must submit a
request for waiver of any construction or physical plant requirements set forth
in 175 NAC 17. An applicant for a waiver may construct a request for waiver
form or obtain a form from the Department.
17-007.04C
Denial of
Waiver: If the Department denies a facility's request for waiver,
the facility may request an administrative hearing as provided in the
Administrative Procedure Act and the Department's rules and regulations adopted
and promulgated under the APA.
Disclaimer: These regulations may not be the most recent version. Nebraska 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.
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