New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-P - Former Division of Public Health Services
Chapter He-P 800 - RESIDENTIAL CARE AND HEALTH FACILITY RULES
Part He-P 830 - ACUTE PSYCHIATRIC RESIDENTIAL TREATMENT PROGRAMS
Section He-P 830.24 - Physical Environment

Universal Citation: NH Admin Rules He-P 830.24

Current through Register No. 40, October 3, 2024

(a) The physical environment shall be maintained, inside and outside, to provide for the health, safety, well-being and comfort of client(s) and personnel, including reasonable accommodations for clients and personnel with mobility limitations.

(b) The PRTP shall:

(1) Have all emergency entrances and exits accessible at all times;

(2) Be maintained in good repair and kept free of hazards to personnel and residents, including but not limited to hazards from falls, burns, or electric shocks;

(3) Be free from environmental nuisances, including excessive noise and odors;

(4) Keep all corridors free from obstructions; and

(5) Take reasonable measures to prevent the presence of rodents, insects, and vermin to include but not be limited to:
a. Having tightly fitting screens on all doors, windows, or other openings to the outside unless the door is self-closing and remains closed when not in use;

b. Repairing holes and caulking of pipe channels; and

c. Extermination by a pesticide applicator licensed under RSA 430.

(c) Equipment providing heat within an PRTP including, but not limited to, gas furnace or boiler, oil furnace or boiler, wood stove or pellet stove shall:

(1) Maintain a temperature as follows, except where clients have control of the thermostat in their own room:
a. Be at least 65 degrees Fahrenheit at night; and

b. Be at least 70 degrees Fahrenheit during the day if the client(s) are present; and

(2) Be serviced once a year or as recommended by the manufacturer with written documentation of such service retained for at least 4 years.

(d) Electric heating systems shall be exempt from (b)(2) above.

(e) Portable space heating devices shall be prohibited, unless the following are met:

(1) Such devices are used only in employee areas where personnel are present and awake at all times; and

(2) The heating elements of such devices do not exceed 212 degrees Fahrenheit.

(f) Unvented fuel-fired heaters shall not be used in any PRTP.

(g) Plumbing shall be sized, installed, and maintained in accordance with the \International Plumbing Code, as specified in the state building code under RSA 155-A:1, IV, as amended by the building code review board pursuant to RSA 155:A:10,V.

(h) Ventilation shall be provided in all enclosed living areas by means of a mechanical ventilation system or one or more screened windows that can be opened.

(i) Each client bedroom shall have natural lighting provided by at least one operable window with a screen to the outside, which is of a size equivalent to or greater than 8% of the room's gross square footage or comparable artificial lighting.

(j) The number of sinks, toilets, tubs or showers shall be in a ratio of one for every 6 individuals, unless personnel have separate bathroom facilities not used by clients.

(k) All showers and tubs shall have slip resistant floors and surfaces, which are intact, easily cleanable, and impervious to water.

(l) All hand-washing facilities shall be provided with hot and cold running water.

(m) In a PRTP there shall be at least 100 square feet per room with a single bed and 160 (80 square feet per client) square feet per room with 2 beds, exclusive of space required for closets, wardrobe, and toilet facilities.

(n) Each bedroom shall:

(1) Contain no more than 2 beds;

(2) Have its own separate entry to permit the client to reach his/her bedroom without passing through the room of another client;

(3) Have a side hinge or pocket door, that meets applicable codes, and not a folding door or a curtain;

(4) Not be used simultaneously for other purposes;

(5) Be separated from halls, corridors and other rooms by floor to ceiling walls;

(6) Be located on the same level as the bathroom facilities, if the client has impaired mobility as identified by the assessment; and

(7) If a licensed bedroom is temporarily being utilized for another purpose, it shall retain the capability of being restored to meet the requirements of a licensed bedroom within 24 hours and without requiring additional construction or renovation.

(o) The licensee shall provide the following for the clients' use, as needed, unless clinically indicated otherwise:

(1) A bed appropriate to the needs of the client;

(2) A firm mattress that complies with the state fire code and codes adopted by reference as defined in RSA 153:1, VI-a, except as modified in Saf-FMO 300;

(3) Clean linens, blankets and a pillow;

(4) A bureau;

(5) A mirror;

(6) A bedside table;

(7) Adequate lighting;

(8) A chair;

(9) A closet or storage space for personal belongings; and

(10) Window blinds, shades or curtains that provide privacy.

(p) The resident or guardian may indicate and the home shall document that the resident does not wish or need to have one of more of the items in (p) above and the reason for the removal.

(q) The licensee at a minimum shall provide the following rooms to meet the needs of clients:

(1) One or more living rooms or multi-purpose rooms; and

(2) Dining facilities with a seating capacity capable of meeting the needs of all clients.

(r) For PRTP licensees who will be involuntarily admitting persons a secure environment shall be provided. This may include the use of restraints in personal safety emergencies, as permitted by RSA 151:21.

(s) Doors on locked units shall comply with He-P 830.24(z).

(t) If a client is determined to be a danger to themselves or others per the assessment in He-P 830.16(c), the licensee must comply with the Facility Guideline Institute (FGI), "Guidelines for Design and Construction of Hospitals" (2018 edition) with regard to protection features, available as noted in Appendix A.

(u) Each area should be evaluated to identify the architectural details, surfaces, and furnishings and exposed mechanical and electrical devices and components in areas where clients might be such as:

(1) Seclusion rooms;

(2) Patient bedrooms and toilet rooms;

(3) An area under good supervision but dealing with unpredictable patients under initial evaluation and if under heavy medication;

(4) Activity spaces, group rooms, and treatment spaces;

(5) Dining rooms and recreation spaces, both indoor and outdoor;

(6) Corridors;

(7) Exam rooms; and

(8) Staff and support areas if accessible by clients.

(v) Each licensee shall have a communication system, such as nurse call, so that all clients can effectively contact personnel when they need assistance with care or in an emergency.

(w) Lighting shall be available to allow clients to participate in activities such as reading.

(x) All bathroom, bedroom and closet door latches or locks shall be designed for easy opening from the inside and outside in an emergency.

(y) Doors that are self-closing and remain closed when not in use shall be exempt from the requirement in (v) above.

(z) If present, seclusion rooms, shall, at a minimum be:

(1) Equipped with an observation window;

(2) Only for one client at a time;

(3) Under constant observation when clients or others are present in them; and

(4) Locked only under the following conditions:
a. If there is immediate threat of bodily harm to staff or other clients; and

b. If the reason for locking the seclusion room is documented in the client record.

(aa) Any locked door providing egress from within the PRTP, shall meet the requirements of the Residential Board and Care or Health Care Occupancy chapter, whichever chapter the facility was designed to meet based on the resident's needs, of NFPA 101, as adopted by reference in RSA 153:1, VI-a, except as modified in Saf-FMO 300.

#10059, eff 12-23-11

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