New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS
Part 12 - REQUIREMENTS FOR ACUTE CARE, LIMITED SERVICES AND SPECIAL HOSPITALS
Section 8.370.12.41 - PHYSICAL ENVIRONMENT
Universal Citation: 8 NM Admin Code 8.370.12.41
Current through Register Vol. 35, No. 18, September 24, 2024
A. General: The buildings of the hospital shall be constructed and maintained so that they are functional for diagnosis and treatment and for the delivery of the hospital services appropriate to the needs of the community and with due regard for protecting the life, health and safety of the patients and staff. The provisions of this section apply to all new, remodeled and existing construction unless otherwise noted.
B. Definitions in 8.370.12.41 NMAC.
(1) "Building, existing" means a
building erected prior to the adoption of this requirement, or one for which a
legal building permit has been issued.
(2) "Existing construction" means a building,
which is in place or is being constructed with plans approved by the authority
prior to the effective date of this chapter.
(3) "Full-term nursery" means an area in the
hospital designated for the care of infants who are born following a full-term
pregnancy and without complications, until discharged to a parent or other
legally authorized person.
(4)
"Intermediate nursery" means an area in the hospital designated for the care of
infants immediately following birth who require observation due to
complications, and for the care of infants who require observation following
placement in the critical care nursery, until discharged to a parent or other
legally authorized person.
(5)
"Life safety code" means the standard adopted by the national fire protection
association (NFPA) known as NFPA 101 life safety code.
(6) "New construction" means construction for
the first time of any building or addition or remodeling to an existing
building, the plans for which are approved after the effective date of this
chapter.
(7) "Remodeling" means to
make over or rebuild any portion of an existing building or structure and
thereby modify its structure, structural strength, fire hazard character,
exits, heating and ventilation systems, electrical system or internal
circulation, as previously approved by the authority. Where exterior walls are
in place but interior walls are not in place at the time of the effective date
of this chapter, construction of interior walls shall be considered remodeling.
"Remodeling" does not include repairs necessary for the maintenance of a
building or structure.
(8) "Special
care unit" means an organized health care service that combines specialized
facilities and staff for the intensive care and management of patients in a
crisis or potential crisis state. "Special care units" include psychiatric
special care, coronary care, surgical intensive care, medical intensive care
and burn units, but do not include post-obstetrical or post-surgical recovery
units or neonatal intensive care units.
C. Approvals: The hospital shall keep all documentation of inspections on file in the hospital following any inspections by state and local authorities for a period of five years.
D. Fire Protection:
(1) Basic responsibility:
The hospital shall provide fire protection adequate to ensure the safety of
patients, staff and others on the hospital's premises. Necessary safeguards
such as extinguishers, sprinkling and detection devices, fire and smoke
barriers, and ventilation control barriers shall be installed and maintained to
ensure rapid and effective fire and smoke control.
(2) New construction: Any new construction or
remodeling shall meet the applicable provisions of the current edition of the
building code, fire code, life safety code, and AIA guidelines for hospitals
and health care facilities.
(3)
Existing facilities: Any existing hospital shall be considered to have met the
requirements of this subsection if, prior to the promulgation of this chapter,
the hospital complied with and continues to comply with the applicable
provisions of the 1967, 1973 or the current edition of the life safety code,
with or without waivers.
(4)
Equivalent compliance: Any existing facility that does not meet all
requirements of the applicable life safety code may be considered in compliance
with life safety code if the facility achieves a passing score on the fire
safety evaluation system (FSES) developed by the U.S. department of commerce,
national bureau of standards, to establish safety equivalencies under the life
safety code.
E. General construction:
(1) Prior to any
construction, one copy of schematic plans shall be submitted to the licensing
authority for review and preliminary approval.
(2) Before construction is started, one copy
of final plans and specifications which, are used for bidding purposes shall be
submitted to the licensing authority for review and approval. Plans must be
prepared, sealed, signed and dated by an architect registered in the state of
New Mexico.
(3) If on-site
construction above the foundation is not started within 12 months of the date
of approval of the final plans and specifications, the approval under these
requirements shall be void and the plans and specifications must be resubmitted
for reconsideration of approval.
(4) Before any construction change(s) is
undertaken affecting the approved final plans, modified plans shall be
submitted to the licensing authority for review and approval. The licensing
authority shall notify the hospital in writing of any conflict with this
subchapter found in its review of modified plans and specifications.
(5) General: Projects involving alterations
of, and additions to, existing buildings shall be programmed and phased so that
on-site construction will comply with all codes and minimize disruptions of
existing functions. Access, exit ways, and fire protection shall be so
maintained that the safety of the occupants will not be jeopardized during
construction.
(6) Minimum
requirements: All requirements listed in Subsection G of 8.370.12.41 NMAC new
construction, relating to new construction projects, are applicable to
renovation projects involving additions or alterations. When existing
conditions make changes impractical to accomplish, minor deviations from
functional requirements may be permitted with the approval of the licensing
authority if the intent of the requirements is met and if the care and safety
of patients will not be jeopardized.
(7) Nonconforming condition: When doing
renovation work, if it is found to be infeasible to correct all of the
non-conforming conditions in the existing facility in accordance with these
standards, acceptable compliance status may be recognized by the licensing
agency if the operation of the facility, necessary access by the handicapped,
and safety of the patients, are not jeopardized by the remaining non-conforming
conditions.
(a) Plan approval and building
permit by the construction industries division or local building department,
are also required for any new construction or remodeling.
(b) Copies of the life safety codes and
related codes can be obtained from the national fire protection association, 11
Tracy Drive, Avon, MA 02322.
F. Construction and inspections. Construction shall not commence until plan-review deficiencies have been satisfactorily resolved.
(1) The completed
construction shall be in compliance with the approved drawings and
specifications, including all addenda or modifications approved for the
project.
(2) A final inspection of
the facility will be scheduled for the purpose of verifying compliance with the
licensing standards, and approved plans and specifications.
(3) The facility shall not occupy any new
structure or major addition or renovation space until the appropriate
permission has been received from the local building and fire authorities and
the licensing authority.
G. New Cconstruction:
(1) General: Every hospital building
hereafter constructed, every building hereafter converted for use as a
hospital, and every addition or alteration hereafter made to a hospital shall
comply with the requirements of these standards.
(a) Compliance with these standards does not
constitute release from the requirements of other applicable state and local
codes and ordinances. These standards must be followed where they exceed other
codes and ordinances.
(b) No
building may be converted for use as a licensed hospital, which because of its
location, physical condition, state of repair, or arrangement of facilities,
would be hazardous to the health and safety of the patients who would be housed
in such a building. Any hospital or related institution that has been vacated
in excess of one year or used for occupancy other than health care will be
classified as a new facility.
(c)
All new construction, remodeling and additions must meet requirements set forth
by these standards, the building and fire codes and by the Americans with
Disabilities Act (ADA), for accessibility for persons with
disabilities.
(2) Codes
and standards: In addition to compliance with these standards, all other
applicable building codes, ordinances, and regulations under city, county or
other state agency jurisdiction shall be observed.
(a) Compliance with local codes shall be
pre-requisite for licensing. In areas not subject to local building codes, the
state building codes shall be prerequisite for licensing, as adopted.
(b) New construction for acute-care
hospitals, limited services hospitals and special hospitals are governed by the
current editions of the following codes and standards: uniform building code
(UBC), uniform plumbing code (UPC), uniform mechanical code (UMC), national
electric code (NEC), national fire protection association standards (NFPA),
American national standards institute (ANSI), American society of heating,
refrigerating, and air conditioning engineers (ASHREA), American institute of
architects (AIA), academy of architecture for health guidelines for design and
construction of hospital and health care facilities, NFPA101, and New Mexico
building code (NMBC).
H. Patient rooms-general:
(1) Bed capacity: Each hospital's bed
capacity may not exceed the capacity approved by the licensing
authority.
(2) Privacy: Visual
privacy shall be provided for each patient in multi-bed patient rooms. In new
or remodeled construction, cubicle curtains shall be provided.
(3) Toilet room:
(a) In new construction, each patient room
shall have access to one toilet without entering the general corridor area. One
toilet room shall serve no more than four beds and no more than two patient
rooms. Where the toilet room serves more than two beds an additional hand
washing shall be placed in the patient room.
(b) In new and remodeled construction, the
door to the patient toilet room shall swing into the patient room, or two-way
hardware shall be provided.
(c) The
minimum door width to the patient toilet room shall be 36 inches (91.4 cm) for
new construction. The door shall swing outward or be double acting.
(4) Minimum floor area: The
minimum floor area per bed shall be 100 square feet of clear floor area in
multi-bed patient rooms, and 120 square feet of clear floor area in single-bed
patient rooms, exclusive of toilet rooms, closets, lockers, wardrobes, alcoves
or vestibules.
(5) Minimum
furnishing:
(a) A hospital-type bed with
suitable mattress, pillow and the necessary coverings shall be provided for
each patient.
(b) There shall be a
bedside table or stand and chair for each patient.
(c) Each patient shall have within their room
adequate storage space suitable for hanging full-length garments and for
storing personal effects.
I. Isolation room(s) Z: Rooms shall be provided for isolation of patients whose condition require isolation for physical health reasons.
(1) Each
isolation room shall have a separate toilet, bathtub (or shower), and a hand
washing sink. These shall be arranged to permit access from the bed area
without passing through the work area of the vestibule or anteroom.
(2) Each room shall have an area for hand
washing, gowning, and storage of soiled materials located directly outside or
immediately inside the entry door to the room.
(3) Each room shall have self-closing devices
on all room exit doors. All wall, ceiling and floor penetrations in the room
shall be sealed tightly.
J. Patient care:
(1) Nursing station or administrative center:
Nursing stations or administrative centers in patient care areas of the
hospital may be located to serve more than one nursing unit, but at least one
of these service areas shall be provided on each nursing floor or wing. The
station or center shall contain:
(a) storage
for records, manuals and administrative supplies;
(b) an area for charting when the charts of
patients are not maintained at patient rooms;
(c) hand washing sink conveniently accessible
to the nurse station;
(d) staff
toilet room: in new construction, a staff toilet room and hand washing sink
shall be provided on each nursing unit; and
(e) securable closet or cabinet for the
personal articles of nursing personnel, located in or near the nursing
station.
(2) Utility
areas: A utility area room for soiled linen and other clean articles shall be
readily accessible to each nursing utility area. Each room shall have:
(a) storage facilities for
supplies;
(b) a hand washing
sink;
(c) work counters;
and
(d) a waste
receptacle.
(3) Bathing
facilities: Showers and bathtubs. When individual bathing facilities are not
provided in patient rooms, there shall be at least one shower or one bathtub
for each 12 beds without such facilities. Each bathtub or shower shall be in an
individual room or enclosure that provides privacy for bathing, drying, and
dressing. One special bathing facility, including space for attendants, shall
be provided for patients on stretchers, carts and wheelchairs for each 100 beds
or fraction thereof.
(4) Equipment
and supply storage: An equipment and supply storage room or alcove shall be
provided for storage of equipment necessary for patient care. Its location
shall not interfere with the flow of traffic.
(5) Corridors and passageways: Corridors and
passageways in patient care areas shall be free of obstacles.
(6) Housekeeping closet: A housekeeping
closet shall be provided on the nursing unit or sufficient cleaning supplies
and equipment shall be readily accessible to the nursing unit.
(7) Patient call system: A reliable call
mechanism shall be provided in locations where patients may be left unattended,
including patients' rooms, toilet and bathing areas and designed high risk
treatment areas where individuals may need to summon assistance.
K. Additional requirements for particular patient care areas:
(1)
Special care units:
(a) In new construction,
sufficient viewing panels shall be provided in doors and walls for observation
of patients. Curtains or other means shall be provided to cover the viewing
panels when privacy is desired.
(b)
In new construction, a sink equipped for hand-washing and a toilet shall be
provided in each private patient room. In multi-bed rooms at least one sink and
one toilet for each six beds shall be provided. Individual wall-hung toilet
facilities with private curtains or another means of safeguarding privacy may
be substituted for a toilet room.
(c) In new construction, all beds shall be
arranged to permit visual observation of the patient by the nursing staff from
the nursing station. In existing facilities, if visual observation is not
possible from the nursing station, sufficient staffing or television monitoring
shall permit continuous visual observation of the patient.
(d) In new construction, the dimensions and
clearances in special care unit patient rooms shall be as follows: single bed
rooms shall have minimum dimensions of 10 feet by 12 feet, multi-bed rooms
shall have minimum side clearances between beds of at least seven feet, and in
all rooms the clearance at each side of each bed shall be not less than three
feet six inches and the clearance at the foot of each bed shall be not less
than four feet.
(2)
Psychiatric units: The requirements for patient room under Paragraph (8) of
Subsection B of 8.370.12.41 NMAC apply to patient rooms in psychiatric nursing
units and psychiatric hospital except as follows:
(a) in new construction or remodeling, a
staff emergency call system shall be included. When justified by psychiatric
program requirements and with the approval of the licensing authority, call
cords from wall-mounted stations of individual patients rooms may be
removed;
(b) doors to patient rooms
and patient toilet room doors may not be lockable from the inside;
(c) patients' clothing and personal items may
be stored in a separate designated area which is locked;
(d) moveable hospital beds are not required
for ambulatory patients.
(3) Surgical and recovery facilities must:
(a) have at least one room equipped for
surgery and used exclusively for this purpose;
(b) have a scrub room or scrub area adjacent
to the surgery room used exclusively for this purpose;
(c) have a clean-up or utility
room;
(d) have a storage space for
sterile supplies;
(e) have means
for calling for assistance in an emergency in each operating room;
(f) have housekeeping facilities adequate to
maintain the operating room or rooms;
(g) have a flash sterilizer, unless
sterilization facilities are accessible from the surgery area;
(h) be located and arranged to prevent
unrelated traffic through the suite;
(i) ensure the room or rooms for
post-anesthesia recovery of surgical patients shall at a minimum contain a
medications storage area, handwashing facilities and sufficient storage space
for needed supplies and equipment; and
(j) have available oxygen and suctioning
equipment in the operating suite and recovery rooms.
(4) Labor and delivery:
(a) The labor and delivery unit shall be
located and arranged to prevent unrelated traffic through the unit.
(b) Facilities within the labor and delivery
unit shall include: at least one room equipped as a delivery room and used
exclusively for obstetrical purposes, a scrub-up room adjacent to the operative
delivery unit if operative deliveries are performed, a cleanup or utility room
with a flush-rim clinical sink, and a separate janitor's closet with room for
housekeeping supplies for the unit.
(c) In new construction, in addition to
lightning for general room illumination, adjustable examination and treatment
lights shall be provided for each labor bed.
(d) The following equipment shall be
available: sleeping unit for each infant, and a clock.
(e) Space for necessary housekeeping
equipment in or near the nursery is required.
(f) An examination area and workspace for
each nursery shall be provided.
(5) Isolation nursery:
(a) If an isolation nursery is provided in
new construction: the isolation nursery shall be within the general nursery
area and may not open directly to another nursery, and access to the isolation
nursery shall be through an anteroom which shall have at least a sink equipped
for hand-washing, gowning facilities, an enclosed storage space for clean linen
and equipment and a closed hamper for disposal of refuse.
(b) A private patient room with handwashing
facilities may be used as an isolation nursery.
(6) Postpartum lounge area: The lounge and
dining room when provided for maternity patients shall be separate from other
areas.
L. Other physical environment:
(1) Thresholds
and expansion joint: Thresholds and expansion joint covers shall be flush with
the floor surface to facilitate the use of wheelchairs and carts, and as may be
required by OSHA. Expansion and seismic joints shall be constructed to restrict
the passage of smoke.
(2) Emergency
fuel and water: The hospital shall make provisions for obtaining emergency fuel
and water supplies.
(3) Emergency
lighting system: The emergency lighting system and equipment shall be tested at
least monthly.
(4) Diagnostic and
therapeutic facilities, supplies and equipment: Diagnostic and therapeutic
facilities supplies and equipment shall be sufficient in number and in good
repair to permit medical and nursing staffs to provide an acceptable level of
patient care.
(5) Walls and
ceilings: The walls and ceilings shall be kept in good repair. Loose, cracked
or peeling wallpaper and paint of walls and ceilings shall be replaced or
repaired. Washable ceilings shall be provided in surgery rooms, delivery rooms,
janitor closets and utility rooms.
(6) Floors: All floor materials shall be easy
to clean and have wear and moisture resistance appropriate for the location.
Floors in areas used for food preparation or food assembly shall be
water-resistant and grease-proof and shall be kept clean and in good
repair.
(7) Cords: Electrical cords
shall be maintained in good repair.
(8) Carpeting:
(a) Carpeting may not be installed in rooms
used primarily for food preparation and storage, dish and utensil washing,
cleaning of linen and utensils, storage of janitor supplies, laundry
processing, hydrotherapy, toiling and bathing, patient isolation or patient
examination.
(b) Carpeting,
including any underlying padding, shall have a flame spread rating permitted by
the national fire protection association's national fire codes. Certified proof
by the manufacturer of this test for the specific product shall be available in
the facility. Certification by the installer that the material installed is the
product referred to in the test shall be obtained by the facility. Carpeting
may not in any case be applied to walls except where flame spread rating can be
shown to be 25 or less.
(9) Acoustical tile: Acoustical tile shall be
noncombustible and non-asbestos.
(10) Wastebaskets: Wastebaskets shall be made
of non-combustible materials.
(11)
Fire report: All incidents of fire in a facility shall be reported in writing
to the licensing authority within 72 hours of the incident.
M. Maintenance: The hospital must maintain written evidence of routine maintenance performed for the facility, supplies and equipment to ensure an acceptable level of safety and quality.
Disclaimer: These regulations may not be the most recent version. New Mexico 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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