Current through Register Vol. 35, No. 18, September 24, 2024
A.
General: The buildings of the nursing facility shall be constructed and
maintained so that they are functional for diagnosis and treatment and for the
delivery services appropriate to the needs of the community and with due for
protecting the health and safety of the patients. The provisions of this
section apply to all new, remodeled and existing construction unless otherwise
noted. Existing waivers at the time these regulations are enacted would
continue to be accepted unless it is determined that the facility is unable to
protect the health and safety of the resident.
B. Definitions: The definitions in the
applicable Life Safety Code required under these regulations apply to this
subchapter. In addition, in this subchapter:
(1) 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.
(2) Life Safety Code: means the National Fire
Protection Association's standard 101.
(3) 1981 Code: means facilities with
construction plans first approved by the authority on or after November 26,
1982, shall be free from dangerous accumulations of combustible materials.
Combustibles such as cleaning rags and compounds shall be
kept in closed metal containers.
(4) Fire safety evaluation system: means a
proposed or existing facility not meeting all requirements of the applicable
Life Safety Code shall be considered in compliance if it achieves a passing
score on the Fire Safety Evaluation System (FSES), developed by the United
State department of commerce, National bureau of standards, to establish safety
equivalencies under the Life Safety Code.
(5) New construction: means construction for
the first time of any building or addition to an existing building, the plans
for which are approved after the effective date of this chapter.
(6) Remodeling: means to make over or rebuild
any portion of a building or structure and thereby modify its structural
strength, fire hazard character, exists, heating and ventilating system,
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 structure.
C. Approvals: The facility shall
keep documentation of approvals on file in the facility following all
inspections by state and local authorities.
D. Fire protection:
(1) Basic responsibility: The facility shall
provide fire protection adequate to ensure the safety of patients, staff and
others on the premises. Necessary safeguards such as extinguishers, sprinkling
and detection devices, fire and smoke barriers, and ventilation control
barriers shall be installed to ensure rapid and effective fire and smoke
control.
(2) New construction: Any
new construction or remodeling shall meet the applicable provisions of the 1981
edition of the Life Safety Code.
(3) Existing facilities: Any existing
facility shall be considered to have met the requirements of this subsection
if, prior to the promulgation of this chapter, the facility complied with and
continues to comply with the applicable provisions of the 1967, 1973, or 1981
edition of the Life Safety Code, with or without waivers.
(4) Equivalent compliance: An existing
facility that does not meet all requirements of the applicable Life Safety Code
may be considered in compliance with it if it achieves a passing score on the
fire safety evaluation system (FSES) developed by the U.S. department of
commerce National bureau of standard, to establish safety equivalencies under
the Life Safety Code.
(5) Note: See
Appendix C of the 1981 Life Safety Code.
E. General construction: All capital
investment plans subject to these regulations, shall be submitted to the
authority for review and approval.
(1) One
copy of preliminary or schematic plans shall be submitted to the authority for
review and approval.
(2) One copy
of final plans and specifications which are used for bidding purposes shall be
submitted to the authority for review and approval before construction is
started. Plans must be prepared and stamped 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
regulations shall be void and the plans and specifications shall be resubmitted
for reconsideration of approval.
(4) Any changes in the approved final plans
affecting the application of the requirements of this subchapter shall be shown
on the approved final plans and shall be submitted to the authority for
approval before construction is undertaken. The authority shall notify the
facility 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 minimize disruptions of existing functions. Access,
exit ways, and fire protection shall be so maintained that the safety of the
occupants will not jeopardized during construction.
(6) Minimum requirements: All requirements
listed in new construction, relating to new construction projects, are
applicable to renovation projects involving additions or alterations, except
that when existing conditions make changes impractical to accomplish, minor
deviations from functional requirements may be permitted if the intent of the
requirements is met and if the care and safety of patients will not be
jeopardized.
(7) Non-conforming
conditions: When doing renovation work, if it is found to be unfeasible to
correct all of the nonconforming 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.
(8) Note #1: Plan approval by construction
industries division, labor and human relations under these regulations is also
required for any new construction or remodeling.
(9) Note #2: Copies of the 1967, 1973, and
1981 Life Safety Codes and related codes can be obtained from the National Fire
Protection Association, Battery March Park, Quincy, PA 02269.
F. Constructions and inspections:
(1) General: Construction, of other than
minor alterations, shall not be commenced until plan-review deficiencies have
been satisfactorily resolved.
(a) The
completed construction shall be in compliance with the approved drawings and
specifications, including all addenda or modifications approved for the
project.
(b) A final inspection of
the facility will be scheduled for the purpose of verifying compliance with the
approved drawings and specifications including all addenda or modifications
approved for the project.
(2) 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.
Compliance with local codes shall be prerequisite for licensing. In areas not
subject to local building codes, the state building codes, as adopted, shall
apply insofar as such codes are not in conflict with these standards.
(a) New construction is governed by the
current editions of the following Codes Standards:
(b) Uniform Building Code (UBC), Uniform
Plumbing Code (UPC), Uniform Mechanical Code (UMC), National Electrical Code
(NEC), National fire protection association standards (NFPA), American National
standard institute (ANSI), American society of heating, refrigerating, and air
conditioning engineers (ASHRAE), department of health and human services (DHHS)
guidelines for construction and equipment of hospital and medical
facilities.
G.
Resident safety and disaster plan:
(1)
Disaster plan:
(a) Each facility shall have a
written procedure which shall be followed in case of fire or other disasters,
and which shall specify persons to be notified, locations of alarm signals and
fire extinguishers, evacuation routes, procedures for evacuating helpless
residents, frequency of fire drills and assignment of specific tasks and
responsibilities to the personnel of each shift and each discipline.
(b) The plan developed by the facility shall
be submitted to qualified fire and safety experts, including the local fire
authority, for review and approval. The facility shall maintain documentation
of approval by the reviewing authority.
(c) All employees shall be oriented to this
plan and trained to perform assigned tasks.
(d) The plan shall be available at each
nursing station.
(e) The plans
shall include a diagram of the immediate floor area showing the exits, fire
alarm stations, evacuation routes and location of fire extinguishers. The
diagram shall be posted in conspicuous locations in the corridor throughout the
facility.
(2) Drills:
Fire drills shall be held at irregular intervals at least four times a year on
each shift and the plan shall be reviewed and modified as necessary. Records of
drills and dates of drills shall be maintained.
(3) Fire inspections: The administrator of
the facility shall arrange for fire protection as follows:
(a) At least annual inspection of the
facility shall be made by the local fire inspection authorities. Signed
certificates of such inspections shall be kept on file in the
facility.
(b) Certification by the
local fire authority as to the fire safety of the facility and to the adequacy
of a written fire plan for orderly evacuation of residents shall be obtained
and kept on file in the facility.
(c) Where the facility is located in a city,
village, or township that does not have an official established fire
department, the licensee shall obtain and maintain a continuing contract for
fire protection service with the nearest municipality providing such service. A
certification of the existence of such contract shall be kept on file in the
facility.
(4) Fire
equipment: All fire protection equipment shall be maintained in readily usable
condition and inspected annually. In addition to any other equipment, a fire
extinguisher suitable for grease fires shall be provided in or adjacent to the
kitchen. Each extinguisher shall be provided with a tag for the date of
inspection.
(5) Fire Report: All
incidents of fire in a facility shall be reported to the authority within 72
hours.
(6) Smoking: Smoking by
residents shall be permitted only in designated areas supervised in accordance
with the conditions, needs, and safety of residents.
(7) Prevention of ignition: Heating devices
and piping shall be designed or enclosed to prevent the ignition of clothing or
furniture.
(8) Floor coverings:
Scatter rugs and highly polished, slippery floors are prohibited, except for
non-slip entrance mats. All floor coverings and edging shall be securely
fastened to the floor or so constructed that they are free of hazards such as
curled and broken edges.
(9) Roads
and sidewalks: The ambulatory and vehicular access to the facility shall be
kept passable and open at all times of the year. Sidewalks, drives, fire
escapes, and entrances shall be kept free of ice, snow, and other
obstructions.
H. Safety
and systems:
(1) Maintenance: The building
shall be maintained in good repair and kept free of hazards such as those
created by any damaged or defective building equipment.
(2) Corridors:
(a) Handrails: Corridors used by residents
shall be equipped with handrails firmly secured on each side of the
corridor.
(b) Size: All corridors
in resident use areas shall be at least eight feet wide.
(3) Doors:
(a) Size: Doors to residents' rooms shall not
be less than three feet eight inches wide and six feet eight inches in height,
and shall be at least one and three-quarter inches solid core wood or
equivalent construction.
(b)
Latches: Each designated fire exit door shall have such latches or hardware
that the door can be opened from the inside by pushing against a single bar or
plate or by turning a single knob or handle.
(c) Locks on exit doors from the building and
from nursing areas and wards may not be hooked or locked to prevent exit from
the inside, shall be installed on the door of the resident's room, unless the
lock is operable from inside the room with a simple one-hand, one-motion
operation without the use of a key unless the resident is confined; a
master-key is available to emergency personnel such as the fire
department.
(4) Toilet
room doors: Resident toilet room doors shall be not less than three feet zero
inches by six feet eight inches, and shall not swing into the toilet room
unless they are provided with two way hardware.
(5) Thresholds: Raised thresholds which
cannot be traversed easily by a bed on wheels, a wheelchair, a drug cart, or
other equipment on wheels shall not be used.
I. Emergency power: Emergency electrical
service with an independent power source which covers lighting as nursing
stations, telephone switchboards, exit and corridor lights, boiler room, and
fire alarm systems, shall be provided. The service may be battery operated if
effective for at least four hours.
J. Fire protection:
(1) Carpeting: Carpeting shall not be
installed in rooms used primarily for the following purposes: food preparation
and storage, dish and utensil washing, soiled utility workroom, janitor closet,
laundry processing, hydro-therapy, toilet and bathing, resident isolation, and
resident examination.
(2) Carpet
fireproofing: Carpeting, including underlying padding, if any, shall have a
flamespread rating of 75 or less when tested in accordance with standard 255 of
the National Fire Protection Association (NFPA), or a critical radiant flux of
more than 0.45 watts per square centimeter when tested in accordance with NFPA
standard 253, 1978 edition. Certified proof by the manufacturer of the
aforementioned 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
shall not be applied to walls in any case except where the flamespread rating
can be shown to 25 or less.
(3)
Acoustical tile: Acoustical tile shall be noncombustible.
(4) Wastebaskets: Wastebaskets shall be of
non-combustible materials.
(5)
Vertical exit stairways: At least one interior exit stairway shall be provided
to that an enclosed protected path of at least one-hour fire resistive
construction is available for occupants to proceed with safety to the exterior
of the facility.
(6) Housing blind,
non-ambulatory, or handicapped residents: In an existing facility of two or
more stories which is not of at least two-hour fire resistive construction,
blind, non-ambulatory, or physically handicapped residents shall not be housed
above the street level floor unless the facility is either of one-hour
protected noncombustible construction (as defined in national fire protection
standard 200), fully sprinklered one-hour protected ordinary construction, or
fully sprinklered one-hour protected wood frame construction.
(7) Storage of oxygen: Oxygen tanks, when not
in use, shall be stored in a ventilated closet designated for that purpose only
or stored outside the building of the home in an enclosed secured area. Oxygen
storage areas must comply with NFPA 99.
K. Sprinklers for fire protection: Facilities
shall have automatic sprinkler protection throughout buildings. In the event of
an addition to, or remodeling of a facility, the entire facility shall have
automatic sprinkler protection throughout unless there is a two hour fire rated
partition wall between the old and new construction, in which case only the new
or remodeled area shall be sprinklered.
L. Mechanical systems:
(1) Water supply:
(a) A portable water supply shall be
available at all times. If a public water supply is available, it shall be
used. If a public water supply is not available, the well or wells shall comply
with applicable regulations.
(b) An
adequate supply of hot water shall be available at all times. The temperature
of hot water at plumbing fixtures used by residents may not exceed 110 degrees
fahrenheit (43 degrees celsius) and shall be automatically regulated by control
valves or by another approved device.
(2) Sewage disposal: All sewage shall be
discharged into a municipal sewage system if available. Otherwise, the sewage
shall be collected, treated, and disposed of by means of an independent sewage
system approved under applicable state law and local authority.
(3) Plumbing: The plumbing for potable water
and drainage for the disposal of excreta, infectious discharge, and wastes
shall comply with applicable state plumbing standards.
(4) Heating and air conditioning:
(a) The heating and air conditioning systems
shall be capable of maintaining adequate temperatures and providing freedom
from drafts.
(b) A minimum
temperature of at least 70 degrees fahrenheit (21 degrees celsius) in all
bedrooms and in all other areas used by residents, unless resident preference
is documented for deviations.
(5) Incineration:
(a) Facilities for the incineration of soiled
dressings and similar wastes, as well as garbage and refuse, shall be provided
when other methods of disposal are not available.
(b) An incinerator shall not be flue fed nor
shall any upper floor charging chute be connected with the combustion
chamber.
(6) Telephone:
There shall be at least one operational non-pay telephone on the premises and
as many additional telephones as are deemed necessary in an
emergency.
(7) General lighting:
(a) Adequate lighting shall be provided in
all areas of the facility. Lighting shall be of a type that does not produce
discomfort due to high brightness, glare or reflecting surface. No candles, oil
lanterns, or other open flame method of illumination may be used.
(b) Facilities shall have lighting during the
evening and night hours that is commensurate with staff needs.
(8) Ventilation:
(a) The facility shall be well-ventilated
through the use of windows, mechanical ventilation, or a combination of both.
Rooms and areas which do not have outside windows and which are used by
residents or personnel shall be provided with functioning mechanical
ventilation to change the air on a basis commensurate with the type of
occupancy.
(b) All inside bathrooms
and toilet rooms shall have mechanical ventilation to the outside.
(c) Mechanical ventilation shall be provided
to the resident area corridors, solaria, dining, living and recreation areas,
and nursing stations. These areas shall be under positive pressure;
(d) All rooms in which food is stored,
prepared or served, or in which utensils are washed shall be well-ventilated.
Refrigerated storage rooms need not be ventilated.
(e) Kitchens, bathrooms, utility rooms,
janitor closets, and soiled linen rooms shall be ventilated.
(9) Elevators: At least one
elevator shall be provided in the facility if resident beds or activities are
located on more than one floor. The platform size of the elevator shall be
large enough to hold a resident bed and an attendant.
(10) Electrical:
(a) In all facilities, non-conductive wall
plates shall be provided where the system is not properly grounded.
(b) In new construction begun after the
effective date of these regulations, at least two duplex-type outlets shall be
provided for each bed.