Current through Register Vol. 46, No. 39, September 25, 2024
The nursing home shall be designed, constructed,
equipped and maintained to provide a safe, healthy, functional, sanitary and
comfortable environment for residents, personnel and the public.
(a) Life safety from fire and other hazards.
(1) Buildings and equipment shall be
maintained and operated so as to prevent fire and other hazards to personal
safety.
(2) Nursing homes shall
comply with section
711.2(a) of this
Title.
(3) The nursing home shall
maintain a procedure to investigate fires. A written report of the
investigation containing all pertinent information shall be made. The report
shall remain on file for not less than six years.
(4) The nursing home shall maintain a
procedure for reporting to a designated administrative officer on a standard
form adopted for the purpose, all accidents to residents, staff, employees or
visitors. The report shall include all pertinent information and shall be kept
on file for not less than six years after the occurrence was
reported.
(b) Equipment.
The nursing home shall maintain all essential mechanical, electrical, and
resident care equipment in safe operating condition.
(c) Resident rooms. Resident rooms shall be
designed and equipped for adequate nursing care, comfort and privacy of
residents. The nursing home shall provide each resident with:
(1) a separate bed of proper size and height
for the convenience of the resident;
(2) a clean, comfortable mattress;
(3) bedding appropriate to the weather and
climate; and
(4) functional
furniture appropriate to the resident's needs, and individual closet space in
the resident's bedroom with clothes racks and shelves accessible to the
resident.
(d) Toilet,
handwashing and bathing facilities. Plumbing and plumbing fixtures shall be
properly maintained and operable.
(e) Dining and resident activities. The
facility shall provide one or more rooms designated for resident dining and
activities. These rooms shall:
(1) be well
lighted;
(2) be well ventilated,
with smoking areas identified;
(3)
be adequately furnished; and
(4)
have sufficient space to accommodate all activities.
(f) Water supplies. Water supplies of nursing
homes shall be operated in conformance with the following requirements:
(1) all water used in operation shall be
provided from a public water supply or from an alternate source, in either
event as approved by the department;
(2) no changes shall be made in the source or
treatment of the water supply without approval of the department;
(3) water shall be adequate in volume and
pressure for all medical purposes;
(4) the water system shall not be operated
with physical connections to other piping systems or connections to fixtures
that may permit contamination of the water supply;
(5) the water system shall be operated with a
hot water system adequate for all medical purposes;
(6) the hot water supply used by residents or
the public shall be regulated to maintain hot water temperature within the
range of 90 degrees to 120 degrees F; and
(7) the nursing home shall ensure that water
is available to essential areas when there is a loss of normal water
supply.
(g) Waste
systems. Waste systems shall be operated so that all sewage and other liquid
wastes are disposed of by connection to a public sewer system or by an
alternate method, in either event as approved by the department.
(h) Ventilating, heating, and air
conditioning systems. Such systems shall:
(1)
be maintained in good repair and shall be operated in a manner which will not
allow for the spread of infection and provide for resident health and comfort;
and
(2) be maintained and operated
in such manner that air shall not be circulated from resident isolation rooms,
laboratories in which work is done in pathology, virology or bacteriology,
autopsy rooms, kitchen and dishwashing areas, toilet and bath rooms, janitors'
closets and soiled utility rooms or soiled linen rooms, to other parts of the
facility.
(i) Grounds
and building. Grounds and buildings shall be maintained:
(1) in a clean condition free of safety
hazards;
(2) in such manner as will
prevent standing water, flooding or leakage; and
(3) free of excessive noise, odors, pollens,
dusts or other environmental pollutants and such nuisances as may adversely
affect the health or welfare of residents.
(j) Housekeeping.
(1) The entire nursing home, including but
not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment
and furnishings, shall be clean. The facility shall be maintained in good
repair including, but limited to buildings, utilities, fixed equipment,
resident care equipment and furnishings.
(2) Responsibility for direct supervision of
housekeeping service shall be assigned to a person, properly qualified by
training and experience.
(3)
Dusting, mopping and vacuum cleaning shall be done in a manner which will not
spread dust or other particulate matter.
(4) Adequate supplies and equipment for
housekeeping functions shall be provided with cleaning compounds and hazardous
substances properly labeled and stored.
(5) The facility shall maintain an effective
pest control program so that it is free of insects and rodents.
(6) Waste.
(i) Solid wastes, including garbage, rubbish
and other refuse, biological wastes and infectious materials, shall be
collected, stored and disposed of in a manner that will prevent the
transmission of disease and not create a nuisance or fire hazard, nor provide a
breeding place for insects or rodents.
(ii) Facilities shall manage regulated
medical waste in accordance with the provisions of Part 70 of this
Title.
(k)
Linen and laundry. The nursing home shall:
(1) provide a sufficient quantity of clean
linen to meet the requirements of residents; nursing homes shall maintain a
linen inventory equal to at least three times the average daily census, and of
this one-third shall be in use, one-third in laundry and one-third in
reserve;
(2) maintain linen in
proper condition for use, free from rips and tears;
(3) provide for satisfactory laundering of
linens and other washable fabrics;
(4) handle, store and process laundry in a
manner that will prevent the spread of infection and assure the maintenance of
clean linen;
(5) wash all linen,
including blankets, between resident use;
(6) bag or enclose all used linen in suitable
containers within the resident care unit for transportation to the
laundry;
(7) separately bag or
enclose used linens from residents with a communicable disease in readily
identifiable containers distinguishable from other laundry;
(8) properly maintain space and equipment for
laundry storage and transportation;
(9) launder only in areas and with equipment
properly maintained and approved for such purpose by the department;
(10) launder in a manner designed to prevent
contamination of clean linen and to prevent infection; and
(11) transport clean linen in clean covered
containers used exclusively for the purpose, and store clean linen in clean
storage areas in a manner to prevent its contamination.
(l) Animals.
(1) Animals, exclusive of those required for
laboratory purposes, shall not be allowed in a nursing home, except in a
nursing home animal visitation or animal-assisted therapy program as permitted
in paragraphs (2) and (3) of this subdivision. Also, service dogs and other
service animals which have been individually trained to do work or perform
tasks for the benefit of an individual with a disability may accompany such
persons when the presence of such animals will not pose a significant risk to
the health and safety of others that cannot be eliminated by reasonable
accommodation and is not medically contraindicated. However, if the safe
operation of the facility would be jeopardized, a service animal need not be
allowed to enter. A finding by appropriate medical personnel at the facility
that the presence or use of a service animal would pose a significant health
risk in certain designated area of a nursing home may serve as a basis for
excluding service animals in those areas.
(2) A nursing home may board animals as part
of an animal-assisted therapy program, provided that:
(i) the health, safety, welfare and rights of
all residents on the unit are assured;
(ii) a staff member has been designated to be
responsible for the care and management of the animal or animals and has had
appropriate training for such responsibilities;
(iii) the animal or animals are free from
disease and have received all immunizations as recommended by a licensed
veterinarian;
(iv) the animal or
animals shall not be allowed in laundry, utensil storage or food preparation
areas;
(v) the well-being of the
participating animal or animals is considered and maintained.
(3) Animal visitations are
permitted in a nursing home provided that:
(i) the visit is prescheduled and approved by
the facility;
(ii) the animal shall
not be allowed in laundry, utensil storage or food preparation areas;
and
(iii) the animal will at all
times be accompanied by a person familiar with and capable of controlling the
animal's behavior.