Current through Register Vol. 47, No. 12, March 26, 2025
(a) The layout and
location of each nursing unit shall comply with the following:
(1) Nursing units shall be arranged to avoid
travel through adjacent nursing units to gain access to resident service
areas.
(2) The number of residents
in a nursing unit arranged in a linear layout shall not exceed 40. However, the
department will consider exceptions to this requirement to enhance the quality
of life for residents when a higher number of residents clearly achieves a
savings in operational costs, improves resident services and is based upon
sub-groups of residents (sub-units).
(3) The maximum travel distance from a
resident room door to a staff work area shall not exceed 150 feet. When
sub-units are used, each sub-unit shall be arranged so as to provide access to
a bathing room and a soiled workroom or soiled holding room located within, or
readily accessible to, the sub-unit.
(4) At least one-tenth of the total number of
residents in any facility shall be located in single rooms, with at least one
toilet shared between two single rooms.
(5) The need for and the number of required
airborne infection isolation room(s) in a nursing facility shall be determined
by an infection control risk assessment.
(b) Each resident bedroom shall meet the
following requirements:
(1) The maximum room
capacity shall be two residents. Changes to the maximum number of two residents
per room may be made upon a determination by the department that an alternate
room configuration provides a clearly superior resident environment for
residents with unusual care requirements. The maximum capacity of single rooms
is one resident and such capacity shall not be exceeded.
(2) The net useable area and configuration of
each room shall permit wheelchair accessibility. The bedroom shall be designed
to permit wheelchair access and a minimum five foot diameter turnaround
adjacent to at least one side of each bed. Where one side of a bed is permitted
to be placed against a side wall of the room and resident care needs require
additional space between the bed and the wall, the room shall be of sufficient
dimension to maintain the required five foot turning space. Furniture and
equipment intended for resident use shall be made accessible and useable by
residents confined to a wheelchair.
(3) Each room shall have a window that can be
opened without the use of tools. The windowsills shall not be higher than three
feet above the floor and shall be above grade. Windows with operable sashes
shall be provided with insect screens. Window openings shall be designed to
prevent accidental falls when open, or shall be provided with security
screens.
(4) A nurses' calling
system shall be provided.
(5) Each
resident shall have access to a toilet room without entering the general
corridor area. One toilet room shall serve no more than two residents. The
toilet room shall contain a water closet and a lavatory. Changes to the number
of residents using one toilet room may be made on a case-by-case basis upon a
determination by the department that such alternative does not adversely affect
resident care and/or as special care needs of resident may require.
(6) Each resident shall have a wardrobe or
closet with minimum clear inside dimensions of 3 feet long by 1 foot 10 inches
deep. An adjustable clothes rod and shelf shall be provided at heights useable
by residents.
(7) Visual privacy
shall be provided for each resident in multi-bed rooms through the use of
non-combustible cubicle curtains.
(8) Medical equipment for the care and
treatment of residents shall be provided in a resident's room as required by
the resident's medical condition. In addition, each resident shall be provided
with the following room furnishings:
(ii) a dresser and nightstand
or a dresser/night stand combination which provides sufficient space for
residents' personal effects;
(iii)
over-bed tables as may be required;
(iv) a wall tackboard/display
panel;
(v) a lockable drawer to
personal valuables and storage of medications; and
(vi) chairs for visitors and
socialization.
(c) The service areas described in this
subdivision shall be located in or be readily accessible to each nursing unit:
The size and location of each service area will depend upon the number and
types of residents served and the efficiency of the facility's staffing
patterns. Although identifiable spaces are required to be provided for each of
the indicated service areas, consideration will be given to design solutions,
which would accommodate some services without a specific designation of areas
or rooms. Decentralized service areas within nursing units will be encouraged.
The following service areas shall be provided:
(1) A staff work station with space for
carrying out the administrative functions of the unit.
(2) Lounge and toilet room(s) for
staff.
(3) Individual closets or
lockers for the safekeeping of coats and personal effects of staff. These shall
be located convenient to the duty station of personnel or in a central
location.
(4) Room(s) to serve the
function of clinical staff office or consultation room for up to four
people.
(5) A clean workroom with a
work counter sized to store clean and sterile supplies as required by the
functional program, or a clean holding facility that is part of an approved
system for storage and distribution of clean and sterile supply materials. The
location(s) of the clean workroom and the clean holding facility shall be based
on the functional program and physical layout of the nursing unit.
(6) A soiled workroom that contains a
clinical sink or equivalent, flushing rim fixture with a rinsing hose or a bed
pan sanitizer, handwashing facilities, work counter, and an area for soiled
linen holding and waste receptacle(s) in a number and type as required by the
functional program. The location of the soiled workroom shall be based on the
functional program and the physical layout of the nursing unit. A soiled
holding facility, if not provided within the workroom, shall be part of an
approved system for collection and disposal of soiled materials.
(7) A closet, designated area within the
clean workroom or a closed cart system for clean linen storage. If a closed
cart system is used, storage may be in an alcove.
(8) A medication preparation room,
self-contained medication dispensing unit, or an equivalent system for
convenient and prompt distribution of medications to residents 24 hours a day.
If used, a medication preparation room or a medication distribution unit shall
be under the nursing staff's visual control and contain a work counter,
refrigerator, and locked storage for biological and controlled
substances.
(9) A nourishment
station that contains a sink equipped for handwashing, equipment for serving
nourishment between scheduled meals, a refrigerator, and storage cabinets. Ice
for residents shall be provided by self-dispensing ice making unit.
(10) Storage for equipment in current use
shall be provided.
(11) Sufficient
space for the parking and holding of stretchers and wheelchairs shall be
located out of the path of normal traffic.
(12) Bathing rooms for scheduled bathing
shall be provided on each nursing unit at a ratio of 1 bathing fixture for each
15 residents or fraction thereof, who are not otherwise served by bathing
facilities within residents' room and shall be located away from public areas
of the nursing unit. Each tub or shower shall be in a room or enclosure with
space provided for the private use of the bathing fixture, for drying and
dressing, and for a wheelchair and an attendant. The dressing area and the
showers, without curbs, shall be designed to permit use by a wheelchair
resident with staff assistance.
(13) Residents' toilet facilities shall
comply with the following:
(i) Each resident
toilet room shall be designed to permit wheelchair access and use. The size and
configuration of the room, including the placement of fixtures within, shall
allow space for staff assistance in transferring a wheelchair resident to the
water closet.
(ii) A toilet room
shall be accessible to each central bathing area without going through the
general corridor.
(14) A
minimum of one telephone per nursing unit shall be provided for residents' use.
The telephone shall be wheelchair accessible and located to assure privacy of
conversation.