Current through Bulletin 2024-06, March 15, 2024
(1) The requirements of
R432-4-24
and the requirements of Sections 2.1 and 2.6 of the Guidelines for Design and
Construction of Health Care Facilities 2010 edition (Guidelines) shall be met.
Where a modification is cited, the modification supersedes conflicting
requirements of the Guidelines.
(2)
The maximum number of beds on each nursing unit shall be 60.
(a) The minimum number of beds in a nursing
unit shall be four.
(b) Rooms and
spaces comprising the nursing unit shall be contiguous.
(3) At least two single-bed rooms, with a
private toilet room containing a toilet, lavatory, and bathing facility, shall
be provided for each nursing unit.
(a) The
minimum patient room area shall be 120 feet.
(b) In addition to the lavatory in the toilet
room, in new construction a lavatory or handwashing sink shall be provided in
the patient room.
(c) Ventilation
shall be in accordance with Part 6, Table 7-1 of Guidelines with all air
exhausted to the outside.
(4) The nurses' station shall have
handwashing facilities located near the nurses' station and the drug
distribution station. The nurses' toilet room, located in the unit, may also
serve as a public toilet room.
(5)
A nurse call system is not required in facilities that care for developmentally
disabled or mentally retarded persons. With the prior approval of the
Department, facilities which serve patients who pose a danger to themselves or
others may modify the system to alleviate hazards to patients.
(6) Patient rooms shall include a wardrobe,
closet, or locker having minimum clear dimensions of 22 inches deep by 36
inches wide, suitable for hanging full length garments.
(7) A clean workroom or clean holding room
with a minimum area of 80 square feet for preparing patient care items which
shall contain a counter, handwashing facilities, and storage facilities.
(a) The work counter and handwashing
facilities may be omitted in rooms used only for storage and holding, as part
of a larger system for distribution of clean and sterile supply
materials.
(8) A soiled
workroom with a minimum area of 80 square feet which shall contain a clinical
sink, a sink equipped for handwashing, a work counter, waste receptacles and a
linen receptacle.
(a) Handwashing sinks and
work counters may be omitted in rooms used only for temporary holding of
soiled, bagged materials.
(9) If a medication dispensing unit is used
it shall be under visual control of staff, including double locked storage for
controlled drugs.
(10) Clean Linen
Storage.
(a) If a closed cart system is used
it shall be stored in a room with a self closing door.
(b) Storage of a closed cart in an alcove in
a corridor is prohibited.
(11) Each nursing unit shall have equipment
to provide ice for patient treatment and nourishment.
(a) Ice making equipment may be located in
the clean workroom or at the nourishment station if access is controlled by
staff.
(b) Ice intended for human
consumption shall be dispensed by self-dispensing ice makers.
(12) At least one room for toilet
training, accessible from the nursing corridor, shall be provided on each floor
containing a nursing unit.
(a) All fixtures
in this room shall comply with the Americans with Disabilities Act and
Architectural Barriers Act Accessibility Guidelines (ADA/ABA-AG).
(b) A toilet room, with direct access from
the bathing area, shall be provided at each central bathing area.
(c) Doors to toilet rooms shall comply with
ADA/ABA-AG. The doors shall permit access from the outside in case of an
emergency.
(d) A handwashing
fixture shall be provided for each toilet in each toilet room.
(13) Storage. There shall be an
equipment storage room with a minimum area of 120 square feet for portable
storage.
(14) Resident Support
Areas Shall Include the Following:
(a)
Occupational Therapy may be counted in the required space of Guidelines section
2.6-2.3 Patient Living Areas.
(b)
Physical Therapy, personal care room and public waiting lobbies may not be
included in the calculation of space of Guidelines section 2.6-2.3 Patient
Living Areas.
(c) Storage space for
recreation equipment and supplies shall be provided and secured for
safety.
(d) There shall be a
general purpose room with a minimum area of 100 square feet equipped with
table, and comfortable chairs.
(e)
A minimum area of ten square feet per bed shall be provided for outdoor
recreation. Recreation areas shall be enclosed by a secure fence.
(15) An examination and treatment
Room shall be provided except when all patient rooms are single-bed rooms.
(a) The examination and treatment room may be
shared by multiple nursing units.
(b) The room shall have a minimum floor area
of 100 square feet, excluding space for vestibules, toilet, closets, and work
counters, whether fixed or movable.
(c) The minimum allowable room dimension
shall be ten feet.
(d) The room
shall contain a lavatory or sink equipped for handwashing; work counter;
storage facilities; and desk, counter, or shelf space for writing.
(16) A room shall be arranged to
permit evaluation of patient needs and progress.
(a) The room shall include a desk and work
area for the evaluators, writing and work space for patients, and storage for
supplies.
(b) If psychological
services are provided, then the unit shall contain an office and work space for
testing, evaluation, and counseling.
(c) If social services are provided, then the
unit shall contain office space for private interviewing and
counseling.
(d) If vocational
services are provided, then the unit shall contain office and work space for
vocational training, counseling, and placement.
(e) Evaluation, psychological services,
social services, and vocational services may share the same office space when
the owner provides evidence in the functional program that the needs of the
population served are met in the proposed space arrangement.
(17) Pediatric and Adolescent
Unit.
(a) Pediatric and adolescent nursing
units shall comply with the spatial standards in section 2.2- 2.13 of the
Guidelines.
(b) There shall be an
area for hygiene, toileting, sleeping, and personal care for parents if the
program allows parents to remain with young children.
(c) Service areas in the pediatric and
adolescent nursing unit shall conform to the standards of section 2.2-2.13.6 of
the Guidelines and the following:
(i)
Multipurpose or individual rooms shall be provided in the nursing unit for
dining, education, and recreation.
(ii) A minimum of 20 square feet per bed
shall be provided.
(iii)
Insulation, isolation and structural provisions shall minimize the transmission
of impact noise through the floor, walls, or ceiling of multipurpose
rooms.
(iv) Service rooms may be
shared by more than one pediatric or adolescent nursing unit, but may not be
shared with adult patient units.
(v) A patient toilet room, in addition to
those serving bed areas, shall be conveniently located to each multipurpose
room and to each central bathing facility.
(vi) Storage closets or cabinets for toys,
educational, and recreational equipment shall be provided.
(d) At least one single-bed isolation room
shall be provided in each pediatric unit. Each isolation room shall comply with
the following:
(i) Room entry shall be
through an adjacent work area which provides for aseptic control, including
facilities separate from patient areas for handwashing, gowning, and storage of
clean and soiled materials. The work area entry may be a separate, enclosed
anteroom.
(ii) A separate, enclosed
anteroom for an isolation room is not required but, when provided, shall
include a viewing panel for staff observation of the patient from the
anteroom.
(iii) One anteroom may
serve several isolation rooms.
(iv)
Toilet, bathing, and handwashing facilities shall be arranged to permit access
from the bed area without entering or passing through the work area of the
vestibule or anteroom.
(17) Rehabilitation therapy, Physical Therapy
and Occupational Therapy areas shall include:
(a) Waiting areas to accommodate patients in
wheelchairs, including room for turning wheelchairs.
(b) Storage space, with separate storage
rooms for clean and soiled linen.