[27 Pa.B. 3609]
[Continued from previous Web Page] (g) An employe shall be in acceptable physical condition as certified by a written statement issued by the examining physician. The statement shall indicate that the individual is free from communicable diseases in the communicable state and from health handicaps which might disqualify the employe from the position which is being sought for employment.
(h) The employe shall have a pre-employment intermediate strength tuberculin skin test--Mantoux. Mantoux positive reactors shall have a pre-employment X-ray and evaluation for appropriate therapy. Persons with a history of a positive Mantoux reaction may have a chest X-ray instead of Mantoux test.
(i) A written report issued by a physician, hospital or agency, of a tuberculin skin test is required. If the test is positive, a chest X-ray, completed within the past 60 days, shall be considered as meeting the requirement as stated in this section. The report shall be available in the facility before employment.
(j) An employe shall be treated or referred for treatment as necessary.
(k) There shall be written policies that provide for registration of employe complaints with the Department or other agencies without threat of reprisal.]
§ 201.20. Staff development.
(a) There shall be an ongoing coordinated educational program which is planned and conducted for the development and improvement of skills of the facility's personnel, including training related to problems [and], needs and rights of the [patients] residents.
* * * * * (c) There shall be at least annual inservice training which includes at least infection prevention and control, fire prevention and safety, accident prevention, disaster preparedness, [patient] resident confidential information, [patient] resident psychosocial needs, restorative nursing techniques and [patient] resident dignity preservation, including the [patient's] resident's protection of privacy and personal property rights.
* * * * * § 201.21. Use of outside resources.
* * * * * (b) If the facility does not employ a qualified professional person to render a specific service to be provided by the facility, it shall make arrangements to have the service provided by an outside resource, a person or agency that will render direct service to [patients] residents or act as a consultant to the facility.
* * * * * (d) [The outside resource, when acting as a consultant, shall apprise the administrator of recommendations, plans for implementation and continuing assessment through dated, signed reports which are retained by the administrator for follow-up action and evaluation of performance.
(e)] Outside resources supplying temporary employes to a facility shall provide the facility with documentation of an employe's health status as required under § [201. 19(e)--(j)] 201.22(c)--(j) and (l)--(m) (relating to [personnel policies and procedures] prevention, control and surveillance of tuberculosis (TB)).
§ 201.22. [Notification of change in patient status] Prevention, control and surveillance of tuberculosis (TB).
(a) [The facility shall have written policies and procedures which relate to notification of the patient's attending physician and other responsible persons in the event of significant changes in the patient's physical, mental or emotional status, or patient's charges, billing and related administrative matters.] The facility shall have a written TB infection control plan with established protocols which address risk assessment and management, screening and surveillance methods, identification, evaluation and treatment of residents who have a possible TB infection or active TB.
(b) [Except in a medical emergency, a patient may not be transferred or discharged nor shall treatment be altered radically without consultation with the patient, or if the patient appears to be mentally incapacitated, without prior notification of the patient's responsible person.] Recommendations of the Centers for Disease Control (CDC), United States Department of Health and Human Services (HHS) shall be followed in treating and managing persons with confirmed or suspected TB.
(c) A baseline TB status shall be obtained on the residents and employes in the facility.
(d) The Mantoux tuberculin skin test is to be used whenever skin testing is done. This consists of an intradermal injection of 0.1 ml of purified protein derivative (PPD) tuberculin containing 5 tuberculin units (TU) using a disposable tuberculin syringe.
(e) The 2-step Mantoux tuberculin skin test shall be the method used for initial testing of residents and employes. If the first test is positive, consider the person infected. If the first test is negative, a second test should be administered in 1--3 weeks. If the second test is positive, consider the person previously infected. If the second test result is negative, the person is to be classified as uninfected.
(f) Persons with reactions of >= 10 mm or persons with symptoms suggestive of TB regardless of the size of the test reaction, shall be referred for further diagnostic studies in accordance with CDC recommendations.
(g) A written report of test results shall be maintained in the facility for each individual, irrespective of where the test is performed. Reactions shall be recorded in millimeters of induration, even those classified as negative. If no induration is found, ''0 mm'' is to be recorded.
(h) Skin test negative employes and volunteers having regular contact of 10 or more hours with residents shall have repeat Mantoux tuberculin skin tests at intervals determined by the risk of transmission in the facility. The existing CDC protocol for conducting a TB risk assessment in a health care facility shall be used to establish the risk of transmission.
(i) Repeat skin tests shall be required for tuberculin-negative employes and residents after any suspected exposure to a documented case of active TB.
(j) New employes shall have the Mantoux skin test before beginning employment unless there is documentation of a previous positive skin reaction. Test results shall be made available prior to assumption of job responsibilities.
(k) The Mantoux tuberculin skin test shall be administered to new residents upon admission, unless there is documentation of a previous positive Mantoux test.
(l) New Mantoux positive reactors (converters) and persons with documentation of a previous positive reaction, shall be referred for further diagnostic testing and treatment in accordance with current standards of practice.
(m) If a chest X-ray is compatible with active TB, the individual shall be excluded from the workplace until a diagnosis of active TB is ruled out or a diagnosis of active TB is established and a determination made that the individual is considered to be noninfectious. A statement from a physician stating the individual is noninfectious shall be required.
(n) A resident with a diagnosis of TB may be admitted to the facility if:
(1) Three consecutive daily sputum smears have been negative for acid-fast bacilli.
(2) The individual has received appropriate treatment for at least 2--3 weeks.
(3) Clinical response to therapy, as documented by a physician, has been favorable.
§ 201.23. Closure of facility.
(a) The administrator or owner shall notify the [Long Term] appropriate Division of Nursing Care Facilities [Field Office] field office at least 90 days prior to closure.
(b) If the facility is to be closed, the licensee shall notify the [patient] resident or the [patient's] resident's responsible person in writing.
(c) Sufficient time shall be given to the [patient] resident or the [patient's] resident's responsible person to effect an orderly transfer [as required in § 201.25(b) (relating to discharge policy)].
(d) No [patient] resident in a facility may be required to leave the facility prior to 30 days following receipt of a written notice from the licensee of the intent to close the facility, except in cases where the Department determines that removal of the [patient] resident at an earlier time is necessary for health and safety.
(e) If an orderly transfer of the [patients] residents cannot be safely effected within 30 days, the Department may require the facility to remain open an additional 30 days.
(f) The Department is permitted to monitor the transfer of [patients] residents.
* * * * * § 201.24. [Admission policy] (Reserved).
[(a) The patient may be permitted to name a responsible person; however, the patient is not required to name a responsible person if the patient is capable of managing his own affairs. The patient's responsible person may not be named the patient's financial guarantor unless this is specifically agreed upon in writing.
(b) A long term care facility may not obtain from or on behalf of patients a release from liabilities or duties imposed by law or this chapter and Chapters 203--211 except as part of formal settlement in litigation.
(c) A long term care facility shall admit only patients whose nursing care and physical needs can be provided by the staff and facility.
(d) A patient with a disease in the communicable stage may not be admitted to the facility unless it is deemed advisable by the attending physician--medical director, if applicable--and administrator and unless the facility has the capability to care for the needs of the patient.
(e) A patient who in the opinion of a qualified physician, is not infectious and is receiving appropriate antituberculosis chemotherapy may be admitted to the facility.]
§ 201.25. [Discharge policy] (Reserved).
[(a) There shall be a centralized coordinated discharge plan to ensure that the patient has a program of needed continuing care after discharge from the facility. The plan shall be developed within 7 days of admission and shall be an integral part of the patient care plan.
(b) Except in an emergency, a patient may not be transferred or discharged from the facility without prior notification. The patient and the patient's responsible person shall receive written notification in reasonable advance of the impending discharge. Reasonable advance notice shall be interpreted to mean 30 days unless appropriate plans can be implemented. The actions shall be documented on the patient record. Suitable clinical notes, list of orders and medications as directed by the attending physician shall accompany the patient if the patient is sent to another medical facility.
(c) Unless the discharge is initiated by the patient or patient's responsible person, the facility is responsible to assure that appropriate arrangements are made for a safe and orderly transfer and that the patient is transferred to an appropriate place that is capable of meeting the patient's needs.
(d) Discharges shall be consistent with the requirements of § 201.29(h) (relating to patient rights).
(e) A patient who becomes mentally disturbed after admission and exhibits behavior which may cause injury to himself or others may be treated in the facility by appropriate medical management and supervision. If, in the opinion of the attending physician, the patient cannot be managed, immediate arrangements shall be made by the attending physician for the transfer of the patient to an appropriate facility at the earliest practical time. The current facility is responsible for the health and safety of the patient and for arranging the safe and orderly transfer of the patient.
(f) If, in the opinion of the attending physician, changes occur in the patient's condition, which require services or a level of care that the facility is not presently providing to its patients, arrangements shall be made to have the patient transferred as soon as possible to another appropriate facility which can care for the patient. The current facility shall maintain the patient with adequate care until appropriate arrangements can be made. The patient and patient's responsible person shall be notified of the need for transfer.
(g) When a patient's condition changes, it is not necessary to transfer a patient within or between facilities when, in the opinion of the attending physician, the transfer may be harmful to the physical and mental health of the patient. The physical shall document accordingly on the patient's record.]
§ 201.26. Power of attorney.
Power of attorney may not be assumed for a [patient] resident by the licensee, owner/operator, members of the governing body, an employe or anyone having a financial interest in the facility unless ordered by a court of competent jurisdiction.
§ 201.27. [Advertisement of special services] (Reserved).
[A facility may not advertise special services offered unless the service is under the direction and supervision of personnel trained or educated in that particular special service, such as, rehabilitation or physical therapy by a registered physical therapist; occupational therapy by a registered occupational therapist; skilled nursing care by registered nurses; special diets by a dietitian; or special foods.]
§ 201.28. [Nondiscriminatory policy] (Reserved).
[(a) Title VI of the Civil Rights Act of 1964 (42 U.S.C.A. §§ 2000e--2000e-17) and the Pennsylvania Human Relations Act (43 P. S. §§ 951--962.2) apply in the following manner:
(1) There shall be a nondiscriminatory policy of the institution which shall apply to patients, physicians and employes. Under no circumstances will the application of this policy result in the segregation or resegregation of buildings, wings, floors and rooms for reasons of race, color, national origin, ancestry, age, sex, religious creed, or handicap or disability.
(2) Specifically, the nondiscriminatory policy shall include, but not be limited to, the following:
(i) Inpatient or outpatient admission or care.
(ii) Assigning patients to rooms, floors and sections.
(iii) Asking patients about roommate preferences.
(iv) Assigning employes to patient services.
(v) Staff privileges of professionally qualified personnel.
(vi) Utilization of facilities of the institution.
(vii) Transfer of patients from the rooms assigned or selected. A patient may request to upgrade the room assigned or selected for any reason if the room requested is readily available and the patient is financially able to pay for the requested room.
(3) Under the Civil Rights Act of 1964 (42 U.S.C.A. §§ 1971--2000h-6) and the Pennsylvania Human Relations Act, a facility is required to comply with and sign the following statement:
''This facility has agreed to comply with the provisions of the Federal Civil Rights Act of 1964, and the Pennsylvania Human Relations Act, (43 P. S. §§ 951--962.2) and all requirements imposed pursuant thereto, to the end that no person shall, on the grounds of race, color, national origin, ancestry, age, sex, or religious creed, or handicap or disability, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination in the provision of any care or service.''
(4) This subsection is subject to § 201.24 (relating to admission policy).
(5) A facility which is operated, supervised or controlled by a religious organization may delete references relating to religious creed.
(b) Segregation of patients is not permitted based on source of payment except as necessary to obtain third party reimbursement or when optional services are being purchased by the patient.
(c) The following records shall be maintained by a facility to show compliance with the statutes cited in subsection (a). These records shall be available for review by the Department:
(1) A signed and dated copy of the facility's admission policy, including the date of its adoption, which shall set forth in clear terms nondiscriminatory practices with regard to race, color, creed, ancestry, age, sex, national origin or handicap or disability, subject to § 201.24.
(2) Copies of a signed and dated annual notification to referral agencies, such as physicians, social workers, hospitals and minority groups, who have been advised of the admission policy.
(3) A copy of a signed and dated annual notification and description of the continuing method used to inform employes of the nondiscriminatory policies.
(4) Evidence that the nondiscriminatory practices of the facility have been publicized in the community at least once every 3 years by one of the following methods:
(i) Newspapers.
(ii) Radio.
(iii) Television.
(iv) Yellow pages.
(v) Brochure.
(5) Other records or reports as may be required by the Department.
(d) Copies of the facility's nondiscriminatory policy shall be posted in locations accessible to the facility's staff and the general public.
(e) The administrator shall forward to the Department a signed and dated copy of nondiscriminatory policy changes within 30 days of the effective date of the changes.]
§ 201.29. [Patient] Resident rights.
(a) [The governing body of the facility shall establish written policies regarding the rights and responsibilities of patients and, through the administrator, shall be responsible for development of and adherence to procedures implementing the policies.
(b) The policies and procedures shall be made available to patients, guardians, next of kin, a sponsoring agency or a responsible person.
(c) Policies of the facility shall be available to staff, patients, consumer groups and the interested public, including a written outline of the facility's objectives and a statement of the rights of its patients. The policies shall set forth the rights of the patient and prohibit mistreatment and abuse of the patient.
(d)] The staff of the facility shall be trained and involved in the implementation of the policies and procedures.
[(e)] (b) The [patient] resident and [patient's] resident's responsible person, or in the case of a Medical Assistance recipient, the recipient [and the relevant County Board of Assistance] in the absence of a [patient's] resident's responsible person, shall be informed verbally and in writing prior to, or at the time of admission, of services available in the facility and of charges. If changes in the charges occur during the patient's stay, the patient shall be advised verbally and in writing reasonably in advance of the change. ''Reasonably in advance'' shall be interpreted to be 30 days unless circumstances dictate otherwise. If a facility requires a security deposit, the written procedure or contract that is given to the patient or patient's responsible person shall indicate how the deposit will be used and the terms for the return of the money. A security deposit is not required for a patient receiving Medical Assistance.
[(f) The patient shall be fully informed, as evidenced by the patient's written acknowledgment, prior to or at the time of admission and during stay of the rights and of regulations governing patient conduct and responsibilities.
(g) The physician shall inform the patient of his medical condition unless it is medically contraindicated, as documented in the medical record. The patient shall be afforded the opportunity to participate in the planning of his medical treatment. The patient has the right to refuse treatment, to the extent permitted by law.
(h)] (c) The [patient] resident shall be transferred or discharged only for medical reasons, for his welfare or that of other [patients] residents or for nonpayment of stay if the facility has demonstrated reasonable effort to collect the debt. Except in an emergency, a resident may not be transferred or discharged from the facility without prior notification. The resident and the resident's responsible person shall receive written notification in reasonable advance of the impending transfer or discharge. Reasonable advance notice shall be interpreted to mean 30 days unless appropriate plans can be implemented. The actions shall be documented on the resident record. Suitable clinical notes, list of orders and medications as directed by the attending physician shall accompany the resident if the resident is sent to another medical facility.
(d) Unless the discharge is initiated by the resident or resident's responsible person, the facility is responsible to assure that appropriate arrangements are made for a safe and orderly transfer and that the resident is transferred to an appropriate place that is capable of meeting the resident's needs.
[(i) The patient shall be encouraged and assisted throughout the period of stay to exercise his rights as a patient and as a citizen and may voice grievances and recommend changes in policies and services to the facility staff or to outside representatives of his choice. The patient or patient's responsible person shall be made aware of the Governor's Action Line (toll free (800) 932-0784) and the Department's Hot Line (800) 692-7254), and the telephone number of the Long Term Care Ombudsman Program located within the Local Area Agency on Aging, and the local Legal Services Program to which the patient may address grievances. A facility is required to post the ombudsman poster in a prominent location.
(j) The patient shall be free from interference, coercion, discrimination or reprisal.
(k) A patient may manage his personal financial affairs.
(l) If the facility accepts the responsibility for the financial affairs of the patient, the patient or responsible person shall designate the transfer of responsibility in writing. The facility shall establish and maintain written policies and procedures that:
(1) Assure that a full accounting of a patient's personal funds is given in writing to the patient or the responsible person at least quarterly.
(2) Prohibit the commingling of a patient's funds with facility funds.
(m) The patient shall be free from mental and physical abuse and free from chemical and, except in emergencies, physical restraints except as authorized in writing by a physician for a specified and limited period of time or when it is necessary to protect the patient from injury to the patient or to others.
(n) The patient shall be assured confidential treatment of the personal and medical records and may approve or refuse their release to an individual outside the facility, except in case of a transfer to another health care institution or as required by statute or third party payment contract.
(o) The patient shall be treated with consideration, respect and full recognition of dignity and individuality, including privacy in treatment and in care for the necessary personal and social needs.
(p) The patient may not be required to perform services for the facility that are not included for therapeutic purposes in the plan of care and agreed to by the patient.
(q) The patient shall be permitted to associate and communicate privately with persons of choice. The patient shall be permitted to send and receive personal mail unopened. Facility staff may assist the patient in sending or receiving personal mail if the patient requests assistance.
(r) The patient shall be permitted, unless medically contraindicated, to participate in social and religious activities without interference from the administrator or the facility staff except as noted in § 201.30 (relating to access requirements).
(s) The patient shall be permitted to meet with community groups unless medically contraindi- cated, as documented by the physician in the medical record.
(t) The patient shall be permitted to retain and use personal clothing and possessions as space permits unless to do so would infringe upon rights of other patients and unless medically contra- indicated, as documented by his physician in the medical record. Reasonable provisions shall be made for the proper handling of personal clothing and possessions that are retained in the facility. The patient shall have access and use of these belongings.
(u) A patient shall be afforded an opportunity to meet in private with visitors or persons of choice.
(v) The rights and responsibilities specified in subsections (f)--(i) and (k) devolve to the patient's responsible person in the following instances:
(1) A patient adjudicated incompetent under Commonwealth statutes.
(2) A patient found by his physician to be medically incapable of understanding his rights.
(3) A patient who is unable to communicate in any way.
(w)] (e) The [patient] resident rights in this section shall be reflected in the policies and procedures of the facility.
[(x) This section shall be posted in a conspicuous place near the entrances and on each floor of the facility. The facility shall post in a conspicuous place near the entrances and on each floor of the facility a notice which sets forth the policy intent of this section. The facility shall on admission provide a patient or patient's responsible person with a personal copy of the notice. In the case of a patient who cannot read, write or understand English, arrangements shall be made to communicate this policy to the patient. A certificate of the provision of personal notice as required in this section shall be entered in the patient's medical record.
(y) No experimental research or treatment in a nursing home shall be carried out without the approval of the Department and without the written approval of the patient after full disclosure. For the purposes of this subsection, ''experimental research'' means an experimental treatment or procedure that:
(1) Is not a generally accepted practice in the medical community.
(2) Exposes the patients to pain, injury, invasion of privacy or asks the patient to surrender their autonomy, such as a drug study.]
§ 201.30. Access requirements.
(a) [Areas of the facility are subject to inspection and review by authorized representatives of the Department.
(b) Visiting hours shall consist of a minimum of 8 hours per day during the period between 8 a.m. and 8 p.m.
(c) A notice listing the visiting hours shall be posted in a conspicuous and public place.
(d) The facility shall permit members of recognized community organizations, representatives of community legal service programs and representatives of the Department of Aging Ombudsman Program, whose purpose includes rendering assistance without charge to patients to have access to the facility. Ombudsman or advocate representatives shall be permitted freedom to see and talk with patients in private if the patients so desire. The purpose of the visits may be to:
(1) Visit, talk with and make personal, social and legal services available to patients.
(2) Inform patients of their rights and entitlements and corresponding obligations, under Federal and State statutes by means of distribution of educational materials and discussion in groups and with individual patients.
(3) Assist patients in asserting their legal rights regarding claims for public assistance, medical assistance and Social Security benefits, as well as in other matters in which patients are aggrieved. Assistance may be provided individually, as well as on a group basis, and may include organizational activity as well as counseling and litigation.
(4) Engage in other methods of assisting, advising and representing patients so as to extend to them the opportunity to fully exercise their rights.
(e) The facility may limit access where it may be a detriment to the care and well-being of the patient in the facility. The facility may not restrict the right of the patient to have legal representation or to visit the representatives of the Department of Aging Ombudsman Program.
(f)] A person entering a facility who has not been invited by [patients] residents or [patients'] residents' responsible persons under [subsection (d)] shall promptly advise the administrator or other available agent of the facility of his presence. The person may not enter the living area of a [patient] resident without identifying themselves to the [patient] resident and without receiving the [patient's] resident's permission to enter.
[(g) An individual patient has the right to terminate a visit by persons having access under subsection (d). Communication between a patient and the person shall be confidential unless the patient authorizes the release of information.
(h)] (b) The facility shall post in a conspicuous place near the entrances and on each floor of the facility a notice [which sets forth the policy intent of § 201.29 (relating to patient rights)] informing residents of their rights. The facility shall on admission provide a [patient] resident or [patient's] resident's responsible person with a personal copy of the notice. If a [patient] resident cannot read, write or understand English, arrangements shall be made to communicate this policy to the [patient] resident. A certificate of the provision of personal notice as required in this section shall be entered in the [patient's medical] resident's clinical record.
[(i) This section may not be construed to restrict a right or privilege of a nursing home patient to receive visitors who are not representative of community organizations or legal services programs.
(j) A patient shall be permitted to meet in private with clergy or with a representative of the clergy during the normal visiting hours. Upon request of the patient or patient's family, the patient shall be permitted to meet with clergy or a representative of the clergy at any time.]
§ 201.31. Transfer agreement.
(a) [The nursing facility shall have in effect a transfer agreement with one or more hospitals, reasonably close, which provides the basis for effective working arrangements. Under the agreement, inpatient hospital care or other hospital services shall be promptly available to the facility's patients when needed.
(b)] A hospital and a facility are considered to have a transfer agreement in effect if, by reason of a written agreement between them or, in the case of two institutions under common control, by reason of a written undertaking by the person or body which controls them, there is reasonable assurance that[:
(1) A transfer of patients will be effected between the other health facility and the nursing facility, ensuring timely admission, whenever the transfer is medically appropriate as determined by the attending physician.
(2) There will be interchange of medical and other information necessary or useful in the care and treatment of individuals transferred between the institutions, or in determining whether the individuals can be adequately cared for other than in either of the institutions.
(3) There] there will be arrangements made for the transfer of personal effects, particularly money and valuables, and for the transfer of information related to these items when necessary.
[(c) A nursing facility which does not have an agreement in effect, but which is found by the Department to have attempted in good faith to enter into an agreement with a hospital or other related health care facility located sufficiently close to the facility to make feasible the transfer of patients and the information referred to in subsection (b), is considered to have an agreement in effect if, and for so long as, the Department finds that to do so is in the public interest and essential to assuring nursing facility services for persons in the community.]
§ 201.32. [Room placements] (Reserved).
[A husband and wife may occupy the same room if they so desire unless it is medically contra- indicated as documented in the medical record by a physician. The room shall comply with standards for a multi-bed room.]
CHAPTER 203. APPLICATION OF LIFE SAFETY CODE FOR LONG TERM CARE NURSING FACILITIES § 203.2. [Restrictions] (Reserved).
[Blind, nonambulatory or physically-handi- capped patients may not be housed above the street-level floor unless the facility is constructed of 1-hour protected noncombustible construction (as defined in National Fire Protection Association Standard No. 220); fully-sprinklered, 1-hour protected ordinary construction; or fully-sprinklered, 1-hour protected wood-frame construction.]
CHAPTER 205. PHYSICAL PLANT AND EQUIPMENT STANDARDS FOR LONG TERM CARE NURSING FACILITIES
BUILDINGS AND GROUNDS § 205.1. Location or site.
A building to be used for and by [patients] residents shall be located in areas conducive to the health and safety of the [patients] residents.
§ 205.2. Grounds.
(a) Grounds shall be adequate to provide necessary service areas and outdoor areas for [patients] residents. A facility with site limitations may provide rooftop or balcony areas if adequate protective enclosures are provided.
(b) Delivery areas, service yards or parking area shall be located so that traffic does not cross areas commonly used by [patients] residents.
§ 205.3. [Building approval] (Reserved).
[A building intended to be used for and by patients shall be approved by the Department before occupancy, construction, conversion, alterations or additions are started.]
§ 205.4. Buildings plans.
(a) [Architectural plans shall be submitted to the Department for preliminary approval prior to the development of final plans.
(b)] * * *
[(c)] (b) * * *
[(d)] (c) The licensee or prospective licensee shall have the opportunity to present and discuss purposes and plans concerning the requested changes indicated on the architectural plans with the Department. If differences occur and cannot be resolved, an administrative hearing may be sought under [§ 8.1] 1 Pa. Code Part II (relating to [applicability of general rules] General Rules of Administrative Practice and Procedure).
[(e)] (d) * * *
[(f) Preliminary architectural plans submitted to the Department for preliminary approval shall include the following:
(1) Site plan--1 inch equals 40 feet--indicating new and existing structures, roads, services, walls and north arrow.
(2) Floor plans using a minimum of 1/8 inch scale.
(3) One-fourth inch scale layout: Main kitchen, nurse's station, utility room, physical therapy room, occupational therapy room and the like.
(4) One-fourth inch scale layout: Typical bedroom, indicating window, door, radiator, air conditioner, electrical outlets, permanent fixtures, furniture placement or other pertinent information; typical bathroom; and a toilet room.
(5) Exterior elevation.
(6) Wall section, typical.
(7) Plans shall be on drawing sheets at least 15 by 24 inches and not exceed 32 by 42 inches in size including the borders.
(g) A copy of the local zoning approval shall be submitted to the Department before final approval is given unless final approval is needed in order to obtain zoning approval.
(h)] (e) Plans submitted to the Department for [final] approval shall include [items in subsection (f)] the following [additional] items:
* * * * * (4) [One set of specifications] Site plan--1 inch equals 40 feet--indicating new and existing structures, roads, services, walls and north arrow.
(5) Floor plans using a minimum of 1/8 inch scale.
(6) One-fourth inch scale layout: Main kitchen, nurse's station, utility room, physical therapy room occupational therapy room and the like.
(7) One-fourth inch scale layout: Typical bedroom indicating window, door, radiator, air conditioner, electrical outlets, permanent fixtures, furniture placement or other pertinent information; typical bathroom; and a toilet room.
(8) Exterior elevation.
(9) Wall section, typical.
(10) Plans shall be on drawing sheets at least 15 by 24 inches and not exceed 32 by 42 inches in size including the borders.
§ 205.5. [Number of building plans to be prepared] (Reserved).
[There shall be two sets of architectural plans submitted to the Department for preliminary approval unless otherwise noted.]
§ 205.6. Function of building.
(a) No part of a building may be used for a purpose which interferes with or jeopardizes the health and safety of [patients] residents. Special authorization shall be given by the Department's Division of [Long Term] Nursing Care Facilities if a part of the building is to be used for a purpose other than health care.
(b) The only persons who may reside in the facility shall be [patients] residents, employes, the licensee, the administrator or members of the administrator's immediate family.
MINIMUM PHYSICAL PLANT STANDARDS § 205.7. Basement or cellar.
[(a) Basements or cellars shall be concreted, vermin-proofed and kept dry and free from dampness.
(b)] Basements or cellars may be used for storage, laundry, kitchen, heat, electric and water equipment. Approval from the Department's Division of [Long Term] Nursing Care Facilities shall be secured before areas may be used for other purposes, such as physical therapy, central supply, occupational therapy and the like.
§ 205.8. Ceiling heights.
[(a) In nursing areas, the ceiling height shall be a minimum of 8 feet, except in corridors, halls, toilet rooms and bathrooms where 7 feet 6 inches is acceptable.
(b) In rooms containing ceiling-mounted patient-lifting devices or ceiling hooks for lifting equipment, ceiling heights shall be a minimum of 9 feet.
(c) In other areas, ceiling] Ceiling heights may be 7 feet 6 inches except in boiler rooms where a minimum of 30 inches shall be provided above the main boiler heater and connecting piping. Adequate headroom for convenient maintenance and other proposed operations shall be maintained below the piping.
§ 205.9. Corridors.
(a) [Corridors in areas used by patients shall meet the provisions of the appropriate NFPA Life Safety Code.
(b) Handrails may project into corridors, but drinking fountains, desks, storage carts or other projections or obstructions may not reduce the required minimum corridor dimension.
(c) Patient] Resident corridors shall have a handrail on both sides with a return to the wall at each rail ending. Handrails shall be detailed and finished for safety and shall be free from snagging. Brackets may not impede the continuous progress of hands along the railing.
[(d)] (b) * * *
[(e)] (c) Areas used for corridor traffic may not be considered as area for dining, storage, diversional or social activities.
§ 205.10. Doors.
(a) [In a new facility, doors into sleeping rooms used by patients may be no less than 44 inches wide and no less than 80 inches in height.
(b)] Doors into bathrooms and toilet rooms used by [patients may] residents shall be [no less than] at least 36 inches wide, except for an existing facility where the minimum width of toilet room doors [shall be] is [a minimum width of] 32 inches.
[(c)] (b) A door to a [patient] resident room shall swing into the room.
[(d) A door into a lounge area, dining room and other multipurpose room may swing out of the room, if the door does not swing into the effective width of the corridor.
(e)] (c) * * *
[(f) Patient] (d) Resident and visitor toilet stall doors shall swing out. Curtains or equivalent shall be considered as meeting this requirement.
[(g)] (e) A door to a basement or a cellar may not be located in a [patient] resident room.
[(h)] (f) * * *
§ 205.11. [Doorways] (Reserved).
[Doorways shall be placed so that no bedroom, kitchen, bathroom or toilet room is rendered a corridor.]
[Continued on next Web Page]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
