[27 Pa.B. 3609]
[Continued from previous Web Page] § 205.12. Elevators.
(a) Elevator service shall be provided for [patients] residents when a [patient] resident use area is located above or below the first floor or grade level entrance in a building constructed or converted for use after January 1975 as a facility providing either skilled or intermediate care.
* * * * * § 205.13. Floors.
(a) Floors traveled by [patients] residents shall be of nonskid material.
* * * * * § 205.14. Locks.
Doors into rooms used by [patients] residents may not be locked from the outside when the [patient] resident is in the room.
§ 205.15. [Outside stairs and ramps] (Reserved).
[(a) Outside stairs and ramps used by patients shall be adequately lighted and may be no less than 44 inches wide.
(b) There shall be at least one entrance that is accessible with a ramp or a lift for handicapped persons.]
§ 205.16. Stairs.
[(a) There shall be no variations in the depth of treads and heights of risers in a flight of stairs.
(b) Stair treads shall have a nonskid surface.
(c)] Stairs used by [patients] residents shall have no locked gates or free swinging doors obstructing ascent or descent.
§ 205.17. Stairways.
[(a) A stairway may be no less than 44 inches wide.
(b) Handrails shall be installed on both sides for stairs 44 inches wide. If a stairway exceeds 66 inches in width, an intermediate handrail shall be installed. Wall handrails other than those on service stairs, shall be continuous through floor and intermediate landings. Handrails and balustrade shall be detailed and finished for safety in use and freedom from snagging. Brackets for handrails may not impede the continuous progress of hands along the railing.
(c) A landing at either end of a flight of stairs used by patients shall be at least as wide as a door leading to the stairs but may be not less than 44 inches in direction of travel.
(d)] There shall be indoor stairs and stairways to a basement if the stairs are to be used by personnel of the facility.
[(e) Stairways shall be adequately illuminated with electric lights controlled by switches located at the top and bottom of the stairs.]
§ 205.18. [Walls] (Reserved).
[(a) Walls shall be suitably finished or covered for their intended use.
(b) Walls in kitchens, bathrooms, toilet rooms, bedpan rooms, utility rooms, shower rooms and the wall area around a sink shall be smooth and have a water resistant finish to a level above the splash or spray line.]
§ 205.19. Windows and windowsills.
(a) [A minimum total glass area on outside walls equal to 10% of the floor area shall be provided in a bedroom.
(b) Openings providing required natural light which open onto a covered porch that exceeds 4 feet in depth shall be increased in area 10% per foot of depth over 4 feet.
(c) Openings which open to a glass enclosed porch may be included in required ventilating area if the required area is obtained in both exterior wall and porch.
(d) The heads of windows--sash opening--may not be more than 12 inches below the finished ceiling unless they are at least 6 feet 8 inches above the finished floor.
(e) Windowsills in patient bedrooms may not be more than 36 inches from the floor, and they shall be above the exterior finished grade.
(f)] * * *
[(g)] (b) Rooms with windows opening onto light or air shafts, or onto an exposure where the distance between the building or an obstruction higher than the windowsill is less than 20 feet may not be used for [patient] resident bedrooms.
[(h) A facility which was licensed prior to July 1, 1987, is not required to comply with the window area requirements, the head of windows, sash openings, or the minimum height of windowsills above the floor, or distance between buildings, as specified in this section.]
§ 205.20. [Patient] Resident bedrooms.
(a) A bed for a [patient] resident shall be placed only in a bedroom approved by the Department.
(b) [No more than four beds may be in a patient room.
(c)] The maximum number of [patients] residents who may be accommodated in the facility shall be indicated on the license. [During the period of a license, the facility may increase the number of beds by not more than ten beds or by 10% of the total bed capacity, whichever is less, if other requirements are met. If the facility exercises this option, it shall notify the Department.
(d)] (c) The number of [patient] resident bedrooms and the number of beds in a room may not exceed the maximum number approved by the Department.
[(e) A bedroom shall be designed to provide adequate placement of furniture and facilities essential to a patient's needs.
(f)] (d) Single bed bedrooms shall [be provided clearance as follows:
(1) No less than 3 feet of open space from the side of the bed to the adjacent wall, a permanent fixture or movable furniture, except bedside chair and cabinet. A bedside cabinet may be next to the bed and not counted in this space requirement.
(2) No less than 4 feet of open space from the foot of the bed to the opposing wall or furniture.
(3) Minimum] (1) Provide minimum room area clearance, in addition to the area of closets, vestibule, wardrobes and toilet rooms, shall be 100 square feet.
[(4) A bed may be placed against a wall if it is in the best interest of the patient, and if the minimum spacial requirements are met.
(g)] (e) Single [patient] resident bedrooms in facilities licensed prior to January 1975, shall [comply with the following minimum requirements:
(1) Contain] contain at least 80 square feet of space.
[(2) Contain no less than 2 feet of space between the side of the bed and the adjacent wall, permanent fixture or movable furniture except bedside chair and cabinet.
(3) Contain no less than 3 feet of space from the foot of the bed and the opposite wall, permanent fixture or movable furniture except bedside chair and cabinet.
(h)] (f) A multibed bedroom shall [be provided clearance as follows:
(1) No less than 2 1/2 feet of open space from the side of the bed to the adjacent wall, permanent fixtures or movable furniture, except bedside chair and cabinet. A bedside cabinet may be next to the bed and may not be counted in this space requirement.
(2) No less than 4 feet of open space between the sides of adjacent beds.
(3) No less than 4 feet of open space from the foot of each bed to the opposing wall or furniture.
(4) No less than 6 feet of open space between the foot of one bed and the foot of a bed placed against an opposing wall.
(5) No less than 3 feet of open space from the side of the bed to adjacent walls, permanent fixtures or moveable furniture, except bedside chair and cabinet if beds are placed with walls adjacent to both sides of the bed.
(6) Minimum] Provide minimum room area clearances, in addition to the area of closets, vestibule, wardrobes and toilet rooms [shall be] of 80 square feet per bed.
[(7) A bed may be placed against a wall if it is in the best interest of the patient, and if the minimum spacial requirements are met.
(i)] (g) In facilities licensed prior to January 1975, [patient] resident multi-bed bedrooms shall [comply with the following:
(1) There shall be] Have at least 65 square feet of space per [patient] resident.
[(2) There shall be no less than 18 inches of open space from the side of the bed to the adjacent wall, permanent fixtures or movable furniture except bedside chair and cabinet.
(3) There shall be no less than 3 feet of open space between the sides of adjacent beds.
(4) There shall be no less than 3 feet of space between the foot of a bed and opposing wall, permanent fixtures or movable furniture, except bedside chair.
(5) There shall be no less than 5 feet of open space between the foot of one bed and the foot of a bed placed against the opposing wall.
(6) There shall be no less than 2 feet of open space from the side of a bed to adjacent walls, permanent fixtures or movable furniture except bedside chair and cabinet if beds are placed with walls adjacent to both sides of the beds.
(j)] (h) * * *
[(k)] (i) * * *
[(l) A room having more than one bed shall have suitable curtain tracks, rods or equivalent durable equipment to permit enclosing a bed with curtains for privacy. The cubicle curtains shall be of sufficient length to provide privacy to the patient when the bed is at the lowest level.
(m) There shall be one clothes closet or wardrobe for each patient. The closet/wardrobe shall comply with the following standards:
(1) It shall be a minimum of 22 inches deep with 30 inches wide hanging space.
(2) It shall have a minimum of one shelf above the clear hanging space.
(3) It shall have a fixed rod or device for clothes hangers.
(4) The maximum height for the rod shall be 5 feet 6 inches above the room finished floor.
(5) The vertical clearance below the rod may not be less than 4 feet 6 inches.]
§ 205.21. Special care room.
(a) Provisions shall be made for isolating a [patient] resident as necessary in a single room which is ventilated to the outside. For new construction, there shall be an adjoining private bathroom which contains a toilet, lavatory and either a standard size tub or a shower.
* * * * * § 205.22. Placement of beds.
A bed may not be placed in proximity to radiators, heat vents, air conditioners, direct glare of natural light or drafts unless adequate provisions are made for [patient] resident comfort and safety.
§ 205.23. Location of bedrooms.
[(a) A bedroom shall be an outside room with direct natural light and ventilation, and shall have direct access to corridors with the floor at or above grade level. Existing facilities may have bedrooms that are an outside room with direct natural light and ventilation, and have direct access to corridors or common rooms with the floor at or above grade level.
(b) A bedroom may not be located in an area classified as a basement or cellar.
(c)] A [patient] resident bedroom shall have adjoining toilet facilities and shall be located conveniently near bathing facilities, except for those facilities licensed prior to January 1975.
§ 205.24. Dining room.
(a) [There shall be at least one dining room available for patients.
(b) No more than 50% of the floor space may be used for a dining area if it is located in, or is part of, the lounge or recreation room. If a multipurpose room is used for dining and patient activities, there shall be sufficient space to accommodate the activities and prevent interference with each other. It should be possible to serve meals without interfering with an activity program.
(c)] * * *
(b) Tables and space shall be provided to accommodate wheelchairs with trays and other devices.
§ 205.25. Kitchen.
* * * * * (b) [A separate kitchen may be necessary if the facility is located in a building with a residential unit which can provide joint services to both units.
(c) Provisions shall be made in the kitchen for the preparation, refrigeration, proper storage and distribution of food to dining areas and to patients.
(d)] * * *
[(e) The kitchen and dietetic food service areas shall be properly ventilated.
(f) Safe, sufficient and sanitary equipment shall be provided for the preparation of food and food service for patients.
(g) Adequate equipment shall be provided for the washing of utensils used for eating, drinking and food preparation.
(h) If manual dishwashing is employed, equipment and utensils shall be thoroughly washed in a warm detergent solution which is kept clean, and then shall be rinsed free from the solution. Eating and drinking utensils and, where required, the food contact surfaces of other equipment and utensils, shall be sanitized by one of the following methods:
(1) Immersion for at least 30 seconds in clean, hot water at a temperature of at least 180°F.
(2) Immersion for a period of at least 1 minute in a sanitizing solution.
(i) The temperature of a refrigerator may not be higher than 45°F. A freezer temperature shall be maintained at no higher than 0°F. A thermometer shall be in place in refrigerators and freezers. Food in a refrigerator or freezer shall be covered.]
§ 205.26. Laundry.
* * * * * (b) [Bed linens shall be washed and dried in a sanitary and efficient manner which will produce hygienically clean linen. The washing process shall have a mechanism for soil removal and bacteria kill.
(c)] * * *
[(d)] (c) The facility shall have a separate room for central storage of soiled linens. The room shall be well ventilated, constructed of materials impervious to odors and moisture and easily cleaned. Soiled linens may not be transported through areas where clean linen is stored.
[(e)] (d) * * *
[(f)] (e) Equipment shall be made available and accessible for [patients] residents desiring to do their personal laundry.
[(g) Provisions shall be made in a nursing unit for a safe and sanitary method of handling and storage of soiled linens. The transportation of linens shall be designed to prevent the spread of infection.]
§ 205.27. Lounge and recreation rooms.
[(a)] There shall be a minimum of 15 square feet of floor space per bed for recreation or lounge rooms provided for the first 100 beds and 13 1/2 square feet for all beds over 100. There shall be recreation or lounge rooms for [patients] residents on each floor.
[(b) Floor space for recreation listed in subsection (a) may include, but is not limited to, solaria, reading rooms, enclosed heated porches, living rooms, libraries, multipurpose rooms used for recreation and similar areas.
(c) A minimum of 50% of the required lounge and recreation space shall be located at exterior walls where windows are provided with maximum 36 inch high sills, except for existing facilities.]
§ 205.28. Nurses' station.
* * * * * (b) The nurses' station may not be more than 120 feet from the most remote [patient] resident room served.
* * * * * [(d) There shall be a nursing staff toilet room including a toilet and lavatory convenient to the nurses' station.]
§ 205.29. [Office] (Reserved).
[(a) Private office space shall be available for the administrator, director of nursing and the business office.
(b) Space for medical records shall be available. This shall be an area which is locked.
(c) Additional office space for other department heads shall be provided as necessary.]
§ 205.31. Storage.
[(a)] General storage space shall be provided for storage of supplies, furniture, equipment, [patients'] residents' possessions and the like. Space provided for this purpose shall be commensurate with the needs of the nursing facility, but may not be less than 10 square feet per bed.
[(b) A floor occupied by patients shall be provided with storage space for linens, supplies, wheelchairs, stretchers, orthopedic appliances and equipment used daily for the care of patients. Space required shall relate to the number of beds on a floor. This space may not be part of the 10 square feet requirement.
(c) Storage space for patients' personal property, trunks, suitcases, seasonal clothing and the like, shall be provided in a dry and protected area. This space may be included in meeting the 10 square feet requirement.
(d) Storage space for indoor recreation equipment shall be provided in recreation areas or adjacent to them, if possible. This space may not be part of the 10 square feet requirement.]
§ 205.32. Janitor closet.
* * * * * (b) [The closet shall be mechanically ventilated and equipped with a service sink and storage space to accommodate janitorial supplies and equipment.
(c)] * * *
§ 205.33. Utility room.
(a) Provisions shall be made in each nursing unit near the nurses' station for utility rooms. The area shall have separate soiled and clean workrooms. The rooms may not be more than 120 feet from the most remote room served. If one nursing station services several [patient] resident corridors, a soiled utility room shall be on each unit.
[(b) The clean workroom shall provide for the storage and assembly of supplies for nursing procedures, contain a counter and sink and be mechanically ventilated. This area may also contain the medicine room and the clean linen storage.
(c) The soiled workroom shall provide for the disassembly of soiled equipment, disposal of liquid and solid wastes, including disposable items. Soiled equipment may be temporarily retained in this area until it can be transported to appropriate areas.]
(b) Facilities for flushing and rinsing bedpans, such as a spray attachment for the clinical sink or a separate bedpan flusher, shall be provided in the soiled workroom of each nursing unit, unless bedpan flushing devices, together with bedpan lugs on toilets are provided in each resident's toilet for this purpose.
(c) Hand-washing facilities shall be available in the soiled and clean utility rooms.
§ 205.34. [Treatment room or examining room] (Reserved).
[A treatment room with a storage cabinet shall be conveniently to patients' rooms, and arranged to accommodate a treatment table, lavatory and instrument table. The treatment room may be used for consultation if the room is of sufficient size to accommodate both functions. This may be centrally located to serve more than one nursing unit.]
§ 205.35. [Telephone] (Reserved).
[A telephone shall be available for patient use. At least one telephone shall be installed on each nursing floor to accommodate patients on wheelchairs. When necessary, staff shall provide assistance to patients using the telephone.]
§ 205.36. Bathing facilities.
(a) The nursing facility shall provide a general bathing area in each nursing unit to serve [patients'] residents' bedrooms which do not have adjoining bathrooms with a bathtub or shower.
(b) [The general bathing area shall contain at least one bathtub or one shower stall.
(c)] * * *
[(d)] (c) * * *
[(e)] (d) Each room or compartment shall provide space for the use of bathing fixtures, wheelchairs and dressing. Sufficient space shall be provided for the attendant who may need to assist the [patient] resident.
[(f)] (e) * * *
[(g)] (f) * * *
[(h) Shower stalls in patient rooms may be 30 inches in least dimension when a 4 feet square shower is provided in the central bathing area.
(i)] (g) * * *
[(j) Bathtubs shall be at least 5 feet long, 30 inches in width and 16 inches in depth unless special institutional tubs are used. If special institutional tubs or bathing devices are used in lieu of the conventional tub, provisions shall be made to assure that they are fire safe, free of cross contamination and meet acceptable electrical codes, if electrical equipment is used with the bathing equipment. Bathing devices that are connected with electrical connections shall have the unit labeled as approved by Factory Mutual or Underwriters Laboratory or other testing laboratories as approved by the Department.
(k) A bathroom with three standard fixtures shall have a minimum measurement of 50 square feet. There may be no less than 4 feet from the long side of the bathtub to the opposing wall or fixture.
(l)] (h) The facility shall have at least one bathtub in each centralized bath area on each floor that is accessible from three sides with a minimum of 3 feet clearance on each side and 4 feet clearance from the foot of the tub to adjacent wall or obstruction. [This bathing fixture shall meet one of the following criteria:
(1) Be a standard or pedestal tub and a minimum of 5 feet long.
(2) Be an institutional style tub that is designed to provide specialized bathing features.
(3) Be an institutional full-length supine tub.
(4) Be a sit-type institutional tub.
(m) A shower in the ratio of one to 15 patients or major fraction thereof may be substituted for bathtubs if there is at least one bathtub fixture with clearance on three sides on each patient floor.]
§ 205.37. Equipment for bathrooms.
* * * * * (b) The general bathroom or shower room used by [patients] residents shall be provided with one emergency signal bell located in close proximity to the tub or shower and which registers at the nursing station. This is in addition to the emergency signal bell located at each toilet unless a single bell can be reached by the [patient] resident from both the toilet and tub or shower.
[(c) Provisions shall be made available to get patients in and out of bathtubs in a safe way to prevent injury to patients and personnel.
(d) A dressing area shall be provided immediately adjacent to the shower stall and bathtub. In the dressing area, there shall be provisions for keeping clothes dry while bathing.]
§ 205.38. Toilet facilities.
(a) In toilet rooms that adjoin patient bedrooms, there shall be at least one toilet for four [patients] residents. This shall be directly accessible from bedrooms without entering the general corridor. In no case may one toilet service more than two bedrooms. [The minimum dimension of a patient toilet room containing only a toilet shall be 3 feet by 6 feet.
(b) There may be no less than 3 1/2 feet of space from front of toilet to opposite wall or fixtures.
(c) There shall be at least one toilet on each floor to accommodate patients in wheelchairs. There may be no less than 2 feet of space on each side of the toilet and no less than 3 1/2 feet of space in front.
(d) At least one toilet room shall be provided for toilet training. This room shall be accessible from the nursing corridor and may serve the bathing area. Minimum dimensions for a toilet-training room containing only a toilet shall be 5 feet by 6 feet.
(e) A patient-used toilet stall may be no less than 3 feet wide and 6 feet long. The door or curtain to the toilet may be no less than 2 feet, 8 inches wide. When a door is used, it shall swing outward.
(f)] (b) Floors or units with more than eight [patients] residents of both sexes shall be provided with separate toilet fixtures in a ratio of 1:4 or major fraction thereof for each sex. In existing facilities, overall toilet fixtures shall be provided in a ratio of 1:8 or major fraction thereof for each bed.
[(g)] (c) * * *
[(h) The number of toilets may be reduced by the number of water urinals but the number of toilets may not be reduced to less than 2/3 of the total number required.]
§ 205.39. Toilet room equipment.
* * * * * (b) [Toilet paper in a suitable dispenser shall be provided within reach of the toilet.
(c)] Toilets used by [patients] residents shall be provided with handrails or assist bars on each side capable of sustaining a weight of 250 pounds and an emergency call bell within reaching distance.
[(d) If a bathroom or toilet room has more than one toilet, each toilet shall be enclosed with permanent partitions.]
§ 205.40. Lavatory facilities.
(a) A floor occupied by [patients] residents shall have lavatories in the ratio of 1:4 [patients] residents or major fraction thereof. In existing facilities, lavatory fixtures shall be provided in a ratio of 1:8 or major fraction thereof for each bed.
(b) A mirror shall be over each lavatory used by [patients] residents.
[(c) A floor occupied by patients shall have at least one lavatory installed to accommodate patients in wheelchairs.
(d) Toilets, mirrors, switches and wall outlets shall be arranged for the convenience of patients in wheelchairs as well as in standing positions.]
MECHANICAL AND ELECTRICAL REQUIREMENTS § 205.61. Heating requirements for existing and new construction.
[(a) The heating system shall comply with local and State codes. If there is a conflict, the more stringent requirements shall apply.
(b) Open fires, fuel-burning space heaters and portable electric space heaters may not be used.
(c) A minimum temperature of 72°F at winter design conditions shall be provided for occupied spaces. The heat in patient-occupied areas shall be thermostatically controlled to provide an even temperature for patient comfort.
(d) Insulation, including finishes and adhesives on the exterior surfaces of pipes and equipment, shall have a maximum flame-spread rating of 25 and a maximum smoke-developed rating of 150.
(e)] Exposed heating pipes, hot water pipes or radiators in rooms and areas used by [patients] residents or within reach of [patients] residents, shall be covered or protected to prevent injury or burns to [patients] residents. This includes hot water or steam piping above 125°F.
§ 205.62. Special heating requirements for new construction.
(a) [Boilers shall have the capacity based on the published Steel Boiler Institute or Institute of Boiler and Radiator Manufacturers net rating to supply the normal requirements of all systems and equipment.
(b)] * * *
[(c)] (b) * * *
§ 205.63. Plumbing and piping systems required for existing and new construction.
* * * * * (c) Hot water outlets accessible to [patients] residents shall be controlled so that the water temperature of the outlets does not exceed 110°F.
[(d) Facilities for flushing and rinsing bedpans, such as a spray attachment for the clinical sink or a separate bedpan flusher, shall be provided in the soiled workroom of each nursing unit, unless bedpan flushing devices, together with bedpan lugs on toilets are provided in each patient's toilet for this purpose.
(e) An automatic fire extinguishing system, such as sprinklers, carbon dioxide, or dry chemical shall be installed, inspected, supervised and maintained under the applicable Life Safety Code as required in § 203.1 (relating to application of the Life Safety Code).
(f) Hand-washing facilities shall be available in the soiled and clean utility rooms.]
§ 205.64. Special plumbing and piping systems requirements for new construction.
* * * * * (d) Shower bases and tubs shall provide nonskid surfaces for standing [patients] residents.
[(e) Other piping systems, such as oxygen, shall follow the NFPA Standards applicable to the appropriate edition of the Life Safety Code.]
§ 205.65. [Ventilation requirements for existing and new construction] (Reserved).
[(a) The exhaust systems of food preparation areas shall conform to the appropriate NFPA Standard No. 96. The ventilation rates may not be less than shown in § 205.66(a) (relating to special ventilation requirements for new construction).
(b) Air handling systems shall meet the requirements of NFPA, 90-A.]
§ 205.66. Special ventilation requirements for new construction.(a) Ventilation for new construction shall conform to the following:
Pressure Min. Air All Air Relationship Changes of Min. Total Air Exhausted Recirculated to Adjacent Outdoor Air Changes Directly to within Area Designation Areas Per Hr. Per Hr. Outdoors Room Units [Patient] Resident Room Equal 2 2 Optional Optional [Patient] Resident Area Corridor Equal [2] Optional [4] 2 Optional Optional Exam and treatment room Equal [2] Optional 6 Optional Optional * * * * * Food preparation center Equal 2 10 Yes [No]Yes Warewashing room Negative Optional 10 Yes [No]Yes * * * * *
Clean linen storage Positive [2] Optional 2 [Optional] Yes [Optional]No * * * * * (c) [Corridors may not be used to supply air or exhaust air from a room except that air from corridors may be used to ventilate bathrooms, toilet rooms and small electrical or telephone closets opening directly on corridors.
(d)] * * *
[(e)] (d) * * *
[(f)] (e) * * *
[(g)] (f) * * *
[(h)] (g) * * *
[(i)] (h) * * *
[(j)] (i) * * *
§ 205.67. Electric requirements for existing and new construction.
* * * * * (c) Electric lights satisfactory for sewing or similar activities at a minimum level of 200 footcandles on the task shall be available for [patients] residents.
(d) Electric lights in rooms used by [patients] residents shall be placed or shaded to prevent direct glare to the eyes of [patients] residents.
(e) Night lights shall be provided in bedrooms, stairways, corridors, bathrooms and toilet rooms used by [patients] residents.
* * * * * (g) [Illumination for exit signs, corridors and stairs, including both normal and emergency circuits shall be controlled by switches accessible to authorized personnel only. Key-operated switches, switching in the nurses' station or similarly supervised or nonaccessible locations or switching in the panel boxes are acceptable means on compliance.
(h)] In addition to night lights, [patient] residents bedrooms shall have general lighting. The light emitting surfaces of the night light may not be in direct view of a [patient] resident in a normal in-bed position.
[(i)] (h) A reading light shall be provided for each [patient] resident.
[(j)] (i) In each [patient] resident room there shall be grounding type receptacles as follows: one duplex receptacle on each side of the head of each bed except for parallel adjacent beds. Only one duplex receptacle is required between beds plus sufficient duplex receptacles to supply portable lights, television and motorized beds, if used, and one duplex receptacle on another wall.
[(k)] (j) A nurse's calling station--signal originating device--with cable with push button housing attached or other system approved by the Department shall be provided at each [patient] resident bed location so that it is accessible to the patient. Two cables and buttons serving adjacent beds may be served by one station. An emergency calling station within reach of the [patient] resident shall be provided at each bathing fixture and toilet unless a single bell can be reached by the [patient] resident from both the bathing fixture and the toilet. Cable and push button housing requirement will apply to those facilities constructed after July 1, 1987.
[(l)] (k) Calls shall register by a signal receiving and indicating device at the nurses' station, and shall activate a visible signal in the corridor at the [patient's] resident's door. In [multi-corridor] multicorridor nursing units, additional visible signal indicators shall be installed at corridor intersections.
§ 205.68. Special electrical requirements for new construction.
* * * * * (c) Minimum lighting levels for long term care nursing facilities shall conform with the following:
Area
Footcandles* * * * *
[Patient] Resident care unit (or room), general 10 [Patient] Resident care room, reading 30
* * * * * (d) The applicable standards for lighting levels are those established by the [United States Department of Health and Human Services publication No. 930-D-16 of January, 1969] most current edition of the Illuminating Engineering Society of North America (IES) Lighting Handbook. [For areas not listed, including those which house machinery and equipment, a general lighting level of 20 footcandles minimum shall be provided. The levels in footcandles except where noted ''on floor'' are maintained values at a horizontal plane, 30 inches above the floor].
FURNISHINGS, EQUIPMENT AND SUPPLIES § 205.71. Bed and furnishings.
[(a) A standard hospital bed no less than 78 inches long and 36 inches wide with an adjustable back rest and a firm adjustable spring or flat pan shall be provided for each patient receiving nursing care.
(b)] A bed shall be equipped with a firm supporting mattress which is [no less than 75 inches long, 35 inches wide and 5 inches deep. It shall be covered or protected with nonporous material.
(c) A bed shall be provided with at least one comfortable bed pillow.
(d) A bed shall be equipped with adjustable side rails if required for the protection and safety of the patient] equal to the size of the frame and provides for the comfort and safety of the resident.
§ 205.72. Furniture.
[(a) For each patient in the room the patient occupies, there shall be an aerated bedside cabinet with a drawer or an aerated bedside chest.
(b) There shall be a dresser for each patient in addition to the bedside cabinet. Built-in dressers may be used in lieu of free-standing dressers.
(c) A towel bar shall be provided for each patient in the room the patient occupies or in the adjoining bathroom.
(d) A comfortable bedside chair for each patient shall be in the room the patient occupies. A geriatric chair may replace the bedside chair.
(e) Footstools shall be available to patients who need them.
(f) Overbed tables, lap tables or an equivalent shall be provided for patients who do not eat meals in the dining area.
(g) A wall, door or dresser mirror that is accessible to patients shall be provided in each bedroom or adjoining bathroom.
(h) In the lounge and recreation areas, comfortable sitting furniture, such as easy chairs, lounge chairs, geriatric chairs or rockers and the like, shall be provided in a number equal to the number of beds in the home. The chairs shall be designed so that the patient can safely and comfortably get into and out of the chairs.
(i) Furniture shall be kept clean and safe for use.
(j)] A [patient] resident shall be provided with a drawer or cabinet in the [patient's] resident's room that can be locked. This section does not apply to existing facilities except as [patient] resident room furnishings are replaced.
§ 205.73. [Sterilization] (Reserved).
[(a) The facility shall make provisions for the sterilization of nursing care equipment and supplies by any of the methods listed below:
(1) Autoclave or automatic sterilizer sufficient in size to meet the needs of the facility. This equipment shall be in the clean utility room or in the central supply room.
(2) Arrangements made with another medical facility possessing the capability to comply with paragraph (1).
(3) A complete system of disposable equipment and supplies provided and used by patients.
(b) Prior to use by another patient, bedpans and urinals shall be processed according to any of the methods:
(1) Autoclaving may be used. This piece of equipment shall be in the clean utility room or the central supply room.
(2) Boiling at 212°F for 30 minutes in equipment designed to indicate temperature and control time.
(3) Chemical disinfectant according to manufacturer's recommended directions.
(4) Combination washer-sanitizers which wash at approximately 150°F and sanitize by rinsing with water at not less than 180°F.
(c) Bedpans used by a patient with, or suspected of having, a communicable intestinal disease, or an infection which may be transmitted by use of bedpans or urinals, shall be autoclaved prior to use by another patient.
(d) A written agreement shall be signed by responsible individuals of both institutions if sterilization of nursing care equipment and supplies is to be done at another institution possessing the capability.]
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