[29 Pa.B. 3999]
[Continued from previous Web Page] § 201.23. Closure of facility.
(a) The administrator or owner shall notify the appropriate Division of Nursing Care Facilities field office at least 90 days prior to closure.
(b) If the facility is to be closed, the licensee shall notify the resident or the resident's responsible person in writing.
(c) Sufficient time shall be given to the resident or the resident's responsible person to effect an orderly transfer.
(d) No 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 when the Department determines that removal of the resident at an earlier time is necessary for health and safety.
(e) If an orderly transfer of the 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 residents.
(g) The licensee of a facility shall file proof of financial responsibility with the Department to insure that the facility continues to operate in a satisfactory manner for a period of 30 days following the notice of intent to close.
§ 201.24. Admission policy.
(a) The resident may be permitted to name a responsible person. The resident is not required to name a responsible person if the resident is capable of managing the resident's own affairs.
(b) A facility may not obtain from or on behalf of residents a release from liabilities or duties imposed by law or this subpart except as part of formal settlement in litigation.
(c) A facility shall admit only residents whose nursing care and physical needs can be provided by the staff and facility.
(d) A resident 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 resident.
§ 201.25. Discharge policy.
There shall be a centralized coordinated discharge plan for each resident to ensure that the resident has a program of continuing care after discharge from the facility. The discharge plan shall be in accordance with each resident's needs.
§ 201.26. Power of attorney.
Power of attorney may not be assumed for a 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.
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. (Reserved).
§ 201.29. Resident rights.
(a) The governing body of the facility shall establish written policies regarding the rights and responsibilities of residents and, through the administrator, shall be responsible for development of and adherence to procedures implementing the policies.
(b) Policies and procedures regarding rights and responsibilities of residents shall be available to residents and members of the public.
(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 residents. The policies shall set forth the rights of the resident and prohibit mistreatment and abuse of the resident.
(d) The staff of the facility shall be trained and involved in the implementation of the policies and procedures.
(e) The resident or if the resident is not competent, the 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 covered and not covered by the per diem rate of the facility. If changes in the charges occur during the resident's stay, the resident 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 resident or resident'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 permitted for a resident receiving Medical Assistance (MA).
(f) The resident shall be transferred or discharged only for medical reasons, for his welfare or that of other 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 which are acceptable to the resident can be implemented sooner. The facility shall inform the resident of its bed-hold policy, if applicable, prior to discharge. The actions shall be documented on the resident record. Suitable clinical records describing the resident's needs, including list of orders and medications as directed by the attending physician shall accompany the resident if the resident is sent to another medical facility.
(g) 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. Prior to transfer, the facility shall inform the resident or the resident's responsible person as to whether the facility where the resident is being transferred is certified to participate in the Medicare and MA reimbursement programs.
(h) It is not necessary to transfer a resident whose condition had changed within or between health care facilities when, in the opinion of the attending physician, the transfer may be harmful to the physical or mental health of the resident. The physician shall document the situation accordingly on the resident's record.
(i) The resident shall be encouraged and assisted throughout the period of stay to exercise rights as a resident and as a citizen and may voice grievances and recommend changes in policies and services to the facility staff or to outside representatives of the resident's choice. The resident or resident's responsible person shall be made aware of the Department's Hot Line (800) 254-5164, the telephone number of the Long-Term Care Ombudsman Program located within the Local Area Agency on Aging, and the telephone number of the local Legal Services Program to which the resident may address grievances. A facility is required to post this information in a prominent location and in a large print easy to read format.
(j) The resident 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.
(k) The resident shall be permitted to retain and use personal clothing and possessions as space permits unless to do so would infringe upon rights of other residents and unless medically contraindicated, 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 resident shall have access and use of these belongings.
(l) The resident's rights devolve to the resident's responsible person as follows:
(1) When the resident is adjudicated incapacitated by a court.
(2) As Pennsylvania law otherwise authorizes.
(m) The resident rights in this section shall be reflected in the policies and procedures of the facility.
(n) The facility shall post in a conspicuous place near the entrances and on each floor of the facility a notice which sets forth the list of resident's rights. The facility shall on admission provide a resident or resident's responsible person with a personal copy of the notice. In the case of a resident who cannot read, write or understand English, arrangements shall be made to ensure that this policy is fully communicated to the resident. A certificate of the provision of personal notice as required in this section shall be entered in the resident's clinical record.
(o) Experimental research or treatment in a nursing home may not be carried out without the approval of the Department and without the written approval of the resident after full disclosure. For the purposes of this subsection, ''experimental research'' means an experimental treatment or procedure that is one of the following:
(1) Not a generally accepted practice in the medical community.
(2) Exposes the resident to pain, injury, invasion of privacy or asks the resident to surrender autonomy, such as a drug study.
§ 201.30. Access requirements.
(a) The facility may limit access to a resident when the interdisciplinary care team has determined it may be a detriment to the care and well-being of the resident in the facility. The facility may not restrict the right of the resident to have legal representation or to visit with the representatives of the Department of Aging Ombudsman Program. A facility may not question an attorney representing the resident or representatives of the Department, or the Department of Aging Ombudsman Program, as to the reason for visiting or otherwise communicating with the resident.
(b) A person entering a facility who has not been invited by a resident or a resident's responsible persons shall promptly advise the administrator or other available agent of the facility of that person's presence. The person may not enter the living area of a resident without identifying himself to the resident and without receiving the resident's permission to enter.
§ 201.31. Transfer agreement.
(a) The facility shall have in effect a transfer agreement with one or more hospitals, located reasonably close by, which provides the basis for effective working arrangements between the two health care facilities. Under the agreement, inpatient hospital care or other hospital services shall be promptly available to the facility's residents when needed.
(b) A transfer agreement between a hospital and a facility shall be in writing and specifically provide for the exchange of medical and other information necessary to the appropriate care and treatment of the residents to be transferred. The agreement shall further provide for the transfer of residents' personal effects, particularly money and valuables, as well as the transfer of information related to these items when necessary.
§ 201.32. (Reserved).
CHAPTER 203. APPLICATION OF LIFE SAFETY CODE FOR LONG TERM CARE NURSING FACILITIES Sec.
203.1. Application of the Life Safety Code. 203.2. (Reserved). § 203.1. Application of the Life Safety Code.
A facility shall meet the applicable edition of National Fire Protection Association 101 Life Safety Code which is currently adopted by the Department. A facility previously in compliance with prior editions of the Life Safety Code is deemed in compliance with subsequent Life Safety Codes except renovation or new construction shall meet the current edition adopted by the Department.
§ 203.2. (Reserved).
CHAPTER 205. PHYSICAL PLANT AND EQUIPMENT STANDARDS FOR LONG TERM CARE NURSING FACILITIES BUILDINGS AND GROUNDS
Sec.
205.1. Location or site. 205.2. Grounds. 205.3. (Reserved). 205.4. Building plans. 205.5. (Reserved). 205.6. Function of building. MINIMUM PHYSICAL PLANT STANDARDS
205.7. Basement or cellar. 205.8. Ceiling heights. 205.9. Corridors. 205.10. Doors. 205.11. (Reserved). 205.12. Elevators. 205.13. Floors. 205.14. Locks. 205.15. (Reserved). 205.16. Stairs. 205.17. Stairways. 205.18. (Reserved). 205.19. Windows and windowsills. 205.20. Resident bedrooms. 205.21. Special care room. 205.22. Placement of beds. 205.23. Location of bedrooms. 205.24. Dining room. 205.25. Kitchen. 205.26. Laundry. 205.27. Lounge and recreation rooms. 205.28. Nurses' station. 205.29. (Reserved). 205.31. Storage. 205.32. Janitor closet. 205.33. Utility room. 205.34. (Reserved). 205.35. (Reserved). 205.36. Bathing facilities. 205.37. Equipment for bathrooms. 205.38. Toilet facilities. 205.39. Toilet room equipment. 205.40. Lavatory facilities. MECHANICAL AND ELECTRICAL REQUIREMENTS
205.61. Heating requirements for existing and new construction. 205.62. Special heating requirements for new construction. 205.63. Plumbing and piping systems required for existing and new construction. 205.64. Special plumbing and piping systems requirements for new construction. 205.65. (Reserved). 205.66. Special ventilation requirements for new construction. 205.67. Electric requirements for existing and new construction. 205.68. Special electrical requirements for new construction. FURNISHINGS, EQUIPMENT AND SUPPLIES
205.71. Bed and furnishings. 205.72. Furniture. 205.73. (Reserved). 205.74. Lien. SUPPLIES
205.75. Supplies.
BUILDINGS AND GROUNDS § 205.1. Location or site.
A building to be used for and by residents shall be located in areas conducive to the health and safety of the residents.
§ 205.2. Grounds.
(a) Grounds shall be adequate to provide necessary service areas and outdoor areas for 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 residents.
§ 205.3. (Reserved).
§ 205.4. Buildings plans.
(a) There may be no new construction of a facility without the Department's approval of final plans. There may be no alterations or additions to an existing building or conversion of a building or facility made prior to the Department's approval of final plans.
(b) Plans, including architectural, mechanical and electrical plans, shall include requested changes and shall be submitted to the Department for final approval before construction, alterations or remodeling begins.
(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, administrative hearing may be sought under 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure).
(d) Plans shall be resubmitted to the Department for approval if construction or alteration has not been started within 24 months from the date the plans received final approval.
(e) Plans submitted to the Department for approval shall include the following items:
(1) Wall sections and details, including stairs, location and fastening of handrails and grab bars.
(2) Mechanical and electrical drawings.
(3) Schedules of room finishes, door type and size, plumbing fixtures, electrical fixtures and special equipment, such as sterilizers, kitchen equipment and the like.
(4) 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. (Reserved).
§ 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 residents. Special authorization shall be given by the Department's Division of 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 residents, employes, the licensee, the administrator or members of the administrator's immediate family.
MINIMUM PHYSICAL PLANT STANDARDS § 205.7. Basement or cellar.
Basements or cellars may be used for storage, laundry, kitchen, heat, electric and water equipment. Approval from the Department's Division of 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.
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) 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.
(b) Corridors shall be lighted adequately during the day and night.
(c) Areas used for corridor traffic may not be considered as areas for dining, storage, diversional or social activities.
§ 205.10. Doors.
(a) Doors into bathrooms and toilet rooms used by residents shall be at least 36 inches wide, except for an existing facility where the minimum width of toilet room doors is 32 inches.
(b) A door to a resident room shall swing into the room.
(c) A door to a toilet room which swings into the toilet area shall be equipped with special hardware which permits the door to be opened from the outside, and swing out, in case of emergency.
(d) Resident and visitor toilet stall doors shall swing out. Curtains or equivalent shall be considered as meeting this requirement.
(e) A door to a basement or a cellar may not be located in a resident room.
(f) A door opening to the exterior, which may be opened occasionally for ventilation purposes, with the exception of an approved exit door, shall be effectively covered with screening.
§ 205.11. (Reserved).
§ 205.12. Elevators.
(a) Elevator service shall be provided for residents when a 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.
(b) The cab platform of an elevator shall measure no less than 5 feet by 7 feet 6 inches. Cab and shaft door may have not less than a 44 inch opening and shall be power operated.
§ 205.13. Floors.
(a) Floors traveled by residents shall be of nonskid material.
(b) Floors in the kitchen, bathroom, toilet rooms, shower rooms, utility rooms, bedpan and hopper rooms shall be of nonskid, nonabsorbent materials and easily cleanable.
§ 205.14. Locks.
Doors into rooms used by residents may not be locked from the outside when the resident is in the room.
§ 205.15. (Reserved).
§ 205.16. Stairs.
Stairs used by residents shall have no locked gates or free swinging doors obstructing ascent or descent.
§ 205.17. Stairways.
There shall be indoor stairs and stairways to a basement if the stairs are to be used by personnel of the facility.
§ 205.18. (Reserved).
§ 205.19. Windows and windowsills.
(a) Window openings in the exterior walls that are used for ventilation shall be effectively covered by screening.
(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 resident bedrooms.
§ 205.20. Resident bedrooms.
(a) A bed for a resident shall be placed only in a bedroom approved by the Department.
(b) The maximum number of residents who may be accommodated in the facility shall be indicated on the license.
(c) The number of resident bedrooms and the number of beds in a room may not exceed the maximum number approved by the Department.
(d) Single bed bedrooms shall provide minimum room area clearance, in addition to the area of closets, vestibule, wardrobes and toilet rooms, of 100 square feet.
(e) Single resident bedrooms in facilities licensed prior to January 1975, shall contain at least 80 square feet of space.
(f) A multibed bedroom shall provide minimum room area clearances, in addition to the area of closets, vestibule, wardrobes and toilet rooms of 80 square feet per bed.
(g) In facilities licensed prior to January 1975, resident multibed bedrooms shall have at least 65 square feet of space per resident.
§ 205.21. Special care room.
(a) Provisions shall be made for isolating a resident as necessary in a single room which is ventilated to the outside as set forth in § 205.66 (relating to special ventilation requirements for new construction). For new construction, there shall be an adjoining private bathroom which contains a toilet, lavatory and either a standard size tub or a shower.
(b) Provisions shall be available to identify this room with appropriate precautionary signs.
§ 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 resident comfort and safety.
§ 205.23. Location of bedrooms.
A 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 a minimum dining area of 15 square feet per bed for the first 100 beds and 13 1/2 square feet per bed for beds over 100. This space is required in addition to the space required for lounge and recreation rooms. These areas shall be well lighted and well ventilated.
(b) Tables and space shall be provided to accommodate wheelchairs with trays and other devices.
§ 205.25. Kitchen.
(a) There shall be at least one kitchen large enough to meet the needs of the facility.
(b) A service pantry shall be provided for each nursing unit. The pantry shall contain a refrigerator, device for heating food, sink, counter and cabinets. For existing facilities, a service pantry shall be provided for a nursing unit unless the kitchen is sufficiently close for practical needs and has been approved by the Department.
§ 205.26. Laundry.
(a) A laundry room shall be provided in a facility where commercial laundry service is not used for the washing of soiled linens.
(b) The entrance and exit to the laundry room shall be located to prevent the transportation of soiled or clean linens through food preparation, food storage or food serving areas.
(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.
(d) A facility shall provide a separate room or area for central storage of clean linens and linen carts.
(e) Equipment shall be made available and accessible for residents desiring to do their personal laundry.
§ 205.27. Lounge and recreation rooms.
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 residents on each floor.
§ 205.28. Nurses' station.
(a) A nurses' station shall be located in each nursing unit, located as centrally as practical within the nursing unit. A common nurses' station serving more than a single nursing unit may be permitted when the design of the project and method of operation indicate a satisfactory level of service. The size and facilities of the nurses' station shall be increased appropriate to the number of beds served and additional staffing required.
(b) The nurses' station may not be more than 120 feet from the most remote resident room served.
(c) The nurses' station shall have facilities for:
(1) A nurses' call system.
(2) Charting and supplies.
(3) Medication storage and preparation, which may be within the clean workroom, if a self-contained cabinet is provided. The medication storage cabinet shall be locked. Mechanical ventilation shall be provided in this workroom. If a medication cart is used, provisions shall be made to lock the cart or to place the cart when not in use in a safe area that can be locked. The cart may not be stored in the corridor.
(4) A double-locked narcotic compartment within the medication area.
§ 205.29. (Reserved).
§ 205.31. Storage.
General storage space shall be provided for storage of supplies, furniture, equipment, 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.
§ 205.32. Janitor closet.
(a) At least one janitor closet shall be provided in a unit. If physical arrangement permits, one janitor's closet may serve more than one nursing unit or wing.
(b) A separate janitor's closet is required for the kitchen.
§ 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 resident corridors, a soiled utility room shall be on each unit.
(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. (Reserved).
§ 205.35. (Reserved).
§ 205.36. Bathing facilities.
(a) The facility shall provide a general bathing area in each nursing unit to serve residents' bedrooms which do not have adjoining bathrooms with a bathtub or shower.
(b) Bathing fixtures for either the tub or shower shall be provided at a ratio of one fixture per 15 beds or major fraction thereof.
(c) Unless bathing fixtures are located in a separate room, there shall be compartments to permit privacy. Cubicle curtains may provide this privacy.
(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 resident.
(e) Each bathing room shall include a toilet and lavatory. If more than one tub or shower is in the bathing room, privacy shall be provided at each bathing facility and at the toilet.
(f) Showers designed for wheelchair use may be no less than 4 feet square, shall be without curbs and shall have handrails and curtains.
(g) Water controls for handicapped shower areas shall be located outside the shower stall. Other shower areas may have standard installation of shower controls.
(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.
§ 205.37. Equipment for bathrooms.
(a) Grab bars shall be installed as necessary at each tub and shower for safety and convenience. Grab bars, accessories and anchorage shall have sufficient strength to sustain a weight of 250 pounds for 5 minutes.
(b) The general bathroom or shower room used by 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 resident from both the toilet and tub or shower.
(c) Provisions shall be made available to get residents in and out of bathtubs in a safe way to prevent injury to residents and personnel. The facility shall provide appropriate supervision and assistance to ensure the safety of all residents being bathed.
(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.
(e) The facility shall ensure that water for baths and showers is at a safe and comfortable temperature before the resident is bathed.
§ 205.38. Toilet facilities.
(a) In toilet rooms that adjoin resident bedrooms, there shall be at least one toilet for four 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.
(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) Floors or units with more than eight 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.
(f) Toilets and lavatories other than resident facilities shall be provided for male and female visitors in facilities.
§ 205.39. Toilet room equipment.
(a) Toilet rooms shall be provided with lavatory, soap or soap dispenser, paper towels, mechanical dryer or other sanitary means of toweling. In toilet rooms adjacent to bedrooms, the lavatory may be omitted if provided in each bedroom.
(b) Toilets used by 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.
§ 205.40. Lavatory facilities.
(a) A floor occupied by residents shall have lavatories in the ratio of 1:4 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 residents.
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) Exposed heating pipes, hot water pipes or radiators in rooms and areas used by residents or within reach of residents, shall be covered or protected to prevent injury or burns to residents. This includes hot water or steam piping above 125°F.
§ 205.62. Special heating requirements for new construction.
(a) Boiler feed pumps, heat circulating pumps, condensate return pumps and fuel oil pumps shall be connected and installed so that the total load can be carried by the remaining pumps with one pump out of service.
(b) To prevent shutting down the entire system when repairs are required, supply and return mains and risers of cooling, heating and process steam systems shall be valved to isolate the various sections of the system. Each piece of equipment shall be valved at the supply and return.
§ 205.63. Plumbing and piping systems required for existing and new construction.
(a) Potable ice may not be manufactured or stored in the soiled utility room.
(b) Water distribution systems shall be designed and arranged to provide potable hot and cold water at hot and cold water outlets at all times. The system pressure shall be sufficient to operate fixture and equipment during maximum demand periods.
(c) Hot water outlets accessible to residents shall be controlled so that the water temperature of the outlets does not exceed 110°F.
§ 205.64. Special plumbing and piping systems requirements for new construction.
(a) Plumbing systems shall be installed to meet the requirements of local plumbing codes and Chapter 14, Medical Care Facility Plumbing Equipment, of the PHCC National Standard Plumbing Code. Sections 14.22 and 14.23 of the PHCC National Standard Plumbing Code are not mandatory, but are recommended. If the codes listed in this subsection conflict, the most stringent requirement shall apply.
(b) Approved backflow preventers or vacuum breakers shall be installed with plumbing fixtures or equipment where the potable water supply outlet may be submerged and which is not protected by a minimum air gap. This includes hose bibs, janitor sinks, bedpan-flushing attachments and other fixtures to which hoses or tubing can be attached.
(c) Each water service main, branch main, riser and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture.
(d) Shower bases and tubs shall provide nonskid surfaces for standing residents.
§ 205.65. (Reserved).
§ 205.66. Special ventilation requirements for new construction.
(a) Ventilation for new construction shall conform to the following:
Pressure Minimum Air Minimum Total All Air Recirculated Relationship to Changes of Outdoor Air Changes Directly within Area Designation Adjacent Areas Air Per Hour Per Hour to Outdoors Room Units Resident Room Equal 2 2 Optional Optional Resident Area Corridor Equal Optional 2 Optional Optional Physical therapy Negative 2 6 Optional Optional Occupational therapy Negative 2 6 Optional Optional Soiled workroom or soiled holding Negative 2 10 Yes No Clean workroom or clean holding Positive 2 4 Optional Optional Toilet room Negative Optional 10 Yes No Bathroom Negative Optional 10 Yes No Janitor's closet Negative Optional 10 Yes No Sterilizer equipment room Negative Optional 10 Yes No Linen and trash chute rooms Negative Optional 10 Yes No Food preparation center Equal 2 10 Yes Yes Warewashing room Negative Optional 10 Yes Yes Dietary day storage Equal Optional 2 Yes No Laundry, general Equal 2 10 Yes No Soiled linen sorting and storage Negative Optional 10 Yes No Clean linen storage Positive Optional 2 Yes No Special Care Room/Isolation Negative 2 6 Yes No (b) Central air systems shall be provided with filters having a minimum efficiency of 25% based on ASHRAE Standard No. 52-68 and certified by an independent testing agency. Central air systems shall have a manometer installed across each filter bed.
(c) Air supply systems shall be operated mechanically. Air exhaust and return systems shall be operated mechanically, except for air not required to be exhausted directly outdoors as indicated in subsection (a). Where subsection (a) requirements for outdoor air is optional, this air may be supplied directly by transfer ducts or grilles to adjacent spaces without being filtered through a central system. Air may not be transferred to or from corridors, to or from adjacent spaces, except as permitted in the applicable edition of the National Fire Protection Association 101 Life Safety Code which is currently adopted by the Department.
(d) The dietary dry storage and kitchenware washing rooms may use direct air from the kitchen without being filtered through a central system.
(e) The ventilation rates indicated in subsection (a) are minimum mandatory rates for the area listed and may not be construed as precluding the use of higher rates. For areas not listed, such as dining rooms, lounge and recreation rooms, solaria, and the like, mechanical ventilation rates are optional, but where mechanical ventilation is provided, the supply air shall be obtained from the outdoors through individual room units or from central systems. The unlisted room areas, if ventilated, shall contain an equal pressure relationship.
(f) Where mechanical ventilation is not mandatory or provided, the areas may be ventilated by outside windows that can be easily opened and closed.
(g) Outdoor air intakes may be no less than 25 feet from waste air discharges, such as discharge from ventilation systems, combustion stacks, plumbing vents, vehicle exhaust and the like. The bottom of outdoor air intakes serving central systems and kitchens may not be less than 3 feet above the finished grade or roof level.
(h) Ventilation air openings which are located near floors shall be installed not less than 3 inches above the finished floor.
(i) Air quantities in cubic feet per minute shall be indicated on the drawings for room supply, return and exhaust ventilation openings.
§ 205.67. Electric requirements for existing and new construction.
(a) Artificial lighting shall be restricted to electric lighting.
(b) Spaces occupied by people, machinery and equipment within buildings shall have electric lighting which is operational at all times.
(c) Electric lights satisfactory for residents' activities shall be available.
(d) Electric lights in rooms used by residents shall be placed or shaded to prevent direct glare to the eyes of residents.
(e) Night lights shall be provided in bedrooms, stairways, corridors, bathrooms and toilet rooms used by residents.
(f) Arrangements to transfer lighting from overhead fixtures to night light fixtures in stairways and corridors shall be designed so that switches can only select between two sets of fixtures and cannot extinguish both sets at the same time.
(g) In addition to night lights, residents' bedrooms shall have general lighting. The light emitting surfaces of the night light may not be in direct view of a resident in a normal in-bed position.
(h) A reading light shall be provided for each resident.
(i) In each 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.
(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 resident bed location so that it is accessible to the resident. Two cables and buttons serving adjacent beds may be served by one station. An emergency calling station within reach of the resident shall be provided at each bathing fixture and toilet unless a single bell can be reached by the 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.
(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 resident's door. In multicorridor nursing units, additional visible signal indicators shall be installed at corridor intersections.
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