| (A) Entrance. Entrances shall be located at grade level, be accessible to individuals with disabilities, and be protected against inclement weather from the point of passenger loading/unloading to the building entrance. When an ASC is located on a floor above grade level, elevators shall be accessible and shall meet the requirements of §135.53 of this title (relating to Elevators, Escalators, and Conveyors). (B) Waiting area. A waiting area or lobby shall be provided within the ASC and include having the following rooms and items: (i) public toilet facilities; (ii) telephone(s) for public use; and (iii) access to potable drinking water. (C) Reception area. A designated reception area with desk or counter shall be provided. (D) Interview space(s). Space shall be provided for private interviews or family members, relating to social services, credit, or admission. (E) General or individual office(s). An office(s) shall be provided for business transactions, records, and administrative and professional staff. (F) Medical records area. The medical records area shall have adequate space for reviewing, dictating, sorting, or recording records. If electronic imaging devices are employed (i.e., microfilm, digital, or optical disc), the medical records area shall have adequate space for transcribing records in the electronic format. Medical record storage space shall be located within a secure designated area under direct visual supervision of administrative staff. (G) General storage room. (i) A minimum of 30 square feet per operating room shall be provided exclusive of soiled holding, sterile supplies, clean storage, drug storage, locker rooms, and surgical equipment storage. General storage may be located in one or more rooms or closets, and shall be located outside of the patient treatment areas. (ii) General storage room(s) shall be separated from adjacent areas by fire-rated construction in accordance with the NFPA 101, §38.3.2.1 and §38.3.2.2. (H) Wheelchair storage space or alcove. Storage space for wheelchairs shall be provided and shall be out of the direct line of traffic. (2) Engineering services and equipment areas. Equipment rooms with adequate space shall be provided for mechanical and electrical equipment. These areas shall be separate from public, patient, and staff areas. (3) Examination room. An examination room is not required, but when provided, the room shall have: (A) a minimum clear floor area of at least 80 square feet exclusive of fixed or moveable cabinets, counters, or shelves; and (B) a work counter with space for writing and a hand washing fixture with hands-free operable controls. (4) Janitor's closet. In addition to the janitor's closet exclusive to the surgery suite, a sufficient number of janitor's closets shall be provided throughout the facility to maintain a clean and sanitary environment. The closet shall contain a floor receptor or service sink and storage space for housekeeping supplies and equipment. (5) Laboratory. (A) General. Laboratory services shall be provided within the ASC or through a contract or other arrangement with a hospital or accredited laboratory. (B) Special requirements. When the laboratory is located on site the following minimum items shall be provided: (i) a room with work counter, utility sink, and storage cabinets or closet(s); and (ii) specimen collection facilities. For dip stick urinalysis, urine collection rooms shall be equipped with a water closet and lavatory. Blood collection facilities shall have space for a chair, work counter, and a hand washing fixture with hands-free operable controls. (C) Code compliance. An on-site laboratory shall comply with the following codes. (i) Construction for fire protection in laboratories employing quantities of flammable, combustible, or other hazardous material shall be in accordance with the National Fire Protection Association 99, Health Care Facilities, 2002 Edition, (NFPA 99). (ii) Laboratories shall comply with the requirements of NFPA 99, Health Care Facilities, 2002 Edition, Chapter 11, as applicable and the requirements of NFPA 45, Standards on Fire Protection for Laboratories Using Chemicals, 2000 Edition, as applicable. (6) Laundry and linen processing area(s). Laundry and linen processing may be done within the center or off site at a commercial laundry. (A) On-site linen processing. When on-site linen processing is provided, soiled and clean processing operations shall be separated and arranged to provide a one-way traffic pattern from soiled to clean areas. The following rooms and items shall be provided: (i) a soiled linen processing room which includes areas for receiving, holding, sorting, and washing; (ii) a clean linen processing room which includes areas for drying, sorting, folding, and holding prior to distribution; (iii) supply storage cabinets in the soiled and clean linen processing rooms; (iv) a hand washing fixture with hands-free operable controls within the soiled linen processing room; and (v) a storage room for clean linen located within the surgical suite. Clean linen storage may be combined with the clean work room. (B) Off-site linen processing. When linen is processed off site, the following rooms or items shall be provided: (i) a storage room for clean linen located within the surgical suite. Clean linen storage may be combined with the clean work room; and (ii) a soiled linen holding room or area located within the surgical suite. Soiled linen holding may be combined with the soiled workroom. (7) Medical waste processing. Space and facilities shall be provided for the safe storage and disposal of waste as appropriate for the material being handled and in compliance with all applicable rules and regulations. (8) Pharmacy. A pharmacy work room or alcove shall be provided and located separate from patient and public areas and under the direct supervision of staff. A work counter, refrigerator, medication storage, and locked storage for biologicals and drugs shall be provided. A hand washing fixture with hands-free operable controls shall be located in the pharmacy room or alcove. (9) Postoperative recovery suite. (A) General. A postoperative recovery suite shall be distinct and separate from preoperative areas. The postoperative recovery suite shall be arranged to provide a one-way traffic pattern from the restricted surgical corridor to the postoperative recovery suite, and then to the extended observation rooms or discharge. (B) Postanesthesia care unit. A minimum of one patient station per operating room, plus one additional station, shall be provided. (i) In a multiple-bed postoperative recovery area, the clearance between the side of a bed/gurney and a wall/partition shall be a minimum of three feet. The clearance between sides of beds/gurneys shall be a minimum of four feet six inches. The minimum distance at the foot of the bed/gurney shall not be less than six feet for single load area/room or nine feet for double load area/room. Four feet of the passage space at the foot of the bed may be shared between two beds/gurneys. The fixed and moveable cabinets and shelves shall not encroach upon the bed/gurney clear floor space/area. (ii) The minimum clear floor space in a private postoperative recovery room shall be 100 square feet exclusive of aisles and fixed and moveable cabinets and selves. A minimum of nine feet width shall be provided for the head wall. (C) Patient toilet. A toilet room with a water closet and a hand washing fixture with hands-free operable controls shall be provided. The toilet room may be shared with the preoperative patient holding area, if located conveniently between both areas. (D) Hand washing fixture. One hand washing fixture with hands-free operable controls shall be provided for every four recovery beds or fraction thereof in open wards. Fixtures shall be uniformly distributed. One hand washing fixture shall be provided within each single-bed recovery room. (E) Extended observation rooms. Separate supervised rooms or areas may be provided for patients who are sufficiently stabilized to leave the postanesthesia care unit, but require additional time in the facility for observation or comfort measures prior to being discharged. (i) When individual rooms are provided for extended observation, the rooms shall have an area of at least 60 square feet. When such rooms include a bed or recliner, a minimum clearance of three feet at the foot and on each side of the bed or recliner shall be provided. Cont'd... |
