| (5) Staff toilet room(s) shall be provided and include hand washing sink(s) with hands-free operable controls. The toilet room shall be outside the treatment area but convenient for staff use only. (6) The water treatment and equipment for the dialysis shall be located in a room not accessible to unauthorized persons. The water room shall be designed and house the water treatment system and meet the requirements of §117.32(b) of this title. (f) Details and finishes in new construction projects, including additions and alterations, shall be in compliance with this subsection, with NFPA 101, Chapter 20, and with local building codes. (1) General detail requirements. (A) Fire safety features, including compartmentation, means of egress, automatic extinguishing systems, inspections, smoking regulations, and other details relating to fire prevention and fire protection shall comply with §117.101 of this title (relating to Construction Requirements for an Existing End Stage Renal Disease Facility), and NFPA 101, Chapter 20. The Fire Safety Evaluation System for Health Care Occupancies contained in the National Fire Protection Association 101A, Alternative Approaches to Life Safety, 2001 Edition, Chapter 4, shall not be used in new building construction, renovations or additions to existing ESRD facilities. (B) Exits, corridors and doors. (i) A facility shall provide two exits remote from each other in accordance with NFPA 101, §20.2.4.1. At least one exit door shall be accessible by an ambulance from the outside. This door may also serve as an entry for loading or receiving goods. (ii) Corridors providing access to all patient treatment area(s) and exits shall be at least three feet eight inches in clear and unobstructed width, not less than seven feet six inches in height, and constructed in accordance with requirements listed in NFPA 101, §20.2.1. (iii) Items such as drinking fountains and vending machines shall be so located as to not project into and restrict exit corridor traffic or reduce the exit corridor width below the required minimum. Portable equipment shall not be stored so as to project into and restrict exit corridor traffic or reduce the exit corridor width below the required minimum. (iv) Doors at all openings between corridors and rooms or spaces subject to occupancy shall be swing type. Elevator doors are excluded from this requirement. (v) Doors, except doors to spaces such as small closets which are not subject to occupancy, shall not swing into corridors in a manner that might obstruct traffic flow or reduce the required corridor width. Large walk-in type closets are considered as occupiable spaces. (vi) All doors in the means of egress shall be not less than 36 inches in clear width. (vii) The minimum width of doors for patient access to treatment, examination, and consultation areas/rooms shall be 36 inches in clear width. (viii) Rooms containing a toilet, intended for patient use, shall be provided with at least one door having hardware which will permit access from the outside in any emergency. (ix) Horizontal sliding doors serving an occupant load of fewer than 10 shall be permitted. The area served by the door shall have no high hazard contents. The door shall be readily operable from either side without special knowledge or effort. The force required to operate the door in the direction of door travel shall be not more than 30 pounds per foot to set the door in motion, and shall be not more than 15 pounds per foot to close the door or open in the minimum required width. The door assembly shall comply with any required fire protection rating, and, where rated, shall be self-closing or automatic closing. The sliding doors opening to the egress corridor doors shall have a latch or other mechanism that ensures that the doors will not rebound into a partially open position if forcefully closed. The sliding doors may have breakaway provisions and shall be installed to resist passage of smoke. The latching sliding panel shall have a minimum clear opening of 36 inches in the fully open position. The fixed panels may have recessed tracks. (x) Doors shall not open immediately onto a stair without a landing. The landing shall be 44 inches deep or have a depth at least equal to the door width, whichever is greater. (xi) All fire doors shall be listed by an independent testing laboratory and shall meet the construction requirements for fire doors in National Fire Protection Association 80, Standard for Fire Doors and Fire Windows, 1999 Edition. Reference to a labeled door shall be construed to include labeled frame and hardware. (C) Glass doors, lights, sidelights, borrowed lights, and windows located within 12 inches of a door jamb or with a bottom-frame height of less than 18 inches and a top-frame height of more than 36 inches above the finished floor which may be broken accidentally by pedestrian traffic shall be glazed with safety glass or plastic glazing material that will resist breaking and will not create dangerous cutting edges when broken. Similar materials shall be used for wall openings in activity areas such as recreation and exercise rooms, unless otherwise required for fire safety. Safety glass, tempered or plastic glazing materials shall be used for shower doors and bath enclosures, interior windows and doors. Plastic and similar materials used for glazing shall comply with the flame spread ratings of NFPA 101, §18.3.3. (D) Grab bars shall be provided at patient toilets and at the weight scales. The bars shall be one and one-half inches in diameter, shall have either one and one-fourth or one and one-half inches clearance to walls, and shall have sufficient strength and anchorage to sustain a concentrated vertical or horizontal load of 250 pounds. Grab bars intended for use by the disabled shall also comply with ADA requirements. (E) Location and arrangement of fittings for hand washing sinks shall permit their proper use and operation. Hand washing sinks with hands-free operable controls shall be provided within each workroom, examination, treatment room, and toilet room. Hands-free includes blade-type handles, and foot, knee, or sensor operated controls. Particular care shall be given to the clearances required for blade-type operating handles. Lavatories and hand washing sinks shall be securely anchored to withstand an applied vertical load of not less than 250 pounds on the front of the sink. In addition to the specific areas noted, hand washing sinks shall be provided and conveniently located for staff use throughout the ESRD facility where patient care contact occurs and services are provided. (F) A liquid or foam soap dispenser shall be located at each hand washing sink. (G) Provisions for hand drying shall be included at all hand washing sinks. There shall be hot air dryers or individual paper towel dispensers enclosed in such a way as to provide protection against dust or soil and ensure single-unit dispensing. (H) The minimum ceiling height shall be eight feet with the following exceptions. (i) Boiler rooms shall have ceiling clearances not less than two feet six inches above the main boiler header and connecting piping. (ii) Rooms containing ceiling-mounted equipment shall have the ceiling height clearance increased to accommodate the equipment or fixtures. (iii) Suspended tracks, rails, pipes, signs, lights, door closers, exit signs, and other fixtures that protrude into the path of normal traffic shall not be less than six feet eight inches above the finished floor. (I) The dialysis facility shall not be located directly under recreation rooms, exercise rooms, and similar spaces where impact noises may be generated unless special provisions are made to minimize noise. (J) Rooms containing heat-producing equipment such as heater rooms, laundries, etc. shall be insulated and ventilated to prevent any occupied floor surface above from exceeding a temperature differential of 10 degrees Fahrenheit above the ambient room temperature. (K) Thresholds and expansion joint covers shall be flush or not more than one-half inch above the floor surface to facilitate the use of wheelchairs and carts. Expansion and seismic joints shall be constructed to restrict the passage of smoke and fire and shall be listed by a nationally recognized testing laboratory. (2) General finish requirements. (A) Portable privacy screens shall be provided to assure patient privacy when required or requested by a patient. When not in use the screens shall be stored conveniently within the treatment area for immediate use. (B) Flame spread and smoke developed limitations of interior finishes shall comply with NFPA 101, §10.2. The use of materials known to produce large or concentrated amounts of noxious or toxic gases shall not be used in exit accesses or in patient areas. Copies of laboratory test reports for installed materials tested in accordance with National Fire Protection Association 255, Standard Method of Test of Surface Burning Characteristics of Building Materials, 2000 Edition, and National Fire Protection Association 258, Standard Research Test Method for Cont'd... |
