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(II) Cubicle curtains shall be provided to assure patient
privacy.
(ii) Flame spread, smoke development and noxious gases.
Flame spread and smoke developed limitations of interior finishes
shall comply with Table 2 of §134.131(b) of this title and NFPA
101, §10-2.1. 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 Determining Smoke
Generation of Solid Materials, 1997 edition, shall be provided.
(iii) Floor finishes. Flooring shall be easy to clean
and have wear resistance appropriate for the location involved. Floors
that are subject to traffic while wet (such as shower and bath areas,
kitchens, and similar work areas) shall have a nonslip surface. In
all areas frequently subject to wet cleaning methods, floor materials
shall not be physically affected by germicidal and cleaning solutions.
The following are acceptable floor finishes:
(I) painted concrete;
(II) vinyl and vinyl composition tiles and sheets;
(III) monolithic or seamless flooring. Where required,
seamless flooring shall be impervious to water, coved and installed
integral with the base, tightly sealed to the wall, and without voids
that can harbor insects or retain dirt particles. Welded joint flooring
is acceptable;
(IV) ceramic and quarry tile;
(V) wood floors;
(VI) carpet flooring. Carpeting installed in patient
rooms and similar patient care areas shall be treated to prevent bacterial
and fungal growth;
(VII) terrazzo; and
(VIII) poured in place floors.
(iv) Wall finishes. Wall finishes shall be smooth,
washable, moisture resistant, and cleanable by standard housekeeping
practices. Wall finishes shall comply with requirements contained
in Table 2 of §134.131(b) of this title, and NFPA 101, §18-3.3.
(I) Wall finishes shall be water resistant in the immediate
area of plumbing fixtures.
(II) Wall finishes in areas subject to frequent wet
cleaning methods shall be impervious to water, tightly sealed and
without voids.
(v) Floor, wall and ceiling penetrations. Floor, wall
and ceiling penetrations by pipes, ducts, and conduits shall be tightly
sealed to minimize entry of dirt particles, rodents and insects. Joints
of structural elements shall be similarly sealed.
(vi) Ceiling types. All occupied rooms and spaces shall
be provided with finished ceilings. Ceilings which are a part of
a rated roof/ceiling assembly or a floor/ceiling assembly shall be
constructed of listed components and installed in accordance with
the listing. Three types of ceilings that are required in various
areas of the facility are:
(I) Ordinary ceilings. Ceilings such as acoustical
tiles installed in a metal grid which are dry cleanable with equipment
used in daily housekeeping activities such as dusters and vacuum cleaners.
(II) Washable ceilings. Ceilings that are made of washable,
smooth, moisture impervious materials such as painted lay-in gypsum
wallboard or vinyl faced acoustic tile in a metal grid.
(III) Monolithic ceilings. Ceilings which are monolithic
from wall to wall (painted solid gypsum wallboard), smooth and without
fissures, open joints, or crevices and with a washable and moisture
impervious finish.
(vii) Special construction. Special conditions may
require special wall and ceiling construction for security in areas
such as storage of controlled substances and areas where patients
are likely to attempt suicide or escape.
(viii) Materials finishes. Materials known to produce
noxious gases when burned shall not be used for mattresses, upholstery,
and wall finishes.
(3) General mechanical requirements. This paragraph
contains common requirements for mechanical systems; steam and hot
and cold water systems; air-conditioning, heating and ventilating
systems; plumbing fixtures; piping systems; and thermal and acoustical
insulation. The facility shall comply with the requirements of this
paragraph and any specific mechanical requirements for the particular
unit or suite of the facility in accordance with §134.123 of
this title.
(A) Cost. All mechanical systems shall be designed
for overall efficiency and life cycle costing, including operational
costs. Recognized engineering procedures shall be followed to achieve
the most economical and effective results. In no case shall patient
care or safety be sacrificed for conservation.
(B) Equipment location. Mechanical equipment may be
located indoors or outdoors (when in a weatherproof enclosure), or
in separate building(s).
(C) Vibration isolation. Mechanical equipment shall
be mounted on vibration isolators as required to prevent unacceptable
structure-borne vibration. Ducts, pipes, etc. connected to mechanical
equipment which is a source of vibration shall be isolated from the
equipment with vibration isolators.
(D) Performance and acceptance. Prior to completion
and acceptance of the facility, all mechanical systems shall be tested,
balanced, and operated to demonstrate to the design engineer or his
representative that the installation and performance of these systems
conform to the requirements of the plans and specifications.
(i) Material lists. Upon completion of the contract,
the owner shall be provided with parts lists and procurement information
with numbers and description for each piece of equipment.
(ii) Instructions. Upon completion of the contract,
the owner shall be provided with instructions in the operational use
of systems and equipment as required.
(E) Heating, ventilating and air conditioning (HVAC)
systems. All HVAC systems shall comply with and shall be installed
in accordance with the requirements of National Fire Protection Association
90A, Standard for the Installation of Air Conditioning and Ventilating
Systems, 1999 edition, (NFPA 90A), NFPA 99, Chapter 5, the requirements
contained in this subparagraph, and the specific requirements for
a particular unit in accordance with §134.123 of this title.
(i) General ventilation requirements. All rooms and
areas in the facility listed in Table 3 of §134.131(c) of this
title shall have provision for positive ventilation. Fans serving
exhaust systems shall be located at the discharge end and shall be
conveniently accessible for service. Exhaust systems may be combined,
unless otherwise noted, for efficient use of recovery devices required
for energy conservation. The ventilation rates shown in Table 3 of
§134.131(c) of this title shall be used only as minimum requirements
since they do not preclude the use of higher rates that may be appropriate.
Supply air to the building and exhaust air from the building shall
be regulated to provide a positive pressure within the building with
respect to the exterior.
(I) Cost reduction methods. To reduce utility costs,
the building design and systems proposed shall utilize energy conserving
procedures including recovery devices, variable air volume, load shedding,
systems shut down or reduction of ventilation rates (when specifically
permitted) in certain areas when unoccupied, insofar as patient care
is not jeopardized.
(II) Economizer cycle. Mechanical ventilation shall
be arranged to take advantage of outside air supply by using an economizer
cycle when appropriate to reduce heating and cooling systems loads.
Innovative design that provides for additional energy conservation
while meeting the intent of this section for acceptable patient care
will be considered.
(III) Outside air intake locations. Outside air intakes
shall be located at least 25 feet from exhaust outlets of ventilating
systems, combustion equipment stacks, medical-surgical vacuum systems,
plumbing vents, or areas which may collect vehicular exhaust or other
noxious fumes. (Prevailing winds and proximity to other structures
may require other arrangements.) Plumbing and vacuum vents that terminate
five feet above the level of the top of the air intake may be located
as close as 10 feet.
(IV) Low air intake location limit. The bottom of outside
air intakes serving central systems shall be located as high as practical
but at least six feet above ground level, or if installed above the
roof, three feet above the roof level.
(V) Contaminated air exhaust outlets. Exhaust outlets
from areas (kitchen hoods, ethylene oxide sterilizers, etc.) that
exhaust contaminated air shall be above the roof level and arranged
to exhaust upward.
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