| (ii) A laundry processing room shall be provided which
shall contain commercial type equipment capable of processing at
least a seven-day laundry supply within the regular scheduled work
week.
(iii) A clean linen processing room shall be provided
and shall include built-in dryers and folding counters or tables.
This area shall have provisions for inspections, folding, packing
and mending of linen.
(iv) A holding room or area for storage and issuing
of clean linen shall be provided but may be combined with clean linen
processing room.
(C) Off-site laundry processing. When linen is processed
off the facility site, the following minimum requirements shall be
provided on-site:
(i) a service entrance which shall have protection
from inclement weather, for loading and unloading of linen;
(ii) control station for pickup and receiving;
(iii) soiled linen holding room;
(iv) a central clean linen storage room and issuing
room in addition to linen storage required at the individual patient
suites. This central holding area shall include provisions for inspecting,
sorting, and mending; and
(v) cart storage areas. The areas shall be located
out of pedestrian traffic and shall be provided separately for clean
and soiled linen.
(D) Service areas for on-site laundry processing. The
laundry shall be separated from patient rooms, areas of food preparation
and storage, and areas in which clean supplies and equipment are stored.
An on-site laundry shall have the following services areas and facilities:
(i) office space for director of laundry services;
(ii) equipment layout for soiled and clean linen. The
laundry equipment processing shall be arranged to permit an orderly
work flow and minimize cross-traffic that might mix clean and soiled
operations;
(iii) storage. Storage space and cabinets for soaps,
stain removers, and other laundry processing agents shall be located
in the soiled and clean processing rooms;
(iv) cart sanitizing shall comply with subsection (b)
of this section;
(v) staff toilets. Toilets may be outside the unit
but shall be convenient for staff use and shall contain hand washing
fixtures with hands-free operable controls;
(vi) staff lockers. Lockers may be in laundry suite
or part of a central locker area when convenient to the laundry; and
(vii) housekeeping room.
(2) Mechanical Requirements. Mechanical requirements
shall be in accordance with §134.122(d)(3) of this title and
this paragraph.
(A) The ventilation system shall include adequate intake,
filtration, exchange rate, and exhaust in accordance with Table 3
and Table 4 of §134.131(c) and (d) of this title.
(B) Filtration requirements for air handling units
serving the laundry suite shall be equipped with filters having efficiencies
equal to, or greater than specified in Table 4 of §134.131(d)
of this title.
(C) Direction of air flow of the HVAC systems shall
be from clean to soiled areas.
(D) The ventilation system for soiled processing area
shall have negative air pressure while the clean processing area shall
have positive pressure.
(m) Medical records suite. The following rooms, areas,
or offices shall be provided in the medical records suite:
(1) medical records administrator or technician office;
(2) review and dictating rooms or spaces;
(3) work area which includes provisions for sorting,
recording, or microfilming records; and
(4) file storage room. Rooms containing open file systems
or moveable filing storage systems shall be considered as hazardous.
The construction protection for the storage room or area shall comply
with NFPA 101, §18-3.2.
(n) Nursing suite. The nursing suite shall be designed
to facilitate care of ambulatory and nonambulatory inpatients.
(1) Physical environment. A nursing suite shall provide
a safe environment for patients and staff.
(A) The environment of the unit shall be characterized
by a feeling of openness with emphasis on natural light and exterior
views and with the organization of various functions accessible to
common spaces while not jeopardizing desirable levels of patient privacy.
(B) Interior finishes, lighting, and furnishings shall
present an atmosphere which is as noninstitutional as possible, consistent
with applicable fire safety requirements. Security and safety devices
should not be present in a manner to attract or challenge tampering
by patients.
(2) Architectural requirements. Architectural requirements
shall be in accordance with §134.122(d)(1) of this title and
this paragraph.
(A) Handicapped accessibility requirements. At least
10% of patient room suites, bathing units and toilets, and all public
and common use areas shall be designed and constructed to be handicapped
accessible. These requirements shall apply in all new construction
and when an existing nursing suite or a portion thereof is converted
from one service to another.
(B) Patient room suites. A patient room suite shall
consist of the patient room and a toilet room or bathroom. Patient
room suites shall comply with the following requirements.
(i) Maximum patient room capacity. The maximum patient
room capacity shall be two patients. In existing facilities where
renovation work is undertaken and the present capacity is more than
two patients, the maximum room capacity shall be no more than the
present capacity with a maximum of four patients.
(ii) Single-bed patient room. In a single-bed patient
room, the minimum clear floor area shall be 100 square feet. The minimum
clear floor area in an accessible private patient room shall be 120
square feet. The minimum room dimension shall be not less than 10
feet.
(iii) Multi-bed patient room. In a multi-bed patient
room, the minimum clear floor area shall be 80 square feet per bed.
Minimum clear floor space in an accessible multi-bed room shall be
110 square feet per bed. Design of multi-bed patient rooms shall not
restrict independent patient access to the corridor, lavatory, or
bathroom.
(iv) Arrangement of patient rooms. Minor encroachments
including columns and wall hung lavatories that do not interfere with
functions may be ignored when determining space requirements for patient
rooms.
(I) Required clear floor space in patient rooms shall
be exclusive of toilet rooms, closets, lockers, built-in cabinets,
wardrobes, alcoves, or vestibules.
(II) A clearance of 3 feet 8 inches shall be available
at the foot of each bed in multi-bed patient rooms to permit the passage
of equipment and beds. A minimum distance of three feet between a
wall and the side of a bed and four feet between beds shall be provided.
A minimum distance of five feet between a wall and the side of a bed
and four feet between beds shall be provided in an accessible semi-private
room or one intended for rehabilitation patients. Arrangement of beds
shall be such that sufficient space is provided for a bed and maneuvering
space for a wheelchair.
(III) Sleeping areas shall have doors for privacy.
Design for visual privacy in multi-bed rooms shall not restrict patient
access to the room, toilet, or observation by staff.
(v) Patient bathroom. Each patient shall have access
to a bathroom without having to enter the general corridor area. Each
bathroom shall contain a toilet, hand washing fixtures, and storage
shelf or cabinet and serve not more than four patient beds or two
patient rooms. Hand washing fixtures may be located in the patient
room.
(vi) Bathing rooms. One bathtub or shower shall be
provided for each four patient beds or space which is not otherwise
served by bathing rooms within patients' rooms. Each tub or shower
shall be in an individual room or enclosure which provides space for
the private use of the bathing fixture and for drying and dressing.
(vii) Patient storage. Each patient shall have a separate
wardrobe, locker, or closet that is suitable for hanging full-length
garments and for storing personal effects. A minimum of 12 lineal
inches of hanging space shall be provided per patient.
(C) Security rooms. When security rooms are provided
by the treatment program narrative, the security rooms shall be single
patient suite rooms designed to minimize potential for escape, hiding,
injury to self or others, or suicide. Access to toilets, showers,
and wardrobes shall be restricted. The patient room suite shall be
in accordance with subparagraph (B)(ii) of this paragraph. Security
rooms may be centralized on one unit or decentralized among units.
Cont'd... |
