Health, Family Health and Preparedness, Licensing

Rule R432-14

Birthing Center Construction Rule

Notice of Proposed Rule

(Amendment)

DAR File No.: 35469
Filed: 11/18/2011 04:19:22 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

In Section R432-14-3, updates a referenced standard that is out of date and out of print and eliminates the possible use of buildings that do not comply with the Life Safety Code. In Section R432-14-4, renumbers to match the reformatted version of the referenced standard and elimination of a definition that is located in another referenced rule. Coordination with the revised title of the updated federal accessibility standard. In Section R432-14-5, coordinates with reformatted edition of an updated referenced standard. These changes have been vetted in two meetings with providers and interested parties and have been approved by the Health Facilities Committee.

Summary of the rule or change:

In Section R432-14-3, updates the adopted reference from the 2001 Guidelines for Design and Construction of Hospital and Health Care Facilities to the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities. Eliminates references to buildings not complying with NFPA 101 Life Safety Code. Eliminates references to "institutional occupancy" since birthing centers are considered "ambulatory health care" under NFPA 101 and "group B ambulatory health care" occupancy under the IBC. In Section R432-14-4, eliminates a definition that is covered in Rule R432-4. Changes the title of the federal accessibility standard to match the revised federal title. Eliminates sink requirements that are covered in the adopted national standard. Clarifies that portable medical gas equipment is acceptable in lieu of fixed equipment. In Section R432-14-5, coordinates with reformatted numbers in the new edition of the referenced standard.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

This rule or change incorporates by reference the following material:

• Updates Guidelines for Design and Construction of Health Care Facilities, published by ASHE (American Society of Healthcare Engineering), 2010 edition

Anticipated cost or savings to:

the state budget:

The cost of purchasing the new referenced standard and the cost of printing and distribution of the revised rule is covered in Rule R432-4, General Construction, which is being amended concurrent with this rule. No others costs are expected. (DAR NOTE: The proposed amendment to Rule R432-4 is under DAR No. 35459 in this issue, December 15, 2011, of the Bulletin.)

local governments:

The rule change has no impact on local government because these standards are enforced at the state level.

small businesses:

Small business birthing centers that build new buildings or remodel existing facilities and the architects and engineers that design the buildings will have the cost of purchasing the new standards. The cost of the new standards is $168. There is currently only one licensed birthing center in Utah. Assuming the one birthing center purchases a copy of the updated standards the aggregate cost to small business is $168.

persons other than small businesses, businesses, or local governmental entities:

There are currently no birthing centers in Utah that are not small businesses.

Compliance costs for affected persons:

The cost to birthing centers constructing or remodeling buildings and architects and engineers designing them is the purchase of the new referenced standards at $168. The rule change will not increase compliance costs for providers.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule has been extensively discussed with the regulated businesses and they appear to concur that updating the rule to adopt updated federal accessibility standards and the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities is appropriate. Public comment received will be carefully evaluated for any unforeseen fiscal impact.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at [email protected]
• Andrew Baxter at the above address, by phone at 801-538-6140, by FAX at 801-538-6325, or by Internet E-mail at [email protected]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

01/17/2012

This rule may become effective on:

01/24/2012

Authorized by:

David Patton, Executive Director

R432. Health, Family Health and Preparedness, Licensing.

R432-14. Birthing Center Construction Rule.

R432-14-1. Legal Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

 

R432-14-2. Purpose.

This rule provides construction and physical plant standards for birthing centers.

 

R432-14-3. General Design Requirements.

(1) Birthing centers shall be constructed in accordance with the requirements of R432-4-1 through R432-4-23 and the requirements of section[s 9.2 and 9.7]5.2 of the Guidelines for Design and Construction of [Hospital and] Health Care Facilities, [2001] 2010 edition [including the Appendix] (Guidelines) and are adopted and incorporated by reference.

(2) Birthing Centers shall consist of at least two, but not more than five birthing rooms.

(3) Birthing rooms and ancillary service areas shall be organized in a contiguous physical arrangement.

(4) [To qualify for licensure, regardless of size, a ]Birthing Center s shall [be constructed in accordance]comply with NFPA 101, Life Safety Code, Chapter 20, New Ambulatory Health Care Occupancies.

[(5) Birthing Centers which are located within a building not constructed in accordance with NFPA 101, Life Safety Code, Chapter 20, shall be physically separated in accordance with requirements established by the local building official having jurisdiction and shall have at least two exits leading directly to the exterior of the building.

(6) Administration and public areas that are not part of the Birthing Center exiting system may be located outside of the institutional occupancy envelope when authorized by the local building official having jurisdiction.

(7)](5) A Birthing Center located contiguous with a general hospital may share radiology services, laboratory services, pharmacy services, engineering services, maintenance services, laundry services, housekeeping services, dietary services, and business functions. The owner shall retain in the Birthing Center a written agreement for the shared services.

 

R432-14-4. General Construction Patient Facilities.

(1) Requirements of section[s 9.2 and 9.7]5.2 of the Guidelines shall be met except as modified in this section.

(2) When a modification is cited, the modification supersedes conflicting requirements of the Guidelines.

[(3) When used in this rule, "room or office" describes a specific separate, enclosed space for the service. When "room or office" is not used, multiple services may be accommodated in one enclosed space.

(4)](3) The facility shall be designed to allow access to service areas and common areas without compromising patient privacy.

[(5)](4) Patient rooms and service areas shall be grouped to form a physically defined service unit.

[(6)](5) Spaces shall be provided for each of the required services.

[(7)](6) Interior finishes, lighting, and furnishings shall reflect a residential rather than an institutional setting.

[(8)](7) Maximum room occupancy shall be one mother and her newborn infant or infants.

[(9)](8) Each birthing room shall have a window in accordance with R432-4-23(5). Windows with a sight line which permits observation from the exterior shall be arranged or draped to ensure patient privacy.

[(10)](9) Patient rooms shall provide each patient a wardrobe, closet, or locker, having minimum clear dimensions of 24 inches by 20 inches, suitable for hanging full-length garments. A clothes rod and adjustable shelf shall be provided.

[(11)](10) A toilet room with direct access from the birthing room shall be accessible to each birthing room.

(a) The toilet room shall contain a toilet, a lavatory, and a shower or tub.

(b) A toilet room may serve two patient rooms.

(c) All toilet room fixtures shall be handicapped accessible and shall have grab bars in compliance with [ADAAG]ADA/ABA-AG.

[(d) Each birthing room shall be equipped with a lavatory for handwashing in addition to the lavatory in the toilet room. If the lavatory is equipped with wrist blades, it may be used for scrubbing.

(12)](11) Newborn infant resuscitation facilities, remote from facilities serving the mother, including electrical [outlets]receptacles, oxygen, and suction shall be immediately available to each birthing room in addition to resuscitation equipment provided for the mother. Portable oxygen and suction equipment shall be permitted.

[(13)](12) A separate room for storage of maintenance materials and equipment shall be provided.

(a) The room may serve as a maintenance office with storage for maintenance files, facility drawings, and operation manuals.

(b) The storage room shall be in addition to the required [janitors closet]environmental services room.

[(14)](13) Special surgical lighting is not required.

[(15)](14) An examination light shall be provided in each patient room. The light, if portable, shall be immediately accessible.

[(16)](15) An emergency electrical [service is]system connected to an on-site emergency generator is required.

(a) Services shall be connected to the emergency generator to include:

(i) fire alarm system;

(ii) telephone;

(iii) nurse call;

(iv) one duplex [convenience outlet]receptacle in each patient room located to allow use of a portable examination light;

(v) one duplex [convenience outlet]receptacle at each nurse station;

(vi) heating system;

(vii) emergency lighting system.

(b) There shall be sufficient fuel storage capacity to permit at least four hours continuous operation.

 

R432-14-5. Sections of the Guidelines which are Excluded.

The following sections of the Guidelines do not apply:

[(1) Parking, Section 9.7A, subsection 9.7B.2., and subsection 9.7C.2.

(2) Radiology, Section 9.2.C.

(3) Laboratory, Section 9.2.D.

(4) General Purpose Examination Rooms, Subsection 9.2.B1.

(5) Special Purpose Examination Rooms, Subsection 9.2.B2.

(6) Treatment Rooms, Subsection 9.2.B3.

(7) Observation Rooms, Subsection 9.2.B4.

] (1) Location, Subsection 5.2-1.3.1.1

(2) Ventilation of Health Care Facilities, Part 6.

 

R432-14-6. Penalties.

The Department may assess a civil money penalty of up to $10,000 and deny approval for patient utilization of new or remodeled areas denied if a health care provider does not submit architectural drawings to the Bureau of Licensing. The Department may assess a civil money penalty of up to $10,000 if the licensee fails to follow Department-approved architectural plans. The Department may assess a civil money penalty of up to $1,000 per day for each day a new or renovated area is occupied prior to licensing agency approval.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [January 5, 2010]2012

Notice of Continuation: November 24, 2009

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-16