Health, Family Health and Preparedness, Licensing

Rule R432-7

Specialty Hospital - Psychiatric Hospital Construction

Notice of Proposed Rule

(Amendment)

DAR File No.: 35462
Filed: 11/18/2011 04:16:34 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

In Section R432-7-4, coordinates with changes in a referenced rule. Coordinates with the revised title of federal accessibility standards. In Section R432-7-5, updates a referenced standard that is out of date and out of print. Coordinates with the revised title of federal accessibility standards. In Section R432-7-6, coordinate with reformatting and renumbering of a 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 R432-7-4, expands the referenced sections so that kitchen appliances must be NSF certified. Coordinates with reformatting of a referenced standard. In Section R432-7-5, updates the adopted reference from the 2001 Guidelines for Design and Construction of Hospital and HealthCare Facilities to the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities. Clarifies door hardware requirements and separation of pediatric and adult psychiatric patients. In Section R432-7-6, coordinates with reformatting of a 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:

Architects and engineers that design the buildings will have the cost of purchasing new standard. The cost of the new standards is $168. Assuming 5 small businesses purchase copies of the updated standards the aggregate cost to small business is $840.

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

Psychiatric Specialty Hospitals that build new buildings or remodel existing facilities will have the cost of purchasing the new referenced standard. The cost of the new referenced standards is $168. Assuming all 7 Utah psychiatric specialty hospitals providers purchase copies of the updated standards the aggregate cost to business is $1,176.

Compliance costs for affected persons:

The cost to psychiatric Specialty Hospitals constructing or remodeling buildings and architects and engineers designing them for the purchase of the new referenced standard is $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 jhoffman@utah.gov
• Andrew Baxter at the above address, by phone at 801-538-6140, by FAX at 801-538-6325, or by Internet E-mail at andrewbaxter@utah.gov

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.

R432-7. Specialty Hospital - Psychiatric Hospital Construction.

R432-7-1. Legal Authority.

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

 

R432-7-2. Purpose.

The purpose of this rule is to establish construction standards for a specialty hospital for psychiatric services.

 

R432-7-3. General Design Requirements.

R432-4-1 through R432-4-22 apply to this rule with the following modifications.

 

R432-7-4. General Construction, Ancillary Support Facilities.

R432-4-23 [(2)](1) through [(19)](20) applies with the following modifications:

(1) Leaf width for patient room doors and doors to patient treatment rooms shall be a minimum of three feet.

(2) Corridors in patient use areas shall be a minimum of six feet wide.

(3) Grab Bars. Where grab bars are provided, the space between the bar and the wall shall be filled. Bars, including those which are part of such fixtures as soap dishes, shall be sufficiently anchored to sustain a concentrated load of 250 pounds. Grab bars shall meet the requirements of [ADAAG]ADA/ABA-AG.

(4) Emergency Electrical Service. An on-site emergency generator shall be provided connecting the following services:

(a) life safety branch, as defined in section 517-32 of the National Electric Code NFPA 70;

(b) critical branch, as defined in 517-33 of the National Electric Code NFPA 70;

(c) equipment system, as defined in 517-34 of the National Electric Code NFPA 70;

(d) telephone;

(e) nurse call;

(f) heating equipment necessary to provide heating space to house all patients under emergency conditions;

(g) one duplex convenience outlet in each patient bedroom;

(h) one duplex convenience outlet at each nurses station; and

(i) duplex convenience outlets in the emergency heated part at a ratio of one for each ten patients.

(5) Nurse Call System. A nurse call system is optional. If installed, provisions shall be made for the easy removal or covering of call buttons.

(6) X-ray Equipment. If installed, fixed and mobile x-ray equipment shall conform to Articles 517 and 660 of NFPA 70.

(7) Security glazing. Security glazing and other security features shall be used at all windows of the nursing unit and other patient activity and treatment areas to reduce the possibility of patient injury or escape.

 

R432-7-5. General Construction, Patient Facilities.

(1) The requirements of R432-4-24 and Section s [11]2.1 and 2.5, of the Guidelines for Design and Construction of [Hospital and] Health Care Facilities, [including the Appendix, 2001]2010 edition (Guidelines) shall be met except as modified in this rule. Where a modification is cited, the modification supersedes conflicting requirements of R432-4-24 and the Guidelines.

(2) Patient Rooms.

(a) At least two single bed rooms with a private toilet room shall be provided for each nursing unit.

(b) Minimum clear dimensions of closets in patient rooms shall be 22 inches deep and 36 inches wide. The clothes rod shall be of the breakaway type.

(3) [The Service Area]Patient bathing facilities, Guidelines Section [11.2.B]2.5-2.2.2.7, is modified as follows:

(a) Each bathtub or shower shall be in an individual room or enclosure sized to allow staff assistance and designed to provide privacy during bathing, drying, and dressing.

(b) At least one shower in central bathing facilities shall be designed in accordance with the Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines [(ADAAG)](ADA/ABA-AG) for use by a person with a wheelchair.

(c) A toilet room with direct access from the bathing area, shall be provided at each central bathing area.

(d) Doors to toilet rooms shall comply with [ADAAG]ADA/ABA-AG. The doors shall be equipped with hospital privacy locks or other hardware that protects patient privacy and permit s access from outside in case of an emergency without the use of keys or tools.

(e) A handwashing fixture shall be provided in each toilet room.

(f) At least one patient toilet room in each nursing unit shall contain a shower or tub in addition to the toilet and lavatory. Fixtures shall be wheelchair accessible with wheelchair turning space within the room.

[ (g) Separate activity areas shall be provided for pediatric and adolescent nursing units.

] (4) Child Psychiatric Unit, Guidelines Section [11.3]2.5-2.3, is modified as follows:

(a) Pediatric and adolescent nursing units shall be physically separated from adult nursing units.

(b) Examination and treatment rooms shall be provided for pediatric and adolescent patients separate from adult rooms.

(i) Each room shall provide a minimum of 100 square feet of usable space exclusive of fixed cabinets, fixtures, and equipment.

(ii) Each room shall contain a work counter, storage facilities, and lavatory equipped for handwashing.

(c) Separate activity areas shall be provided for pediatric and adolescent nursing units.

(5) In addition to the service area requirements, individual rooms or a multipurpose room shall be provided for dining, education, and recreation.

(a) Insulation, isolation, and structural provisions shall minimize the transmission of impact noise through the floor, walls, or ceiling of these multipurpose rooms.

(b) Service rooms may be shared by more than one pediatric or adolescent nursing unit, but shall not be shared with adult nursing units.

(6) A patient toilet room, in addition to those serving bed areas, shall be conveniently accessible from multipurpose rooms.

(7) Storage closets or cabinets for toys, educational, and recreational equipment shall be provided.

(8) Linen services shall comply with R432-4-24[(7)](8).

 

R432-7-6. Exclusions to the Guidelines.

The following sections of the Guidelines do not apply:

(1) Linen services, section [11.16]2.5-5.2.

[ (2) Parking, Subsection 11.1.C.

]

R432-7-7. 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 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: [February 4, 2010]2012

Notice of Continuation: November 24, 2009

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-2.1; 26-21-20