SubPart 713-3 - Standards for nursing home construction projects completed or approved between July 2, 1990 and December 31, 2010

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete
Statutory Authority: 
Public Health Law Section 2803

Section 713-3.1 - Applicability

713-3.1 Applicability.

This Subpart sets forth minimum construction and physical environment standards applicable to: (a) nursing home facilities built and to portions of nursing home facilities altered or renovated pursuant to department or commissioner approval granted between July 2, 1990 and December 31, 2010; and, (b) other nursing home facility construction that does not require commissioner or department approval and is completed prior to December 31, 2010.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.2 - Pertinent standards

713-3.2 Pertinent standards.

Nursing homes shall comply with pertinent requirements, codes and technical standards set forth or incorporated by reference into Part 711 of this Title. Nursing homes that were built and had received an operating certificate prior to September 11,2003 shall comply with Chapter 19, "Existing Health Care Occupancies", of NFPA 101, Life Safety Code, 2000 edition. Nursing homes built and receiving an initial operating certificate after September11, 2003 shall comply with Chapter 18, "New Health Care Occupancies" of NFPA 101, Life Safety Code, 2000 edition. These referenced materials are described in more detail in section 711.2(a) of this Title.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.3 - General design criteria

713-3.3 General design criteria.

(a) Nursing homes shall be designed to provide flexibility in order to meet the changing physical, medical and psychological needs of the residents. The facility design shall produce a supportive environment to enhance and extend quality of life for residents. The architectural design, through the organization of functional space, the specification of ergonomically appropriate and arranged furniture, equipment, details and finishes, shall eliminate as many barriers as possible to effective access and use by residents of all space, services, equipment and utilities appropriate for daily living.

(b) Services for resident care shall be contained within the facility or the project narrative shall indicate the manner in which needed services are to be provided. Each space provided within the facility must comply with the requirements outlined in this Subpart. Appropriate modifications or deletions in space requirements required by this Subpart may be made to meet an approved operational program or when support services are permitted to be shared or purchased from facilities other than the facility under review.

(c) The sizes of the various service departments will depend upon operational program objectives and the functional organization of support spaces within the facility such that they maximize the best standards of safety and of medical and nursing practices and a high level of resident amenities.

(d) The physical characteristics of the facility, including interior finishes, shall be designed to meet the unique characteristics and needs of the residents including, but not limited to, visual, olfactory and hearing impairments, temperature requirements, and ambulation.

(e) The resident use areas such as bedrooms, dining areas, lounges and recreational areas shall be designed to facilitate resident identification with surroundings while promoting privacy, dignity, self-identity and self-determination. The interior design of resident use areas shall consider lighting, the use of finish materials, furniture arrangement and equipment, and shall specify ergonomically designed furnishings and equipment in order to promote resident independence and self-propelled ambulation, commensurate with the physical and mental capacity of the residents. Resident toilet rooms shall be provided in close proximity to these areas and shall be accessible to the physically handicapped. The configuration of these areas shall allow for self-determined socialization and leisure activities. The spaces shall be planned to promote resident use.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.4 - Nursing units

713-3.4 Nursing units.

(a) The layout and location of each nursing unit shall comply with the following:

(1) Nursing units shall be arranged to avoid travel through adjacent nursing units to gain access to resident service areas.

(2) The number of residents in a nursing unit arranged in a linear layout shall not exceed forty. However, the department will consider exceptions to this requirement to enhance the quality of life for residents when a higher number of residents clearly achieves a savings in operational costs, improves resident services and is based upon sub-groups of residents (sub-units).

(3) The maximum travel distance from a resident room door to a staff work area shall not exceed one hundred fifty feet. When sub-units are used, each sub-unit shall be arranged so as to provide access to a bathing room and a soiled workroom or soiled holding room located within, or readily accessible to, the sub-unit.

(4) At least one-tenth of the total number of residents in any facility shall be located in single rooms, with at least one toilet shared between two single rooms.

(5) The need for and the number of required airborne infection isolation room(s) in a nursing facility shall be determined by an infection control risk assessment.

(b) Each resident bedroom shall meet the following requirements:

(1) The maximum room capacity shall be two residents. Changes to the maximum number of two residents per room may be made upon a determination by the department that an alternate room configuration provides a clearly superior resident environment for residents with unusual care requirements. The maximum capacity of single rooms is one resident and such capacity shall not be exceeded.

(2) The net useable area and configuration of each room shall permit wheelchair accessibility. The bedroom shall be designed to permit wheelchair access and a minimum five foot (5'-0") diameter turnaround adjacent to at least one side of each bed. Where one side of a bed is permitted to be placed against a side wall of the room and resident care needs require additional space between the bed and the wall, the room shall be of sufficient dimension to maintain the required five foot (5'-0") turning space. Furniture and equipment intended for resident use shall be made accessible and useable by residents confined to a wheelchair.

(3) Each room shall have a window that can be opened without the use of tools. The windowsills shall not be higher than three feet above the floor and shall be above grade. Windows with operable sashes shall be provided with insect screens. Window openings shall be designed to prevent accidental falls when open, or shall be provided with security screens.

(4) A nurses' calling system shall be provided.

(5) Each resident shall have access to a toilet room without entering the general corridor area. One toilet room shall serve no more than two residents. The toilet room shall contain a water closet and a lavatory. Changes to the number of residents using one toilet room may be made on a case-by-case basis upon a determination by the department that such alternative does not adversely affect resident care and/or as special care needs of resident may require.

(6) Each resident shall have a wardrobe or closet with minimum clear inside dimensions of three feet long by one foot ten inches deep. An adjustable clothes rod and shelf shall be provided at heights useable by residents.

(7) Visual privacy shall be provided for each resident in multi-bed rooms through the use of non-combustible cubicle curtains.

(8) Medical equipment for the care and treatment of residents shall be provided in a resident's room as required by the resident's medical condition. In addition, each resident shall be provided with the following room furnishings:

(i) a bed;

(ii) a dresser and nightstand or a dresser/night stand combination which provides sufficient space for residents' personal effects;

(iii) over-bed tables as may be required;

(iv) a wall tackboard/display panel;

(v) a lockable drawer to personal valuables and storage of medications; and,

(vi) chairs for visitors and socialization.

(c) The service areas described in this subdivision shall be located in or be readily accessible to each nursing unit: The size and location of each service area will depend upon the number and types of residents served and the efficiency of the facility's staffing patterns. Although identifiable spaces are required to be provided for each of the indicated service areas, consideration will be given to design solutions, which would accommodate some services without a specific designation of areas or rooms. Decentralized service areas within nursing units will be encouraged.

The following service areas shall be provided:

(1) A staff work station with space for carrying out the administrative functions of the unit.

(2) Lounge and toilet room(s) for staff.

(3) Individual closets or lockers for the safekeeping of coats and personal effects of staff. These shall be located convenient to the duty station of personnel or in a central location.

(4) Room(s) to serve the function of clinical staff office or consultation room for up to four people.

(5) A clean workroom with a work counter sized to store clean and sterile supplies as required by the functional program, or a clean holding facility that is part of an approved system for storage and distribution of clean and sterile supply materials. The location(s) of the clean workroom and the clean holding facility shall be based on the functional program and physical layout of the nursing unit.

(6) A soiled workroom that contains a clinical sink or equivalent, flushing rim fixture with a rinsing hose or a bed pan sanitizer, handwashing facilities, work counter, and an area for soiled linen holding and waste receptacle(s) in a number and type as required by the functional program. The location of the soiled workroom shall be based on the functional program and the physical layout of the nursing unit. A soiled holding facility, if not provided within the workroom, shall be part of an approved system for collection and disposal of soiled materials.

(7) A closet, designated area within the clean workroom or a closed cart system for clean linen storage. If a closed cart system is used, storage may be in an alcove.

(8) A medication preparation room, self-contained medication dispensing unit, or an equivalent system for convenient and prompt distribution of medications to residents twenty-four hours a day. If used, a medication preparation room or a medication distribution unit shall be under the nursing staff's visual control and contain a work counter, refrigerator, and locked storage for biological and controlled substances.

(9) A nourishment station that contains a sink equipped for handwashing, equipment for serving nourishment between scheduled meals, a refrigerator, and storage cabinets. Ice for residents shall be provided by self-dispensing ice making unit.

(10) Storage for equipment in current use shall be provided.

(11) Sufficient space for the parking and holding of stretchers and wheelchairs shall be located out of the path of normal traffic.

(12) Bathing rooms for scheduled bathing shall be provided on each nursing unit at a ratio of one bathing fixture for each fifteen residents or fraction thereof, who are not otherwise served by bathing facilities within residents' room and shall be located away from public areas of the nursing unit. Each tub or shower shall be in a room or enclosure with space provided for the private use of the bathing fixture, for drying and dressing, and for a wheelchair and an attendant. The dressing area and the showers, without curbs, shall be designed to permit use by a wheelchair resident with staff assistance.

(13) Residents' toilet facilities shall comply with the following:

(i) Each resident toilet room shall be designed to permit wheelchair access and use. The size and configuration of the room, including the placement of fixtures within, shall allow space for staff assistance in transferring a wheelchair resident to the water closet.

(ii) A toilet room shall be accessible to each central bathing area without going through the general corridor.

(14) A minimum of one telephone per nursing unit shall be provided for residents' use. The telephone shall be wheelchair accessible and located to assure privacy of conversation.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.5 - Physical environment standards for long-term care programs for ventilator dependent residents

713-3.5 Physical environment standards for long-term care programs for ventilator dependent residents. (a) Each bedroom occupied by a resident receiving long term ventilator care shall comply with applicable criteria in section 713-3.4 (b) of this Subpart and shall provide adequate space for a mechanical ventilator and for equipment to be used in the administration of oxygen and suction to each resident. The facility shall have a sufficient number of single rooms to accommodate one-fifth of the facility's total capacity of ventilator dependent residents. If the facility has less than five beds, there must be at least one single room for the treatment of ventilator dependency. At least one single-bedded ventilator care room shall be designed and equipped for use as an infection control room with an additional lavatory conveniently located for staff handwashing, but not within the resident toilet room (a bathing facility may be omitted).
(b) The following service areas shall be readily available:
(1) a conference room for in-service education and training of respiratory care staff;
(2) a treatment room equipped with facilities for the administration of oxygen and suction;
(3) adequate office space for staff serving ventilator dependent residents;
(4) adequate storage and maintenance space to ensure routine servicing of ventilators and related equipment;
(5) dining space that is wheelchair accessible; and
(6) adequate therapy space for respiratory rehabilitation.
(d) At least one resident bathing facility shall be equipped with a mechanical lift and space for equipment and staff assistance.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.6 - Traumatic brain injury units

713-3.6 Traumatic brain injury units. (a) When provided, a separate head injury unit shall comply with the requirements of a general skilled nursing unit in accordance with section 713-3.4 of this Subpart, with the following variations and additional requirements:
(1) A minimum of twenty percent of the total residents in a unit shall be in single rooms.
(2) The minimum room areas exclusive of toilet rooms, closets, wardrobes, alcoves or vestibules shall provide adequate space for special needs and equipment for each resident.
(3) The resident rooms shall be provided with room furnishings and equipment required for continuing unscheduled therapeutic program activities.
(b) Therapy spaces for services such as cognitive therapy and psychological social therapy shall be provided and designed to meet the special needs of the program(s). Ancillary support facilities such as resident toilet rooms and storage facilities shall be provided in each program area.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.7 - Units for residents requiring behavioral interventions

713-3.7 Units for residents requiring behavioral interventions.

(a) When provided, behavioral intervention units shall comply with the requirements of a nursing unit in accordance with section 713-3.4 of this Subpart, with the following variations and additional requirements:

(1) The unit shall be planned as a secure unit that is separate from other units.

(2) The unit shall be designed for a minimum of fifteen residents and a maximum of twenty residents.

(3) All resident bedrooms shall be single occupancy.

(4) Doors to resident bedrooms shall open outward.

(5) A private toilet room shall be provided for each resident bedroom.

(6) An exercise room shall be located on the unit and provide a minimum of twenty-five square feet per resident. Additional space shall be provided for storage. Adjacent dedicated resident toilet and showers shall be provided.

(7) An activity room shall be located on the unit and provide a minimum of thirty-eight square feet per resident. Additional space shall be provided for equipment storage. Adjacent resident toilet and bathing facilities shall be provided.

(8) A room shall be provided for quieting down periods for over active and acting out residents. The room shall provide a minimum of one hundred twenty five square feet of clear space, and shall be designed and furnished to protect the resident from self-injury. The door to the room shall be provided with a one-way panel with a view of the entire room.

(9) Conference/counseling rooms sufficient for private family meetings with facility personnel and for meetings of facility staff shall be provided on the nursing unit. At least one such room shall accommodate up to eight persons.

(10) Adequate on-unit offices shall be provided for staff use.

(11) Resident bathing facilities shall be provided at a ratio of one fixture per seven residents.

(12) In addition to the requirements set forth in section 713-3.21 of this Subpart, details and finishes shall be designed to provide a high degree of safety and security for both residents and staff and shall comply with the following:

(i) Doors to all resident rooms shall be located so as to negate a possible resident hiding space behind the door.

(ii) Doors, which separate the unit from adjacent functional areas of the facility, shall be secure.

(iii) The walls of resident use rooms shall be constructed so as to resist damage.

(iv) The ceilings of resident use rooms shall be constructed to resist damage. The ceiling surface shall be monolithic from wall to wall.

(v) Light switches and electric convenience outlets shall be tamper proof.

(vi) Major room furnishings such as desks, dressers, night tables, and shelving shall be designed and/or installed to minimize the danger of injury to residents and staff.

(vii) Shower heads in resident bathing rooms shall be of a recessed type.

(viii) Operable windows shall be provided with devices that prevent the possibility of accidental falls. The operable sash opening shall be limited to six inches, however, alternate window opening protection may be acceptable, i.e., security screens. Window bars are not permitted.

(ix) An emergency call system for staff use shall be provided in all resident use spaces to permit staff communications in an emergency.

(x) Outside activity areas shall be provided. Resident access to the areas shall be directly from the unit.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.8 - Dementia programs

713-3.8 Dementia programs.

The department will review on a case-by-case basis the architectural designs and interior finishes which are required to implement special programs for residents with dementia. Any special space requirements or interior features of approved programs will be considered additions to the minimum requirements of this Subpart.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.9 - Communal areas

713-3.9 Communal areas.

Resident communal areas shall be provided and shall include, at a minimum, the following:

(a) Resident dining space shall be provided at a minimum ratio of twenty-eight square feet net useable areas per resident. Dining facilities may be provided in separate satellite dining areas within or adjacent to nursing units to accomplish less densely populated groupings and to be easily accessible to the residents. Toilets accommodating wheelchair residents shall be readily accessible to all dining areas.

(b) Resident recreation and lounge areas shall be provided at a minimum of twelve square feet net usable area per resident. Such spaces may be provided within or adjacent to nursing units to provide for resident accessibility.

(1) Recreation and lounge areas shall be designed and furnished in a home-like manner to encourage resident participation and provide for resident identification with surroundings.

(2) Toilets accommodating wheelchair residents shall be readily accessible to all recreation and lounge areas.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.10 - Physical therapy facilities

713-3.10 Physical therapy facilities.

Physical therapy facilities shall include and comply with the following:

(a) Treatment areas shall have space and equipment commensurate with all approved programs including, but not limited to, thermotherapy, diathermy, ultrasound, and hydrotherapy. Provision shall be made for cubicle curtains around each individual treatment area, handwashing facility(ies) (one lavatory or sink may serve more than one cubicle), and facilities for the collection of soiled linen and other material.

(b) An exercise area.

(c) Storage for clean linen, supplies, and equipment.

(d) Residents' dressing areas, showers, lockers, and toilet rooms, as may be required by the approved program.

(e) A service sink.

(f) Wheelchair and stretcher storage.

(g) Office space.

(h) The requirements of subdivisions (c), (d), (e),(f) and (g) of this section may be planned and arranged for shared use by occupational therapy residents and staff if the approved program reflects this sharing concept.

(i) If there is an approved adult day health care program, additional space and equipment may be included.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.11 - Occupational therapy facilities

713-3.11 Occupational therapy facilities.

Occupational therapy facilities shall include and comply with the following:

(a) An activities area with space and equipment commensurate with department approved programs. Provision shall be made for sink or lavatory, and facilities for collection of waste products prior to disposal.

(b) Storage for supplies and equipment.

(c) Residents' toilet rooms that may be shared with residents receiving physical therapy residents if the approved narrative program reflects this sharing concept.

(d) If there is an approved adult day health care program, operating on premises, the department may require that additional space and equipment be provided.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.12 - Hair and grooming areas

713-3.12 Hair and grooming areas.

Separate room(s) shall be provided for hair care and grooming needs of residents.

The space and equipment provided shall be commensurate with the number of residents within the facility. At least one sink for staff handwashing shall be provided that is trimmed with valves that are operable without the use of hands. There shall be another sink that may be used to wash hair. Resident toilets shall be readily accessible to the hair and grooming area(s).

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.13 - Dietary facilities

713-3.13 Dietary facilities.

(a) Construction, equipment and installation of dietary facilities shall comply with the standards in Part 14 of this Title (State Sanitary Code). Food service facilities shall be designed and equipped to meet the nutritional requirements of the residents. Dietary facilities shall consist of an on-site food preparation system, a contractual convenience food service system, or an appropriate combination thereof.

(b) The following functional elements shall be provided in such size as required to implement the type of food service system selected:

(1) A control station for receiving food supplies.

(2) Storage space for four days' supply including cold storage.

(3) Food preparation facilities as required by the program. Conventional food preparation systems shall include space and equipment for preparing, cooking, and baking. Convenience food service systems such as frozen prepared meals, bulk packaged entrees, individual packaged portions, or systems using contractual commissary services shall include space and equipment for thawing, portioning, cooking or baking.

(4) Staff handwashing facilities located within the food preparation area.

(5) Resident meal service space including facilities for tray assembly and distribution.

(6) A dining area for ambulatory residents, staff and visitors.

(7) Space for dishwashing equipment in a room or an alcove separate from food preparation and serving areas. This shall include commercial-type dishwashing equipment. Space also shall be provided for receiving, scraping, sorting and stacking soiled tableware and for transferring clean tableware to the using areas. A lavatory shall be conveniently available for handwashing.

(8) Pot washing facilities.

(9) Sanitizing facilities and storage areas for cans, carts and mobile tray conveyors. The sanitizing facilities may be combined with those required for linen services.

(10) Waste storage facilities in a separate room that is easily accessible to the outside for direct pickup or disposal.

(11) Office or suitable workspace for the dietitian or the dietary service manager.

(12) Toilets for dietary staff with handwashing facilities immediately adjacent to the work area.

(13) A janitor's closet located within the dietary department. The closet shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies.

(14) Self-dispensing ice-making facilities.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.14 - Administration and public areas

713-3.14 Administration and public areas. Administration and public areas shall include and comply with the following:
(a) A main entrance at grade level sheltered from the weather that can accommodate wheelchairs.
(b) A lobby, which shall include:
(1) a reception and information counter or desk;
(2) waiting space(s) with seating areas;
(3) public toilet facilities, which are wheelchair accessible;
(4) public telephone(s);
(5) drinking fountain(s); and
(6) a bulletin board.
(c) Interview space(s) for private interviews relating to social services, credit arrangements and admissions.
(d) General or individual office(s) for business transactions, medical and financial records, and administrative and professional staff. (e) A multi-purpose room for conferences, meetings and health education purposes, including facilities for showing visual aids.
(f) Storage for office equipment and supplies.
(g) An equipped clinical nurses aide training facility if the nursing home provides training support or a training program for nurses aides.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.15 - Linen services

713-3.15 Linen services. (a) If linen is to be processed on the site, the following shall be provided:
(1) A laundry processing room with commercial type equipment that can process seven days' needs within a regularly scheduled workweek. Handwashing facilities shall be provided.
(2) A soiled linen receiving, holding and sorting room with handwashing facilities.
(3) Storage for laundry supplies.
(4) Clean linen inspection, storage and issuing room(s).
(5) A janitors' closet containing a floor receptor or service sink and storage space for housekeeping equipment and supplies. (6) Sanitizing facilities and storage area for carts. The sanitizing facilities may be combined with those required for dietary facilities.
(b) If linen is processed off the site, the following shall be provided:
(1) A soiled linen holding room.
(2) Clean linen receiving, holding, inspection and storage room(s).
(3) Sanitizing facilities and storage area for carts. The sanitizing facilities may be combined with those required for dietary facilities.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.16 - Central stores

713-3.16 Central stores.

General storage rooms shall have a total area of not less than twelve square feet per resident and not less than ninety cubic feet in volume per resident. Storage of not-in-use institutional furniture, equipment, and supplies shall generally be concentrated in one centralized area. Storage of out-of-season clothing and residents' belongings not currently in use may be decentralized in close proximity to nursing units.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.17 - Employees' facilities

713-3.17 Employees' facilities.

In addition to employees' facilities such as locker rooms, lounges, toilets or shower facilities called for in certain departments, a sufficient number of such facilities as are required to accommodate the needs of all personnel and volunteers shall be provided. An outdoor smoking area shall be designated.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.18 - Janitors' closets

713-3.18 Janitors' closets.

In addition to the janitors' closets called for in certain departments, sufficient janitors' closets shall be provided throughout the facility to maintain a clean and sanitary environment. These shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.19 - Engineering service and equipment areas

713-3.19 Engineering service and equipment areas.

Engineering service and equipment areas shall include and comply with the following:

(a) Equipment room(s), which shall consist of room(s) or separate building(s) for boilers, mechanical equipment and electrical equipment;

(b) engineers' quarters providing office or suitable desk space for engineer;

(c) maintenance shop(s);

(d) storage room(s) for building maintenance supplies which may be part of maintenance shop in nursing homes of less than one hundred residents; and

(e) yard equipment storage, which shall consist of a separate room or building for yard maintenance equipment and supplies.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.20 - Waste processing services, storage and treatment

713-3.20 Waste processing services, storage and treatment.

Space and facilities shall be provided for waste storage and removal. Where on-site treatment is by incineration, or other approved method, appropriate additional space and facilities shall be provided.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.21 - Details and finishes

713-3.21 Details and finishes.

Details and finishes shall be designed to provide a high degree of safety for the occupants and shall minimize the incidence of accidents with special consideration for residents who will be ambulatory. Hazards such as sharp corners shall be avoided.

(a) All details shall comply with the following requirements:

(1) Compartmentation, corridors widths, exits, automatic extinguishment systems, and other details relating to fire prevention and fire protection shall comply with requirements of NFPA 101, Life Safety Code, 2000 edition. Further details concerning this referenced material are contained in section 711.2(a) of this Title.

(2) Items such as drinking fountains, telephone booths, vending machines, and portable equipment shall be located so as not to restrict corridor traffic or reduce the corridor width below the required minimum.

(3) All rooms containing bathtubs, sitz baths, showers or water closets that are subject to use or occupancy by residents, shall be equipped with doors and hardware which will permit access from the outside in any emergency. When such rooms have only one opening or are small, the doors shall be capable of opening outwards or be otherwise designed to be opened without need to push against a resident who may have collapsed within the room.

(4) The minimum width of all openings to rooms needing access for beds or stretchers shall be three feet eight inches.

(5) Doors on all openings between corridors and rooms or spaces subject to occupancy, except elevator doors, shall be swing type. Opening to showers, baths, residents' toilets, and other small wet-type areas not subject to fire hazard are exempt from this requirement.

(6) Doors, except doors to spaces such as small closets that 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 spaces subject to occupancy.

(7) Doors, sidelights, borrowed lights, and windows in which the glazing extends down to within eighteen inches of the floor, thereby creating possibility of accidental breakage by pedestrian traffic, shall be glazed with safety glass, wire glass, or plastic glazing material that will resist breaking and will not create dangerous cutting edges when broken. Similar materials shall be used in wall openings of recreation rooms and exercise rooms unless required otherwise for fire safety. Glazing materials as noted above shall be used for shower doors and bath enclosures.

(8) Thresholds and expansion joint covers shall be made flush with the floor surface to facilitate use of wheelchairs and carts.

(9) Grab bars shall be provided for all residents' showers, tubs and sitz baths. All grab bars shall have sufficient strength and anchorage to sustain a concentrated load of two hundred fifty pounds.

(10) Recessed soap dishes shall be provided in showers and bathrooms.

(11) Handrails for use by residents shall be provided on both sides of corridors. A clear distance of one and a half inches shall be provided between the handrail and the wall.

(12) Ends of handrail and grab bars shall be constructed to prevent snagging the clothes of residents.

(13) The location and arrangement of handwashing facilities shall permit their proper use and operation. Particular care shall be given to the clearances required for blade-type operating handles. Lavatories intended for use by residents shall be installed to permit use by residents in wheelchairs.

(14) Mirrors shall be arranged for convenient use by residents in wheelchairs as well as by residents in a standing position.

(15) Paper towel dispensers and waste receptacles shall be provided at all handwashing fixtures.

(16) Ceiling heights shall be as follows:

(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 height required to accommodate the equipment.

(iii) All other rooms shall have not less than seven feet ten inch ceilings. Suspended tracks, rails and pipes located in path of normal traffic, including resident room vestibule ceilings, shall be not less than six feet eight inches above the floor.

(17) Recreation rooms, and similar spaces where impact noises may be generated shall not be located directly over resident bed areas unless special provisions are made to minimize such noise.

(18) Rooms containing heat-producing equipment, such as boiler or heater rooms, and laundries, shall be insulated and ventilated to prevent any floor surface above from exceeding a temperature ten degrees Fahrenheit above the ambient room temperature.

(b) Finishes shall include and comply with the following:

(1) Floor materials shall be easily cleanable and have wear resistance appropriate for the location involved. Floors in areas used for food preparation or food assembly shall be water-resistant and grease-proof. Joints in tile and similar material in such areas shall be resistant to food acids. In all areas frequently subject to wet cleaning methods, floor materials shall not be physically affected by germicidal and cleaning solutions. Floors that are subject to traffic while wet, such as shower and bath areas, kitchen and similar work areas, shall have a non-slip surface.

(2) Wall bases in kitchen, soiled workrooms, and other areas which are frequently subject to wet cleaning methods shall be made integral and coved with the floor, tightly sealed within the wall, and constructed without voids that can harbor insects.

(3) Wall finishes shall be washable and, in the immediate area of plumbing fixtures, shall be smooth and moisture resistant. Finish, trim, and wall and floor construction in dietary and food preparation areas shall be free from spaces that can harbor rodents and insects.

(4) Floor and wall penetrations by pipes, ducts and conduits shall be tightly sealed to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed.

(5) Ceilings throughout the facility shall be easily cleanable. Dietary and food preparation areas shall have finished ceilings covering all overhead piping and duct work. Finished ceilings may be omitted in mechanical and equipment spaces, shops, general storage areas, and similar spaces, unless required for fire-resistive purposes.

(6) Acoustical ceilings and acoustical wall treatment, including acoustical in-wall insulation as required, shall be provided for corridors in resident areas, nurses' stations, dayrooms, recreation rooms, dining areas and waiting areas to reduce ambient noise in resident living and sleeping areas.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.22 - Construction, including fire-resistive requirements

713-3.22 Construction, including fire-resistive requirements.

(a) Every building and every portion thereof shall be designed and constructed to sustain all dead and live loads in accordance with accepted engineering practices and standards, including seismic forces where they apply.

(b) Foundations shall rest on natural solid bearing if a satisfactory bearing is available at reasonable depths. Proper soil-bearing values shall be established in accordance with recognized standards. If solid bearing is not encountered at practical depths, the structure shall be supported on driven piles or drilled piers designed to support the intended load without detrimental settlement, except that one-story buildings may rest on a fill designed by a soils engineer. When engineered fill is used, site preparation and placement of fill shall be done under the direct full-time supervision of the soils engineer. The soils engineer shall issue a final report on the compacted fill operation and certification of compliance with the job specifications. All footings shall extend to a depth not less than one foot below the estimated maximum frost line.

(c) An emergency radio communication system shall be provided in each facility. This system shall be self-sufficient in time of emergency and capable of operation without reliance on the building service or emergency electric power supply. It shall also be linked with the available community or State emergency communication network, including connections with police and fire department or system.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.23 - Elevators

713-3.23 Elevators.

(a) All buildings having resident facilities such as bedrooms, dining rooms, recreation areas, critical services such as diagnostic and therapy functions located on other than the main entrance floor shall have at least two electric or electrohydraulic elevators, one of which shall be of the hospital-type. Engineering studies of the facility design and location of resident service areas including an analysis of peak loads and waiting time to determine the elevator needs for handling residents, staff, the public, food, and supplies shall be submitted to the department for approval prior to the completion of design development drawings.

(1) Hospital-type elevator cars shall have inside dimensions that will accommodate a resident bed and attendants, and shall be at least five feet wide by seven feet six inches deep. The car door shall have a clear opening of not less than three feet eight inches wide.

(2) Elevators shall be equipped with an automatic leveling device of the two-way automatic maintaining type with an accuracy of one-half inch.

(3) Elevators, except freight elevators, shall be equipped with a two-way special service switch to permit cars to bypass all landing button calls and be dispatched directly to any floor.

(4) Elevator controls, alarm button and telephones shall be accessible to persons in wheelchairs.

(5) Elevator call buttons, controls and door safety stops shall be of a type that will not be activated by heat or smoke.

(b) The nursing home operator shall conduct or arrange for a third party to conduct field inspections and tests of elevators. The licensed operator of the nursing home facility shall obtain and maintain written certification that the installation meets the requirements set forth in this section and all applicable safety regulations and codes.

(c) The operation of elevators shall conform to NFPA 99, Standard for Health Care Facilities, 1999 edition, "Essential Electrical Distribution Requirements - Type II Systems". Further details concerning this referenced material are contained in section 711.2(a) of this Title.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.24 - Mechanical systems and equipment

713-3.24 Mechanical systems and equipment. 

(a) Prior to completion and acceptance of the facility, all mechanical systems shall be tested, balanced and operated to demonstrate to the licensed operator or owner or his or her representative that the installation and performance of these systems conform to the requirements of the approved plans and specifications. Upon completion of the contract, the owner and licensed operator shall be furnished with a complete set of manufacturers' operating, maintenance, and preventive maintenance instructions, parts lists with numbers and descriptions for each piece of equipment. The licensed operator shall obtain instructions on the operation of systems and equipment as required.

(b) Thermal insulation and acoustical insulation (if applicable) shall be provided on the following fixtures and equipment in the nursing home facility and shall comply with the following: 

(1) boilers, smoke breeching and stacks;

(2) steam supply and condensate return piping;

(3) hot water piping above one hundred eighty (180) degrees Fahrenheit and all hot water heaters, generators and converters;

(4) hot water piping above one hundred twenty five degrees Fahrenheit which is exposed to contact by residents;

(5) chilled water, refrigerant, other process piping and equipment operating with fluid temperatures below ambient dew point;

(6) water supply and drainage piping on which condensation may occur;

(7) air ducts and casings with outside surface temperatures below ambient dew point; and,

(8) other piping, ducts, and equipment as necessary to maintain the efficiency of the system.

(9) Insulation may be omitted from hot water and steam condensate piping not subject to contact by residents when such insulation is unnecessary for preventing excessive system heat loss or excessive heat gain.

(c) Steam and hot water systems shall comply with the following: 

(1) Boilers shall have the capacity to supply the normal requirements of all systems and equipment. Boilers shall have the capacity, based on the net ratings published by the Hydronics Institute or another generally accepted national standard approved by the commissioner, which is adequate to assure resident safety and comfort, to supply not less than seventy percent of the normal requirements of all systems and equipment. Their number and arrangements shall accommodate facility needs despite the breakdown or routine maintenance of any one boiler. The capacity of the remaining boiler(s) shall be sufficient to provide hot water service for clinical, dietary, and resident use; steam for dietary purposes, and heating for general resident rooms. However, reserve capacity for facility space heating is not required in geographic areas where a design dry-bulb temperature of twenty five degrees Fahrenheit (minus four degrees Celsius) or more represents not less than ninety nine percent of the total hours in any one heating month. 

(2) Boiler feed pumps, heating circulating pumps, condensate return pumps and fuel oil pumps shall be connected and installed to provide normal and standby service.

(3) Supply and return mains and risers of cooling, heating and process steam systems shall be valved to isolate the various sections of each system. Each piece of equipment shall be valved at the supply and return ends.

(d) Heating, cooling and ventilating systems for resident occupied areas of the facility shall comply with the following minimum standards except where other minimum standards are shown on Table 8 of this subdivision:

(1) Heating systems shall provide for a minimum temperature of seventy five degrees Fahrenheit at design temperature. Cooling systems shall be designed to permit a maximum temperature of eighty degrees Fahrenheit at design temperature.

(2) All air-supply and air-exhaust systems shall be mechanically operated. All fans serving exhaust systems shall be located at the discharge end of the system. The ventilation rates shown in Table 8 of this subdivision shall be considered as minimum acceptable rates and shall not be construed as precluding the use of higher ventilation rates provided such higher rates do not result in undesirable air velocity in resident-use areas.

(i) Outdoor air intakes shall be located as far as practical, but not less than twenty five feet, from exhaust outlets of ventilating systems, combustion equipment stacks, medical-surgical vacuum systems, plumbing vent stacks, or from areas which may collect vehicular exhaust and other noxious fumes. The bottom of outdoor air intakes serving central systems shall be located as high as practical but not less than six feet above ground level, or if installed above the roof, three feet above roof level.

(ii) The ventilation systems shall be designed and balanced to provide the pressure relationship as shown in Table 8, below.

TABLE 8

PRESSURE RELATIONSHIPS AND VENTILATION OF NURSING HOME FACILITIES

Area designation Pressure relationship adjacent areas Minimum air changes of outdoor air per hour supplied to room Minimum total air changes per hour supplied to room All air exhausted directly to outdoors Recirculated within room units
Resident Room E 2 2 Optional Optional
Resident Area Corridor E 2 4 Optional Optional
Examination and Treatment Room E 2 6 Optional Optional
Physical Therapy N 2 6 Optional Optional
Occupational Therapy N 2 6 Optional Optional
Soiled Workroom or Soiled Holding N 2 10 Yes No
Clean Workroom or Clean Holding P 2 4 Optional Optional
Toilet Room N Optional 10 Yes No
Bathroom N Optional 10 Yes No
Janitors' Closets N Optional 10 Yes No
Sterilizer Equipment Room N Optional 10 Yes No
Linen and Trash Chute Rooms N Optional 10 Yes No
Food Preparation Center E 2 10 Yes No
Warewashing Room N Optional 10 Yes No
Dietary Day Storage E Optional 2 Yes No
Laundry, General E 2 2 Yes No
Soiled Linen Sorting and Storage N Optional 10 Yes No
Clean Linen Storage P 2 2 Optional Optional

P=Positive N=Negative E=Equal

(iii) The bottoms of ventilation openings shall be not less than three inches above the floor of any room.

(iv) Corridors shall not be used to supply air to or exhaust air from any room, except that air from corridors may be used to ventilate bathrooms, toilet rooms, janitors' closets, and small electrical or telephone closets opening directly on corridors.

(v) All central ventilation or air conditioning systems shall be equipped with filters having efficiencies no less than those specified in Table 9 of this subdivision, below. The filter bed shall be located upstream of the air conditioning equipment, unless a prefilter is employed. In this case, the prefilter shall be upstream of the equipment and the main filter may be located further downstream. 
 

TABLE 9
FILTER EFFICIENCIES FOR CENTRAL VENTILATION AND AIR CONDITIONING SYSTEMS IN NURSING HOME FACILITIES

Area Designation

Minimum number
of filter beds

Filter efficiency
(percent) main filter bed

Resident Care, Treatment 
Diagnostic & Related Areas

1

80*

Food Preparation Areas and Laundries

1

80

Administrative, Bulk Storage and Soiled Holding Areas

1

25

* May be reduced to thirty five percent for all outdoor air systems.

(vi) All filter(s) efficiencies shall be average atmospheric dust spot efficiencies tested in accordance with ANSI/ASHRAE Standard 52.2-1999, Method of Testing Air-Cleaning Devices for Removal Efficiency by Particle Size, 1999 edition. Further details concerning this referenced material are contained in section 711.2(b) of this Title. Filter frames shall be durable and carefully dimensioned and shall provide an air-tight fit with the enclosing duct work. All joints between filter segments and the enclosing duct work shall be gasketed or sealed to provide seal against air leakage. A manometer shall be installed across each filter bed serving central air systems.

(vii) Exhaust hoods in food preparation centers shall have an exhaust rate of not less than fifty cubic feet per minute per square foot of face area. Face area is defined for this purpose as the open area from the exposed perimeter of the cooking surfaces. All hoods over cooking ranges shall be equipped with grease filters, fire extinguishing systems, and heat actuated fan controls. Cleanout openings shall be provided every twenty feet in horizontal exhaust duct systems serving these hoods.

(viii) Boiler rooms shall be provided with sufficient outdoor air to maintain combustion rates of equipment and to limit temperature in working stations to ninety seven degrees Fahrenheit.

(e) All plumbing systems and other piping systems shall be designed and installed in accordance with the requirements of the local or municipal building code authority having jurisdiction.

(1) Plumbing fixtures shall comply with the following:

(i) The material used for plumbing fixtures shall be of non-absorptive acid-resistant material.

(ii) The water supply spout for lavatories and sinks required in resident care areas shall be mounted so that its discharge point is a minimum distance of five inches above the rim of the fixture. All fixtures used by medical and nursing staff, and all lavatories used by residents and food handlers shall be trimmed with valves, which can be operated without the use of hands. Where blade handles are used for this purpose, they shall not exceed four and one-half inches in length, except that handles on clinical sinks shall be not less than six inches long.

(iii) Clinical sinks shall have an integral trap in which the upper portion of a visible trap seal provides a water surface.

(iv) Shower bases and tubs shall provide non-slip surfaces for standing residents.

(2) Water supply systems shall comply with the following:

(i) Water in sufficient quantity shall be provided that is of a quality, which conforms to Part 5 of this Title.

(ii) Systems shall be designed to supply water at sufficient pressure to operate all fixtures and equipment during maximum demand periods.

(iii) Each water service main, branch main, riser and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture.

(iv) Backflow preventers (vacuum breakers) shall be installed on hose bibs, janitors sinks, bedpan flushing attachments, and on all other fixtures to which hoses or tubing can be attached.

(v) Flush valves installed on plumbing fixtures shall be of a quiet operating type, equipped with silencers.

(vi) Water distribution systems shall be narrated to provide hot water at each hot water outlet at all times. Hot water at shower, bathing and handwashing facilities shall not exceed one hundred ten degrees Fahrenheit.

(3) Hot water heating systems shall comply with the following:

(i) The hot water heating system shall have sufficient capacity to supply water at the temperatures and amounts indicated below. Water temperatures shall be taken at hot water point of use or inlet to processing equipment.

(ii) Storage tank(s) shall be fabricated of corrosion-resistant metal or lined with non-corrosive material.

 

Clinical

USE
Dietary

Laundry

Gallons (per hour per resident)

6 1/2

4

4 1/2

Liters (per second per resident)

.007

.004

.005

Temperature (F)

110 *

180

180

*Maximum

(4) Drainage systems shall comply with the following requirements:

(i) Insofar as possible, drainage piping shall not be installed within the ceiling nor installed in an exposed location in food preparation centers, food serving facilities, food storage areas, and other critical areas. Special precautions shall be taken to protect these areas from possible leakage or condensation from necessary overhead piping systems.

(ii) Building sewers shall discharge into a community sewage system. Where such a system is not available, a facility providing sewage treatment must conform to applicable local and state regulations.

(5) If used, nonflammable medical gas systems installations shall be in accordance with the requirements of NFPA 99, Standard for Health Care Facilities, 1999 edition. Further details concerning this reference material are contained in section 711.2(a) of this Title.

(6) If used, clinical vacuum system installations shall be in accordance with the requirements of NFPA 99, Standard for Health Care Facilities, 1999 edition, and Compressed Gas Association Inc. (CGA) Pamphlet E-10: Maintenance of Medical Gas and Vacuum Systems in Health Care Facilities, third edition. Further details concerning these reference materials are contained in section 711.2 of this Title.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.25 - Electrical Requirements

713-3.25 Electrical Requirements.

(a) All material including equipment, conductors, controls and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities shown in the specifications or indicated on the plans. Materials and installation shall conform to NFPA 70, National Electric Code, 1999 edition and NFPA 99, Standard for Health Care Facilities, 1999 edition. Further details concerning these referenced materials are contained in section 711.2(a) of this Title. All electrical installations and systems shall be tested to show that the equipment is installed and operates as planned or specified.

(b) Circuit breakers or fusible switches that provide disconnecting means and overcurrent protection for conductors connected to switchboards and panel boards shall be enclosed or guarded to provide a deadfront type of assembly. The main switchboard shall be located in a separate enclosure accessible only to authorized persons. The switchboard shall be convenient for use, readily accessible for maintenance, clear of traffic lanes, and in a dry ventilated space free of corrosive fumes or gases. Overload protective devices shall be suitable for operating properly in ambient temperature conditions.

(c) Panel boards serving lighting and appliance circuits shall be located on the same floor as the circuits they serve. This requirement does not apply to emergency system circuits.

(d) All spaces occupied by people, machinery, equipment within buildings, approaches to buildings, and parking lots shall have lighting commensurate with intended use. Residents' rooms shall have general lighting and night lighting. A reading light shall be provided for each resident. At least one light fixture for night lighting shall be switched at the entrance to each resident room. All switches for control of lighting in resident areas shall be of the quiet operating type.

(e) Receptacles (convenience outlets) shall comply with the following:

(1) Each resident room shall have duplex grounding-type receptacles as follows: one located near each side of the head of each bed; one for television if used; and one on another wall.

(2) Duplex receptacles for general use shall be installed approximately fifty feet apart in all corridors and within twenty five feet of ends of corridors.

(f) The electrical circuit(s) to fixed or portable equipment in hydrotherapy units shall be provided with five milliampere ground fault interrupters.

(g) Nurses' calling systems shall comply with the following:

(1) In resident occupied areas, each room shall be served by at least one calling station and each resident shall be provided with a call device. Two call devices serving adjacent beds may be served by one calling station. Calls shall register with the floor staff and shall activate a visible signal in the corridor at the residents' door, in the clean workroom, in the soiled workroom, and in the nourishment station of the nursing unit. In multi-corridor nursing units, additional visible signals shall be installed at corridor intersections, in rooms containing two or more calling stations, indicating lights shall be provided at each station. Nurses' calling systems that provide two-way voice communication shall be equipped with an indicating light at each calling station with lights, and remain lighted as long as the voice circuit is operating.

(2) A nurse's call emergency device shall be provided for residents' use at each residents' toilet, bath and shower.

(3) Alternate technologies can be considered for emergency or nurse call systems. If radio frequency systems are used, consideration should be given to electromagnetic compatibility between internal and external sources. The department will consider the use of alternate technologies on a case-by-case basis and may approve the use of such technology if resident safety is assured.

(h) Emergency electric services shall comply with the following requirements:

(1) To provide electricity during an interruption of the normal electric supply, an emergency source of electricity shall be provided and connected to certain circuits for lighting and power.

(2) The source of this emergency electric service shall be as follows:

(i) an emergency generating set when the normal service is supplied by one or more central station transmission lines; and,

(ii) an emergency generating set or a central station transmission line when the normal electric supply is generated on the premises.

(3) Emergency electrical service shall be provided to the distribution systems as follows:

(i) Illumination for means of egress and for exit signs and exit directional signs as required in NFPA101, Life Safety Code, 2000 edition. Further details concerning this referenced material are contained in section 711.2(a) of this Title.

(ii) Corridor duplex receptacles in resident areas.

(iii) Nurses' calling systems.

(iv) Equipment necessary for maintaining telephone service.

(v) Elevator service that will reach every resident floor when resident rooms are located on other than the ground floor. Throwover facilities shall be provided to allow temporary operation of any elevator for release of persons who may be trapped between floors.

(vi) A fire pump, if installed.

(vii) Equipment for heating resident rooms, except where the facility is served by two or more electrical services supplied from separate generators of a utility distribution network having multiple power input sources and arranged to provide mechanical and electrical separation so that a fault between the facility and the generating sources will not likely cause an interruption of its service feeders.

(viii) General illumination and selected receptacles in the vicinity of the generator set.

(ix) Paging or speaker systems if intended for communication during emergency. Radio transceivers where installed for emergency use shall be capable of operating for at least one hour upon total failure of both normal and emergency power.

(x) Alarm systems, including fire alarms activated at manual stations, water flow alarm devices of sprinkler system if electrically operated, fire and smoke detecting systems, and alarms required for non-flammable medical gas systems if installed.

(xi) Walk-in refrigerator and freezer.

(xii) Electric duplex outlets for all resident rooms, communal areas and service areas serving residents requiring ventilator care.

(4) The emergency lighting shall be in operation within ten seconds after the interruption of normal electric power supply. Emergency service to receptacles and equipment may be delayed automatic or manually connected. Receptacles connected to emergency power shall be distinctively marked. When the generator is operated by fuel, which is normally piped underground to the site from a utility distribution system, fuel storage facilities on the site will not be required.

(5) Each resident sleeping room shall be protected by an automatic smoke and heat detection system which includes an approved and operational automatic smoke and heat detector in such room. The detector shall conform to the applicable provisions of NFPA 72, National Fire Alarm Code, 1999 edition. Further details concerning this referenced material are contained in section 711.2(a) of this Title.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete

Section 713-3.26 - Compliance with more current standards

713-3.26 Compliance with more current standards.

Notwithstanding any provision to the contrary in this title, a licensed operator or applicant, when submitting a construction project application for approval, may elect to comply with all applicable requirements of Subpart 713-4 in lieu of complying with this Subpart.

Effective Date: 
Wednesday, December 29, 2010
Doc Status: 
Complete