SubPart 83-1 - Shared Health Facilities

Effective Date: 
Wednesday, December 24, 2014
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 4712

Section 83-1.1 - Applicability

83-1.1 Applicability.

The requirements and standards set forth in this Part shall apply to shared health facilities as defined.
 

Doc Status: 
Complete

Section 83-1.2 - Definitions

83-1.2 Definitions.

(a) Shared health facility or facility shall mean any arrangement or operation for the delivery of medical or heath care or services which meets all of the following requirements:

(1) Any combination of four or more practitioners licensed under:

(i) article 131 of the Education Law (physician); or

(ii) article 131 A of the Education Law (physical therapist, physiotherapist, physician's associate, specialist's assistant); or

(iii) article 132 of the Education Law (chiropractor); or

(iv) article 133 of the Education Law (dentist, dental hygienist); or

(v) article 137 of the Education Law (pharmacist); or

(vi) article 139 of the Education Law (registered professional nurse, licensed practical nurse); or

(vii) article 141 of the Education Law (podiatrist); or

(viii) article 143 of the Education Law (optometrist); or

(ix) article 144 of the Education Law (ophthalmic dispensor, optician); or

(x) article 156 of the Education Law (occupational therapist); or

(xi) article 159 of the Education Law (speech pathologist, audiologist).

(2) One or more of the practitioners receives payment under the Medical Assistance Program on a fee-for-service basis;

(3) The total aggregate remuneration from the Medical Assistance Program of one or more of the practitioners exceeds $5,000 for any one month during the preceding 12 months;

(4) The practitioners practice their professions at a common physical location;

(5) The practitioners share:

(i) common waiting rooms or areas; or

(ii) examining rooms; or

(iii) treatment rooms; or

(iv) other space; or

(v) the services of supporting staff; or

(vi) equipment.

(6) A person, whether a practitioner or not:

(i) is in charge of, controls, manages or supervises substantial aspects of the arrangement or operation for the delivery of health or medical services at the practitioners' common physical location; or

(ii) makes available to the practitioners the services of administrative, nursing, clerical, secretarial, maintenance, or other supporting staff who are not employees of the practitioners.

(b) Practitioner shall mean a person who is engaged in the practice of human medicine, dentistry or related professions and duly licensed in accordance with the provisions of title VIII of the New York State Education Law.

(c) Provider shall mean any qualified physicians, dentists, nurses, optometrists and other related professional personnel receiving reimbursement from the program.

(d) Purveyor shall mean any person who, whether or not located in a building which houses a shared health facility, engages in the business of supplying to patients, directly or indirectly, any medical supplies, equipment or services for which reimbursement under the program is received, including, but not limited to, clinical laboratory services or supplies, X-ray laboratory services or supplies; inhalation therapy services or equipment; ambulance services; sick room supplies; physical therapy services or equipment; orthopedic or surgical appliances or supplies; drugs, medication or medical supplies; eyeglasses, lenses, or other optical supplies or equipment; hearing aids or devices; and any other goods, services, supplies, equipment or procedures prescribed, ordered, recommended or suggested for medical diagnosis, care or treatment.

(e) Program shall mean the New York State program of medical assistance for needy persons (Medicaid) as provided in title II of article 5 of the New York State Social Services Law.

(f) Patient shall mean anyone eligible to receive or receiving benefits under the provisions of the New York State program of medical assistance for needy persons, as provided in title XI of article 5 of the New York State Social Services Law.

(g) Commissioner shall mean the Commissioner of Health of the State of New York.

(h) Department shall mean the New York State Department of Health.

(i) Operator shall mean the owner of the premises in which a shared health facility is located, or the lessee, if the structure in which the shared health facility is located has been leased pursuant to a lease.

(j) Manager or administrator shall mean an individual designated by the shared health facility owner or operator to assume functional responsibility for the management and coordination of the activities within the facility.

(k) For purposes of this Part, a combination of four or more practitioners shall be deemed to exist for the remainder of the shared health facility registration period if at any time during such registration period four or more practitioners occupy professional office space or practice their professions at a common physical location.
 

Doc Status: 
Complete

Section 83-1.3 - Applicability of other laws, codes, rules and regulations

83-1.3 Applicability of other laws, codes, rules and regulations.

Shared health facility providers, purveyors, operators, administrators, managers and employees shall comply with all Federal, State and local laws, codes, rules, and regulations pertaining to participation in the Medical Assistance Program, including, but not limited to pertinent sections and provisions of title XIX of the Social Security Act, the New York State Social Services Law, the New York State Public Health Law and codes, rules and regulations enacted pursuant thereto; the New York State Medical Handbook, medical plans of local social services districts, and with local laws, ordinances, codes, rules and regulations having general application.
 

Doc Status: 
Complete

Section 83-1.4 - Registration of shared health facilities required

83-1.4 Registration of shared health facilities required.

(a) No shared health facility shall be operated in New York State after the effective date of this Part unless the facility operator shall possess a valid facility registration issued by the department.

(b) The registration may specify the kind or kinds of medical care, services or supplies which may be provided in the shared health facility. Such determinations may be based on the availability of space, equipment and appropriate trained personnel in the facility.
 

Doc Status: 
Complete

Section 83-1.5 - Registration of shared health facilities

83-1.5 Registration of shared health facilties.

(a) Application for the registration of a shared health facility shall be made upon forms prescribed by the department and shall contain the information required therein.

(b) Each operator of a shared health facility shall apply for renewal of the registration not earlier than 90 days and not later than 30 days prior to the expiration of the current facility registration.

(1) Applications for registration of shared health facilities shall be obtained from the department regional office having responsibility for the administration and supervision of the Medical Assistance Program in the local social services district in which the shared health facility is located.

(2) The shared health facility registration and registration number shall be issued in the name of the facility and the facility operator, and shall not be transferred or discontinued except upon written approval or demand of the department.

(3) A shared health facility registration, issued pursuant to the application specified in this section, shall be issued for a period not to exceed two years, shall be used by the facility operator only for the designated place of operation and shall be prominently posted within the designated premises.

(4) The department may verify the information submitted on the application or a registration. Such verification may be by onsite visit to the applicant operator's premises and may include interview of any owner, operator, practitioner, provider, purveyor, patient or employee encountered on the premises, inspection of any business records, patient records, leases or other contracts executed by any provider or purveyor maintaining a professional practice or business on the premises, and any equipment or instruments used therein.
 

Doc Status: 
Complete

Section 83-1.6 - Denial of applications for registration; suspension or revocation of registrations

83-1.6 Denial of applications for registration; suspension or revocation of registrations.

(a) The department may deny the issuance of a registration, revoke or suspend the registration of a shared health facility upon one or more of the following grounds:

(1) a finding by the department that false information was submitted as part of the application;

(2) a finding of fraudulent practices on the part of any of the facility's providers or purveyors;

(3) a finding by the department that the facility is not in substantial compliance with the minimum physical or environmental standards for shared health facilities as set forth in this Part, provided, however, that a provisional registration may be issued to a facility operating prior to September 1, 1977, which is not in substantial compliance with these regulations when the condition of the premises does not constitute an immediate danger to the public health; the physical deficiencies are capable of correction within a set period of time; and the applicant or applicants warrant that the specified deficiencies will be corrected within that period;

(4) a finding by the department that the facility has failed to comply with the rules and regulations set forth in this Part;

(5) a finding by the department that any individual having a direct or indirect interest in the facility operation or business, or the manager or administrator of such facility is not of the requisite good moral character:

(i) no application for registration shall be denied solely on the basis that an individual has been convicted of a crime without consideration having been given to:

(a) the public policy of the State to encourage the licensure and employment of persons previously convicted of one or more criminal offenses;

(b) the specific duties and responsibilities necessarily related to the operation of a shared health facility;

(c) the bearing, if any, the criminal offense or offenses for which the person was previously convicted will have on his fitness or ability to perform one or more of such duties and responsibilities;

(d) the time which has elapsed since the occurrence of the criminal offense or offenses;

(e) the age of the person at the time of occurrence of the criminal offense or offenses;

(f) the seriousness of the offense or offenses;

(g) any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct; and

(h) the legitimate interest of the department in preventing abuses in shared health facilities and in ensuring the quality, continuity and coordination of medical care provided in such facilities.

(ii) In making a determination as to the moral character of any such person, the department shall also give consideration to a certificate of relief from disabilities or a certificate of good conduct issued to such person, which certificate shall create a presumption of rehabilitation in regard to the offense or offenses specified therein.

(b) Upon denial of an application for registration, the applicant will be notified by the department of the denial, the basis for the denial, and will be afforded an opportunity for a hearing. A request for a hearing must be made within 15 days of the notice of denial. All hearings under this section will be conducted in accordance with the procedures set forth in paragraphs (2) and (3) of this subdivision:

(1) The registration of a shared health facility shall be suspended or revoked, pursuant to a hearing as further described in paragraphs (2) and (3) of this subdivision; provided, however, that a registration may be suspended or limited for a period not in excess of 30 days upon written notice to the shared health facility operator following a determination by the commissioner that the public health or safety is in imminent danger.

(2) A notice of hearing which sets forth the time, place and nature of the hearing; the legal authority and jurisdiction under which the hearing is to be held; a reference to the particular sections of the statutes and rules involved; and a short and plain statement of the matters asserted shall be served in person or mailed by certified mail to the facility at least 21 days before the date fixed for the hearing. The shared health facility shall file with the department, not less than eight days prior to the hearing, a written answer to the charges.

(3) Hearings shall be conducted in accordance with section 12-a of the Public Health Law and pursuant to the provisions of the State Administrative Procedure Act by the commissioner or by a hearing officer appointed by the commissioner. The hearing officer shall not determine, but shall submit his report to the commissioner setting forth his findings of facts, his conclusions and his recommendations. (4) Final appropriate action shall be taken upon waiver of the right to a hearing by the shared health facility operator or upon failure by the operator of a shared health facility to appear at a hearing.

(5) All orders or determinations hereunder shall be subject to review as provided in article 78 of the Civil Practice Law and Rules. Application for such review must be made within 60 days after service in person or by certified mail of a copy of the order or determination upon the applicant.

(6) Any shared health facility provider or purveyor who violates any provision of article 47 of the Public Health Law pertaining to shared health facilities or of this Part may, subject to the review and hearing procedures specified in 18 NYCRR Part 515, be barred from collecting any payments under the program from the date such violation occurs.
 

Doc Status: 
Complete

Section 83-1.7 - Required notifications

83-1.7 Required notifications.

(a) The owner, operator or manager of a shared health facility shall notify the department within 15 days of any change in: (1) the persons, partnerships or corporations having ownership (including leasehold ownership) of the shared health facility;

(2) the persons, partnerships or corporations holding any mortgage, lien, leasehold or other security interest in the shared health facility; and

(3) the individual designated to assume functional responsibility for coordination and management of the activities within the shared health facility.

(b) The owner, operator or manager of a shared health facility shall notify the department within 15 days of:

(1) any termination of services of any practitioner in the shared health facility;

(2) the identity of each practitioner newly participating in the facility.

(c) All required notifications shall be made in writing upon forms provided, and shall contain such information as prescribed, by the department.
 

Doc Status: 
Complete

Section 83-1.8 - Quality of care requirements

83-1.8 Quality of care requirements. (a) Each shared health facility shall:

(1) have an individual designated as a manager or administrator, who shall have functional responsibility for the management and coordination of activities within the facility, and who shall help to ensure that the facility and its providers, purveyors and employees comply with the various provisions of this Part;

(2) have an appropriate means of ensuring that:

(i) patients will be scheduled to return to the facility for follow-up care or services when such follow-up care or services are deemed necessary and appropriate; and

(ii) each patient will be treated or served by practitioners, providers or purveyors familiar with the patient's medical history.

(b) Each individual provider or purveyor practicing his profession or conducting his business in the facility shall maintain proper records, which at a minimum shall contain:

(1) the full name, address and medical assistance program number of each patient treated or served in the facility;

(2) the date of each patient visit to the individual provider or purveyor;

(3) the patient's chief complaint for each visit;

(4) the patient's pertinent medical history and the findings for any physical examination performed by any provider;

(5) the diagnostic impressions for each visit;

(6) a notation of all medication prescribed and the precise dosage and prescription regimen for each medication prescribed;

(7) a description of any X-rays, laboratory tests and electrocardiograms ordered or performed and a notation of the results thereof;

(8) a notation as to any referral by any provider or purveyor in the facility to another provider, practitioner or purveyor, a statement as to the reason for such referral, and the results of such referral; and

(9) a statement as to whether or not the patient is expected to return for further treatment, and the prospective dates for all return appointments.

(c) Each individual provider and purveyor practicing his profession or conducting his business in a shared health facility shall furnish to patients only services and supplies which are of high quality and necessary to prevent, diagnose, correct or cure conditions that cause acute suffering, endanger life, result in illness or infirmity, interfere with the patients' capacity for normal activity or threaten some significant handicap.

(d) Each shared health facility shall:

(1) provide suitable space and equipment for the storage of medical records, and maintain in a centralized location within the facility, original or true copies of each provider's or purveyor's medical records and medical assistance program invoices submitted for reimbursement;

(2) assign an individual and clearly identified practitioner to each patient requesting treatment or services in the shared health facility, provided, however, that the assignment may be changed at any time at the patient's discretion;

(3) conspicuously post and otherwise make available to patients either:

(i) the manned central answering service telephone number of each patient's designated practitioner or such designated colleague(s); or

(ii) the telephone number of the facility's centralized 24 hour-a-day, 7 days-a-week manned telephone line for off-hour emergency patient questions.

(e) Each shared health facility shall provide equipment and space which will ensure that all patients have a maximum of privacy during interview, examination and treatment.

(f) Each shared health facility shall post in a location and manner conspicuous to visiting and waiting patients a notice which shall provide the telephone number and identity of the New York State Department of Health agency which is responsible for providing information concerning shared health facilities and for receiving complaints concerning the provision of health care services in shared health facilities. Such notices may be provided to the facility by the department, and if so provided, shall be posted in lieu of any notices to the same or similar effect.

(g) The facility shall post in a location and manner conspicuous and comprehensible to visiting and waiting patients the names and scheduled office hours of all practitioners practicing in the facility.

(h) Nothing in this Part shall in any way be interpreted as infringing upon the patient's right to free selection of a personal practitioner.

(i) The department shall have the right to inspect patient medical records, business records, leases and other contracts executed by any provider or purveyor in a shared health facility. Such inspection may be by onsite visits to the facility.
 

Doc Status: 
Complete

Section 83-1.9 - Daybook registry

83-1.9 Daybook registry. Each shared health facility shall maintain a central daybook registry which shall as a minimum record:

(a) the full name and Medical Assistance Program number of all patients requesting or receiving care or services at the facility;

(b) the chief complaint of each patient;

(c) the names of providers or purveyors whose services the patient requested and the names of all providers and purveyors to whom the patient was directed or assigned; and

(d) the name of the provider, practitioner or purveyor from whom the patient was referred.
 

Doc Status: 
Complete

Section 83-1.10 - Shared health facility report and audit requirements

83-1.10 Shared health facility report and audit requirements.

(a) Each shared health facility shall establish and maintain a system of uniform reports and internal utilization review audits as prescribed by the commissioner.

(b) The information contained in the required reports and audits shall be made available from time to time in such manner and form as required by the department.
 

Doc Status: 
Complete

Section 83-1.11 - Provider and purveyor leases

83-1.11 Provider and purveyor leases.

(a) Each shared health facility operator shall file with the department a true copy of any lease and any renewal of a lease executed by the facility operator and any provider or purveyor practicing his profession in the facility. If a lease or lease renewal is verbally made, the operator shall file with the department an accurate written account of the terms of such verbal agreement signed by all parties to such agreement.

(b) Copies of existing provider and purveyor leases shall be submitted to the department together with the application for registration of a shared health facility. Leases or lease renewals executed subsequent to the initial issuance of a facility registration shall be filed with the department within 15 days of execution.
 

Doc Status: 
Complete

Section 83-1.12 - Prohibited practices-additional requirements

83-1.12 Prohibited practices-additional requirements.

(a) The fee for letting of space, provision of services by supporting staff and employees, use or control of equipment or for other considerations necessary for the provision of medical care and services shall not be calculated or paid as a percentage of the earnings or billings of the providers or purveyors for services rendered on the facility premises.

(b) No purveyor, whether or not located in a building which houses a shared health facility shall directly or indirectly offer, pay or give to any provider, and no provider shall directly or indirectly solicit, request, receive or accept from any purveyor any sum of money, credit or other valuable consideration for:

(1) recommending or procuring goods, services or equipment of such purveyor; or (2) directing patronage or clientele to such purveyor; or

(3) influencing any person to refrain from using or utilizing goods, services or equipment of any purveyor.

(c) No provider or purveyor shall demand or collect from any patient compensation for care or services in excess of the fee specified in the appropriate program fee schedule.

(d) No purveyor shall provide to a patient eligible to receive or receiving benefits under the provisions of the program any services, equipment, pharmaceutical or other medical supplies differing in quantity in any other respect from that described in the payment invoice submitted by such purveyor to the department. No purveyor shall provide to any patient eligible to receive or receiving under the provisions of the program any services, equipment, pharmaceutical or medical supplies differing in quality, quantity or in any other respect from that prescribed by the provider.

(e) No provider or purveyor in a shared health facility or person employed in a facility shall refer a patient to another provider or purveyor located in such facility unless there is a medical need for such referral and unless the records of the referring provider or purveyor pertaining to such patient clearly sets forth the justification for such referral.

(f) Every provider or purveyor practicing in a shared health facility who treats a patient referred to him by another provider practicing in the same facility shall communicate in writing to the referring provider the diagnostic evaluation and the therapy rendered. The referring provider or purveyor shall incorporate such information into the patient's permanent record.

(g) The invoice submitted to the program by the provider or purveyor to whom such patient has been referred shall:

(1) contain the name and program number of the referring provider or purveyor; and

(2) identify the medical problem or condition which necessitated the referral.

(h) All provider and purveyor invoices submitted to the program for reimbursement for services rendered at a shared health facility shall:

(1) contain the registration code of the facility at which the service was performed;

(2) clearly identify the provider or purveyor who provided the service; and

(3) be signed by the provider or purveyor only after the service has been performed.

(i) Invoices submitted to the program for care, supplies or services rendered at a shared health facility lacking a valid, current registration issued by the department are not eligible for reimbursement by the program.

(j) All orders issued by providers for ancillary clinical services, including but not limited to x-rays, electrocardiograms, clinical laboratory services, electroencephalograms, as well as orders for medical supplies and equipment, shall contain the registration number assigned to the facility at which the order was written.

(k) Any pharmacy maintaining a business in or adjacent to the building in which a shared health facility is located shall prominently post a notice informing patients that all pharmaceuticals prescribed in the program may be obtained at any pharmacy of the patient's choice enrolled in the program.

(l) No purveyor who maintains a business in the building in which a shared health faculty is located shall maintain a door or window opening into the space occupied by the facility, except where the profession of a provider permits the provider to function simultaneously as a purveyor.

Doc Status: 
Complete

Section 83-1.13 - Engineering and maintenance

83-1.13 Engineering and maintenance.

(a) Water supplies of shared health facilities shall be operated in conformance with the following requirements:

(1) water shall be adequate in volume and pressure for all medical purposes; (2) the water system shall not be operated with physical connections to other piping systems or connections to fixtures that may permit contamination of the water supply;

(3) the water system shall be operated with a hot water system adequate for all medical purposes; and

(4) the hot water supply shall be regulated by thermostatic or other control devices which shall be either locked or located in places not accessible to patients or the general public so that the hot water used by patients and the public is maintained at an even temperature which cannot cause personal injury.

(b) Plumbing and plumbing fixtures shall be properly maintained.

(c) Ventilation, heating, air conditioning and air changing systems shall be: (1) sufficient to provide for patient health and comfort;

(2) sufficient to assure that relative humidity is maintained at a minimum of 50 percent in those areas where conductive floors are required; and

(3) maintained in good repair and operated in a manner to prevent the spread of infection.

(d) Grounds and buildings shall be maintained:

(1) in a clean condition free of safety hazards;

(2) in such manner as will prevent standing water, flooding or leakage; and

(3) free of excessive noise, odors, pollens, dusts or other environmental pollutants and such nuisances as may adversely affect the health or welfare of patients.
 

Doc Status: 
Complete

Section 83-1.14 - Housekeeping

83-1.14 Housekeeping.

(a) The entire facility, including, but not limited to the floors, walls, windows, doors, ceilings, fixtures, equipment and furnishings shall be maintained in good repair, clean and free of insects, rodents and trash.

(b) Dusting, mopping and vacuum cleaning shall be done in a manner which will not spread dust or other particulate matter.

(c) Adequate supplies and equipment for housekeeping functions shall be provided; cleaning compounds and hazardous substances shall be properly labeled and stored.

(d) Solid wastes, including garbage, rubbish and other refuse, biological wastes and infectious material, shall be collected, stored and disposed of in a manner that will prevent the transmission of disease and not create a nuisance or fire hazard, nor provide a breeding place for insects or rodents.

(e) Adequate measures shall be instituted for the handling and disposal of infectious wastes, including needles and syringes, dressings, surgical and biological wastes.
 

Doc Status: 
Complete

Section 83-1.15 - Fire and safety

83-1.15 Fire and safety.

(a) Buildings and equipment shall be so maintained as to prevent fire and other hazards to personal safety.

(b) Exits, stairways, doors and corridors shall be kept free of obstructions. Corridors or passageways that do not provide a clear, unobstructed path to the outside shall not be marked as exits.

(c) Flammable and nonflammable medical gases shall be labeled, stored, handled and used in compliance with the requirements of the National Fire Protection Association No. 56A Inhalation Anesthetics, 1973 Edition, 56B Respiratory Therapy 1973 Edition, and 56F Non-Flammable Medical Gas Systems, 1973 Edition. These standards were published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy of each of these standards is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.

(d) Flammable and combustible liquids shall be labeled, stored, handled and used in compliance with the requirements of the National Fire Protection Association No. 30, Flammable and Combustible Liquids Code, 1973 Edition. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.

(e) The facility shall exercise proper safeguards for the prevention of accidents to patients, staff and employees.

(f) Portable fire extinguishers shall be provided in accordance with the National Fire Protection Association No. 10, Installation of Portable Fire Extinguishers, 1973 Edition, and shall be inspected at least annually, recharged or repaired as needed and labeled with the date of the last inspection. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.
 

Doc Status: 
Complete

Section 83-1.16 - Infection control

83-1.16 Infection control.

(a) Shared health facilities shall assure that effective procedures in aseptic technique are followed by all personnel.

(b) Shared health facilities shall provide disposable covers for examination tables and for dental chair headrests and assure that such covers are changed after each patient's use.

(c) Physicians practicing in shared health facilities shall report the presence of any communicable disease as defined in section 2.1 of the State Sanitary Code, directly to the city, county or district health officer and to the department within 24 hours from the time the case is first seen by the physician.
 

Doc Status: 
Complete

Section 83-1.17 - Linen and laundry

83-1.17 Linen and laundry.

(a) Shared health facilities shall:

(1) provide a sufficient quantity of clean linen to meet the requirements of patients;

(2) separately bag or enclose used linens from infectious patients in readily identified containers distinguishable from other laundry; and

(3) transport and store clean linen in a manner to prevent its contamination.
 

Doc Status: 
Complete

Section 83-1.18 - Disinfection and sterilization

83-1.18 Disinfection and sterilization.

(a) Shared health facilities shall:

(1) assure proper cleaning, disinfection, sterilization and storage of all equipment and supplies that require such treatment;

(2) provide for monthly bacteriological tests of sterilization processes, and keep a record of the results of such tests; and

(3) assure proper cleaning and disinfection or sterilization of gas, oxygen, aspirating and vaporizing equipment.
 

Doc Status: 
Complete

Section 83-1.19 - General structural equipment and safety standards

83-1.19 General structural equipment and safety standards.

(a) Compliance with local laws and regulations. Shared health facilities shall conform with all local laws, regulations and codes relating to fire and safety, sanitation, plumbing and other health requirements, where such laws, regulations and codes impose standards in addition to those required by this Part.

(b) Shared health facilities shall comply with pertinent provisions of the American National Standard Institute (ANSI) Standard No. A117.1, American Standard Specifications for making buildings and facilities accessible to, and usable by, the physically handicapped (1961). Copies of this publication are available from the publisher, American National Standards Institute, Inc., 1430 Broadway, New York, NY, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.

(c) Office space and public areas. There shall be:

(1) a lobby which shall include:

(i) an information counter or desk;

(ii) adequate waiting space; however, no corridor, subcorridor or passageway shall be used as waiting space; and

(iii) public toilet facilities;

(2) suitable storage facilities for sterile supplies, clinical laboratory specimens, pharmaceutical supplies, housekeeping supplies, and equipment.

(d) Clinical facilities shall include:

(1) general purpose examination room(s) for medical, dental, obstetrical and similar examinations shall have a minimum floor area of 64 square feet excluding such spaces as vestibule, toilet and closet. A lavatory or sink equipped for handwashing and a counter for shelf space for writing shall be provided. Room sizes for specialized examinations or procedures, such as eye, dental, and ear, nose and throat, shall provide sufficient space for treatment of patients and accommodation of equipment.

(2) a drug distribution center, if required by facility needs, which shall include double-locked storage for controlled substances; and

(3) sterilizing facilities for the sterilization of equipment and supplies if supplies, or equipment requiring sterilization are used.

(e) Diagnostic facilities shall meet the following requirements:

(1) Radiographic installations, when provided, shall conform to the applicable requirements of Part 16 of the State Sanitary Code, and shall include:

(i) dressing areas with convenient access to a public toilet;

(ii) radiographic room(s);

(iii) film processing facilities;

(iv) viewing and administrative areas; and

(v) film storage facilities.

(2) Laboratory facilities shall contain at least a specimen collection room, which may be a public toilet that contains a water closet and lavatory.

(f) Janitor's closet or area. Each facility shall have at least one janitor's closet or separate area for the storage of housekeeping equipment and supplies, and a floor receptor or service sink.

(g) Details and finishes.

(1) Toilet rooms which may be used by patients shall be equipped with hardware which will permit access from the outside in any emergency.

(2) Soap and towel dispensers and waste receptacles shall be provided at all hand-washing fixtures. Handwashing sinks in examination rooms shall be provided with other than hand controls and with hot and cold water.

(3) Cubicle curtains and draperies shall be noncombustible and shall pass both the large and small scale tests of the National Fire Protection Association, Standard 701, Standard Methods of Fire Tests for Flame-Resistant Textiles and Films, 1969 edition. This standard was published by the National Fire Protection Association, Batterymarch Park, Quincy, MA, and a copy is available for inspection and copying at the offices of the records access officer of the Department of Health, Coming Tower, Empire State Plaza, Albany, NY.

(4) Floor materials shall be easily cleanable and have wear resistance appropriate for the location involved.

(5) Wall finishes shall be washable and, in the immediate area of plumbing fixtures, shall be smooth and moisture resistant.

(h) Construction, including fire safety requirements. Shared health facilities shall comply with the National Fire Protection Association No. 1O1, Chapter 13, Life Safety Code for Business Occupancies, 1973 Edition. The Life Safety Code is published by the National Fire Protection Association, Batterymarch Park, Quincy, MA, and a copy of the 1973 edition is available for inspection and copying at the offices of the records access officer of the Department of Health, Corning Tower, Empire State Plaza, Albany, NY.

(i) mechanical requirements.

(1) The facility shall maintain a minimum temperature of 65 degrees Fahrenheit during operating hours.

(2) Toilet rooms shall be provided with mechanical exhaust of air or screened windows which open to the outside. (3) Vacuum breakers shall be provided on all plumbing fixtures to which hoses or tubing can be attached.

(j) Electrical requirements.

(1) Adequate electrical outlets shall be provided in all areas of the facility to accommodate necessary equipment without the use of receptacle adapters which allow multiple appliances to be plugged into a single outlet or which adapt three-pronged, grounded plugs to two-wire, ungrounded circuits.

(2) Sufficient lighting to permit normal operation and to avoid any hazards to personal safety shall be provided.

(k) The commissioner may, upon application, waive the specific requirements of section 83-1.19 of this Part for any shared heath facility, upon a satisfactory showing by the applicant and a determination that:

(1) there are specified practical difficulties in conforming with the pertinent provisions of section 83-1.19 of this Part;

(2) the waiver of such requirement does not adversely affect the health and safety of the patients, visitors or staff;

(3) the construction of the facility when reviewed in its entirety provides adequate protection to the health and safety of the patients, visitors and staff.
 

Doc Status: 
Complete