Title: Section 715-1.4 - Ambulatory medical facility construction projects approved or completed between October 14, 1998 and December 31, 2010

715-1.4 Ambulatory medical facility construction projects approved or completed between October 14, 1998 and December 31, 2010.

This section applies to ambulatory medical facility construction projects approved by the department or commissioner between October 14, 1998 and December 31, 2010 and to ambulatory medical facility construction projects not requiring such approval that are completed between October 14, 1998 and December 31, 2010. (a) Ambulatory medical facilities other than chronic renal dialysis facilities shall comply with Chapter 39, "Existing Business Occupancies", of NFPA 101, Life Safety Code, 2000 edition. Chronic renal dialysis facilities shall comply with provisions of NFPA 101, Life Safety Code, 2000 edition, applicable to new or existing Ambulatory Health Care Centers, as appropriate. The materials referred to in this subdivision are described in more detail in section 711.2(a) of this Title.

(b) Ambulatory medical facilities, where specifically indicated, shall comply with applicable provisions of the 1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities, 1996 edition, which is described in more detail in section 711.2(b)(6) of this Title.

(c) Ambulatory medical facilities shall include all pertinent elements described in this section. The amount and types of diagnostic, clinical and administrative facilities to be provided shall be determined by the services contemplated and the estimated patient volume as described in the construction application. When services are shared or purchased, the commissioner may approve appropriate deletions and modifications in space and equipment requirements to avoid duplication. With respect to ambulatory medical facilities that provide specialized services or a limited scope of services, the commissioner may, on the basis of an approved program, waive compliance with the requirements of this Subpart, provided that the waiver does not adversely affect the health and safety or function of the facility.

(d) The design and size of each examination, treatment, or patient care room or space provided shall be determined by the equipment used therein, efficient access to the patient and the need for safe circulation of health care personnel within the space.

(e) All ambulatory medical facilities shall include:

(1) at least one private toilet for the exclusive use of patients;

(2) a separate enclosed space for the exclusive purpose of holding soiled disposable items and other medical waste;

(3) for each exam, diagnostic, treatment room or laboratory, provide a separate lavatory, equipped for hand washing, within the room or space; and

(4) privacy for patient. The planning of ambulatory medical facilities shall provide for the patient's privacy and dignity during interview, examination and treatment.

(f) Ventilation shall be provided in accordance with Section 7.31.D1 of the 1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities, 1996 edition, which is described in more detail in section 711.2(b)(6) of this Title.

(g) Freestanding renal dialysis centers shall comply with pertinent requirements in Section 7.14 of Chapter 7, "General Hospital", of the1996-97 Guidelines for Design and Construction of Hospital and Health Care Facilities, 1996 edition, which is described in more detail in section 711.2(b)(6) of this Title, and the provisions of Chapter 21, "Existing Ambulatory Health Care Occupancies" of NFPA 101, Life Safety Code, 2000 edition, which is described in more detail in section 711.2(a) of this Title. Patient areas and patient-related service areas shall also comply with the following:

(1) Individual cubicles for treatment shall be separated by non-inflammable curtains.

(2) A lavatory for hand washing, operable without the use of hands, shall be provided for each ten patients served.

(3) A sealed floor and floor drain shall be provided in each dialysis unit where hemodialysis is performed.

(h) Freestanding birthing center facilities shall include and comply with the following:

(1) Each birthing room shall have available oxygen, vacuum and medical air.

(2) An area for locked storage for drugs and refrigeration for biologicals (separate from the nourishment area refrigerator) shall be provided.

(3) A separate area for storing clean and sterile supplies shall be provided.

(4) Provisions shall be made for separate collection, storage and disposal of soiled materials. Fluid waste may be disposed of in the toilet adjacent to the birth room.

(5) Sterile supplies may be prepackaged disposables or processed off-site. If instruments and supplies are sterilized on-site, an area for accommodation of sterilizing equipment as appropriate shall be provided.

(6) As needed, the following elements shall be provided for clinical services to satisfy the functional program:

(i) birthing rooms shall be adequate in size, excluding vestibule, toilet and closets, to accommodate one patient, her family or other companion(s) and attending staff;

(ii) toilet, sink and bath/shower facilities with appropriately placed grab bars shall be adjacent to each birthing room. Bath/shower facilities shall be shared by not more than two birthing rooms;

(iii) hand washing fixtures operable without the use of hands, shall be located conveniently accessible to the birthing rooms; and

(iv) each birthing room shall be equipped with a system for communicating to other parts of the center and to an outside telephone line.