Title: Section 716.4 - Rehabilitation facility construction projects approved or completed prior to October 14, 1998
716.4 Rehabilitation facility construction projects approved or completed prior to October 14, 1998.
This section applies to rehabilitation facilities built, renovated or altered prior to October 14, 1998 and to rehabilitation facility construction projects approved by the department or commissioner prior to October 14, 1998.
(a) Outpatient rehabilitation facilities shall comply with applicable requirements set forth in Part 715 of this Title. Inpatient rehabilitation facilities shall comply with applicable requirements set forth in Part 712 of this Title. The requirements of this Part shall supercede any inconsistent requirements set forth in Part 715 or Part 712 of this Title.
(b) Each inpatient and outpatient rehabilitation facility shall contain a medical evaluation
unit. The medical evaluation unit shall include an office for medical personnel and one
or more examination rooms. Each examination room shall contain a lavatory or sink
equipped for handwashing, a work counter, storage facilities and a desk, counter or shelf
space for writing. In addition, each inpatient and outpatient rehabilitation facility shall
include one or more of the following units:
(1) a psychological services unit;
(2) a social services unit; and,
(3) a vocational services unit.
(c) Each inpatient and outpatient rehabilitation facility shall provide the following service areas if they are not otherwise conveniently available to the facility:
(1) patient's dining, activities and day spaces;
(2) dietary unit;
(3) personal care facilities;
(4) unit for teaching activities of daily living:
(5) administration department;
(6) engineering service and equipment areas;
(7) linen services;
(8) janitor's closet; and,
(9) employee's facilities.
(d) The department may require, based on the proposed services to be provided at a rehabilitation facility, that a rehabilitation facility have additional special service areas. The sizes of the various departments shall depend upon the requirements of the facility. The additional service areas may include the following:
(1) an inpatient nursing unit;
(2) sterilizing facilities;
(3) a physical therapy unit;
(4) an occupational therapy unit;
(5) a prosthetics and orthotics unit;
(6) a speech and hearing unit;
(7) a dental unit;
(8) a radiology unit;
(9) a pharmacy unit; and,
(10) an electromyography room.
(e) Clinical laboratory facilities shall be provided within the rehabilitation facility or clinical laboratory services may be provided through a contract arrangement with a clinical laboratory. If clinical laboratory services are provided through such a contract, then the following minimum laboratory facilities shall be provided in the rehabilitation facility:
(1) A laboratory work counter(s) with sink, gas and electric service.
(2) Lavatory(ies) or sink(s) equipped for handwashing.
(3) Storage cabinet(s) or closet(s).
(4) Specimen collection facilities including urine collection rooms equipped with a water closet, lavatory and blood collection facilities with space for a chair and work counter.
(f) When provided in an inpatient or outpatient rehabilitation facility, a psychological service unit shall include an office and workspace for testing, evaluation and counseling.
(g) When provided in an inpatient or outpatient rehabilitation facility, a social services unit shall include office space for private interviewing and counseling.
(h) When provided in an inpatient or outpatient rehabilitation facility, a vocational services unit shall include office and workspace for vocational services activities such as evaluation, both prevocational and vocational, training, counseling and placement.
(i) Inpatient and outpatient rehabilitation facilities shall include one or more rooms of adequate size, appropriately furnished and designed for patient dining and patient activities or such rooms shall be conveniently available to inpatient and outpatient rehabilitation facilities. If a multi-purpose room is used for dining and patient activities, there shall be sufficient space to accommodate all activities and prevent their interference with each other. Storage space shall be provided for activities' supplies and recreational equipment.
(j) A dietary unit shall be provided or conveniently available to all inpatient and outpatient rehabilitation facilities. Construction, equipment and installation of such dietary facilities shall comply with applicable standards of Subpart 712-1 of this Title.
(k) A minimum of one personal care room shall be provided or be conveniently available to all inpatient and outpatient rehabilitation facilities.
(l) A unit for teaching activities for daily living shall be provided at or be conveniently available to all inpatient and outpatient rehabilitation facilities. It shall include a bedroom, bath, kitchen and space for stairs.
(m) The following shall be provided for all inpatient and outpatient rehabilitation facilities:
(1) A public entrance, located at grade level, sheltered from the weather and able to accommodate wheelchairs.
(2) A lobby that includes:
(i) wheelchair storage space(s);
(ii) reception and information counter or desk;
(iii) waiting space(s);
(iv) public toilet facilities;
(v) public telephone(s); and,
(vi) drinking fountain(s).
(3) Interview space(s) for private interviews relating to social service, credit and admissions.
(4) General or individual office(s) for business transactions, records and administrative and professional staffs.
(5) Multi-purpose room(s) for conferences, meetings, health education purposes and library.
(6) Special storage for employee's personal effects.
(7) General storage for office supplies, sterile supplies, pharmaceutical supplies, splints and other orthopedic supplies and housekeeping supplies and equipment.
(n) All inpatient and outpatient rehabilitation facilities shall include the following:
(1) Equipment rooms for boilers, mechanical equipment and electrical equipment.
(2) Storage room(s) for building maintenance supplies and yard equipment.
(o) All inpatient and outpatient rehabilitation facilities shall provide clean linen consistent with this subdivision.
(1) If linen is to be processed on the site, the following shall be provided:
(i) a laundry processing room with commercial-type equipment;
(ii) A soiled linen receiving, holding and sorting room with handwashing facilities;
(iii) storage for laundry supplies;
(iv) a clean linen inspection and mending room or area;
(v) clean linen storage, issuing and holding room or area;
(vi) a janitor's closet containing a floor receptor or service sink and storage space for housekeeping equipment and supplies; and,
(vii) sanitizing facilities and storage area for carts.
(2) If linen is processed off the rehabilitation facility site, the following shall be provided:
(i) a soiled linen holding room;
(ii) clean linen receiving, holding, inspection and storage room(s); and,
(iii) sanitizing facilities and storage area for carts.
(p) At least one janitors' closet shall be provided on each floor of all inpatient and outpatient rehabilitation facilities. Each janitor's closet shall contain a floor receptor or service sink and storage space for housekeeping supplies and equipment.
(q) In addition to the employees' facilities such as locker rooms, lounges, toilets or shower facilities called for in certain departments, all inpatient and outpatient rehabilitation facilities shall provide a sufficient number of such facilities as required to accommodate the needs of all personnel and volunteers.
(r) When provided, physical and occupational therapy units in inpatient or outpatient rehabilitation facilities shall comply with this subdivision.
(1) The physical therapy unit shall include:
(i) Office space.
(ii) Waiting space.
(iii) Treatment area(s) that comply with the following:
(a) cubicle curtains shall be provided around each individual treatment area for thermotherapy, diathermy, ultrasound, hydrotherapy and similar treatments;
(b) handwashing facilities shall be provided, although one lavatory or sink may serve more than one cubicle; and,
(c) facilities for collection of wet and soiled linen and other material shall be provided;
(iv) An exercise area.
(v) Storage for clean linen, supplies and equipment.
(vi) Patients' dressing areas, showers, lockers and toilet rooms.
(vii) A service sink.
(viii) Wheelchair and stretcher storage.
(2) The occupational therapy unit shall include:
(i) Office space.
(ii) Waiting space.
(iii) Treatment and activities of daily living area. Provision shall be made for a sink or lavatory and for the collection of waste products prior to disposal.
(iv) Storage for supplies and equipment.
(v) Patients' dressing areas, showers, lockers and toilet rooms.
(3) Office space, waiting space, storage areas and patients' dressing areas, showers, lockers and toilet rooms may be shared by physical and occupational therapy.
(s) When provided in inpatient or outpatient rehabilitation facilities, the prosthetics and orthotics unit shall consist of the following:
(1) work space for technician(s);
(2) space for evaluation and fitting with provision for privacy; and
(3) space for equipment, supplies and storage.
(t) When provided, speech and hearing units in inpatient or outpatient rehabilitation facilities shall consist of:
(1) office(s) for therapists;
(2) space for evaluation and treatment; and
(3) space for equipment and storage.
(u) When provided, dental units in inpatient or outpatient rehabilitation facilities shall include an operatory with a lavatory and a laboratory and film processing facilities.
(v) When provided, radiology units provided in inpatient or outpatient rehabilitation facilities shall contain the following:
(1) radiographic room(s);
(2) film processing facilities;
(3) viewing and administration area(s);
(4) film storage facilities;
(5) a toilet room with handwashing facility, directly accessible from each fluoroscopy room without entering the general corridor area;
(6) dressing area(s);
(7) a waiting room or alcove for ambulatory patients; and
(8) a holding area for stretcher patients, out of direct line of normal traffic.
(w) When provided in inpatient or outpatient rehabilitation facilities, the size and type of services to be provided in the pharmacy shall depend upon the type of drug distribution system to be used in the rehabilitation facility and whether the rehabilitation facility proposes to provide, purchase or share pharmacy services with other facilities. Provision shall be made for the following:
(1) administrative functions, to include requisitioning, recording and reporting, receiving, storage including refrigeration, and counting;
(2) quality control area, if bulk compounding and/or packaging functions are performed;
(3) locked storage for drugs and biologicals;
(4) dispensing area;
(5) handwashing facilities;
(6) drug information area for reference materials and personnel, with convenient access to public toilets; and
(7) sterile products area for compounding of intravenous admixtures and other sterile dosage forms.
(x) In freestanding outpatient rehabilitation facilities, details relating to exits and fire safety shall be in accordance with the provisions of NFPA 101, Life Safety Code, 2000 edition, applicable to business occupancies. Further details concerning this referenced material are contained in section 711.2(a) of this Title.
(y) Details and finishes shall comply with the following requirements:
(1) 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.
(2) Minimum width of all doors to rooms needing access for beds or stretchers shall be three feet four inches. Doors to patients' toilet rooms and other rooms needing access for wheelchairs shall have a minimum width of two feet six inches.
(3) Doors on all openings between corridors and rooms or spaces subject to occupancy, except elevator doors, shall be swing type. Openings to showers, baths, patients' toilets and other small wet-type areas not subject to fire hazard are exempt from this requirement.
(4) No corridor, subcorridor or passageway shall be used as a waiting space.
(5) Dumbwaiters, conveyors and material handling systems shall comply with the requirements set forth in Subpart 712-1 of this Title. Grab bars shall be provided at all patients' toilets, tubs, showers and sitz baths.
(6) Soap dishes shall be provided in showers and bathrooms.
(7) Ends of handrails and grab bars shall be constructed to prevent snagging the clothes of patients.
(8) Mirrors shall be arranged for convenient use by patients in wheelchairs as well as by patients in a standing position.
(9) Paper towel dispensers and waste receptacles shall be provided at all handwashing fixtures.
(z) At least one elevator shall be provided if any patient areas are located on any floor above or below the entry level.
(aa) Each inpatient nursing unit of a rehabilitation facility shall comply with applicable requirements of Subpart 713-2 of this Title, including but not limited to, mechanical requirements, details and finishes.
VOLUME D (Title 10)