Title: Section 1007.12 - Physical Standards 

Section 1007.12 Physical Standards 

(a) General.  

(1) The operator must maintain the facility in a good state of repair and sanitation and in conformance with applicable state and local building codes and other laws. 

(2) The facility shall be appropriate for a recipient resting and recuperating from the recipient’s qualifying condition.  

(3) The facility or a dedicated portion of the facility must be used exclusively to operate a medical respite program. An operator may request prior permission from the department, in writing, to utilize space for other activities. The operator must demonstrate that the proposed use is not incompatible with the medical respite program, will not be detrimental to recipients and complies with applicable local codes. 

(b) Flood protection. If the facility is located in a flood plain, the commissioner may require that the facility comply with any, or all, of the following: 

(1) Health facility footings, foundations, and structural frame shall be designed to be stable under flood conditions. 

(2) The facility shall be designed and capable of providing services necessary to maintain the life and safety of patients and staff if floodwaters reach the 100-year flood crest level and shall include the following: 

(i) electrical service, emergency power supply, heating, ventilating and sterilizers; 

(ii) fire alarm system; 

(iii) dietary service; 

(iv) an acceptable alternate to the normal water supply system; and 

(v) an acceptable emergency means of storage and/or disposal of sewage, biological waste, and garbage. 

(c) Smoke and fire protection.   

(1) A supervised smoke detection system, which is listed by an acceptable testing laboratory, shall be installed in the following locations: 

(i) in each corridor at least every 40 feet on center, or less if required by the manufacturer; 

(ii) at the top of all stairways, elevator and hoist way and other unsealed shafts; and 

(iii) in attics, basements and open floor areas designated for public or recipient use, at least one detector for each 1,000 square feet of open or unpartitioned space. 

(2) In a facility that is approved by the department to house fewer than 40 recipients, which has a fire protection system capable of being directly connected to the local fire department or a central station, at least one of the fire protection systems shall be so connected unless local fire officials refuse to establish such a connection. The operator must document such refusal. 

(3) There shall be at least two means of egress from each floor designated for public or recipient use. The required means of egress shall: 

(i) be remote from one another; 

(ii) be open in the direction of exit travel; 

(iii) be equipped with panic (quick-release) hardware; 

(iv) be equipped with a self-closing device;  

(v) not pass through a bedroom or bathroom; and 

(vi) be clear of trash, clutter or obstruction and freely accessible at all times. 

(4) Illuminated exit signs shall be installed at each required exit. When the exit is not visible, illuminated directional exit signs shall be installed in all corridors to indicate the location of each means of egress. 

(5) Emergency lighting which is listed by an acceptable testing laboratory and powered by battery or an automatic generator shall be installed in all exit hallways, stairwells and public areas. 

(6) Fire extinguishers which meet National Fire Protection Association standards, and which are appropriate for the type of fire which may occur at the site of installation shall be: 

(i) placed at accessible locations on each floor and each wing; 

(ii) wall-hung; and 

(iii) properly charged and checked. 

(7) Evacuation procedures which set forth areas of refuge, the duties of all staff and recipients, and directions for the rapid evacuation of the premises shall be posted in a conspicuous place on each floor and wing. 

(8) The following are fire hazards and are prohibited: 

(i) smoking in other than designated areas; 

(ii) portable electric space heaters; 

(iii) self-contained, fuel-burning space heaters; 

(iv) nonmetal containers for furnace ashes; 

(v) accumulation of combustible materials in any part of the building; 

(vi) storage of flammable or combustible liquids in anything other than closed containers listed by an acceptable testing laboratory; 

(vii) cooking appliances in a recipient’s room; and 

(viii) overloaded electrical circuits. 

(d) Safety procedures. 

(1) Neither devices such as chain locks, hasps, bars, nor other items such as furniture, can be used in any recipient use area in a way that would inhibit access to an exit or the free movement of recipients. 

(2) Doors in recipients’ sleeping units may be secured by the recipient provided such doors can be unlocked from the outside by facility attendants or employees or security staff at all times. 

(3) Recipients must not have access to storage areas used for cleaning agents, bleaches, insecticides, or any other poisonous, dangerous or flammable materials. 

(4) Lighting must be adequate in all spaces. Night lights must be provided and working in all hallways, stairways and bathrooms which are not private. 

(5) Hallways, corridors and means of emergency egress must be free from obstruction and may not be used for storage of equipment or trash. 

(e) Furnishings and equipment. 

(1) The operator shall provide furnishings and equipment which support daily activities and are durable, clean, appropriate to function and do not endanger recipient health, safety and welfare. 

(2) The operator shall furnish each recipient with a single bed that is a minimum of 30 inches in width. Each bed shall be substantially constructed, in good repair, and have: 

(i) a clean, comfortable and well-constructed mattress, standard in size for the bed; 

(ii) a cover sufficient to protect against insect infestation; and 

(iii) one clean and comfortable pillow of average bed size. 

(3) Recipients shall be supplied with the following in quantities sufficient to meet the needs of the recipient: 

(i) suitable sheets, pillowcases, pillows, and blankets; 

(ii) towels; 

(iii) soap;  

(iv) toilet tissue; and 

(v) menstrual products.  

(4) Bed linens, blankets and towels shall be: 

(i) clean and washable; 

(ii) free from rips and tears; and 

(iii) available when changes are necessary. 

(5) A complete change of bed linens and towels shall be provided to recipients at entry, at least once a week, and more often if needed. 

(6) Sufficient numbers of noncombustible trash containers with covers shall be available. 

(7) All operable windows must be equipped with screens and where necessary to provide privacy, with curtains, shades or other appropriate widow covering to ensure privacy. 

(8) Light fixtures must be shaded to prevent glare. 

(9) Heating and cooling systems must be in good working order. 

(10) Suitable fans should be provided to recipients when necessary to maintain reasonable air circulation. 

(11) Laundry facilities, either on-site in a clean, dry, well-lighted area, or at a nearby commercial laundromat. Reasonable accommodations will be provided for recipients who are unable do their own laundry.

(12) A telephone or telephones must be available for recipient to use and receive calls at no cost to the recipient. 

(13) High-speed internet must be available for recipient use at no cost, whether on a device owned by the operator or on the recipient’s personal device(s). 

(14) Medication storage, including refrigeration for medications requiring refrigeration.

(15) The operator shall maintain areas suitable for posting required notices, documents and other written materials in locations visible to, and accessible to, recipients, staff and visitors. 

(f) Housekeeping. 

(1) The operator shall maintain a clean and comfortable environment. 

(2) All areas of the facility shall be free of vermin, rodents and trash. 

(3) All areas of the facility, including, but not limited to, the floors, walls, windows, doors, ceilings, fixtures, equipment and furnishings shall be clean and free of odors. 

(4) Blankets and pillows shall be laundered as often as necessary for cleanliness and freedom from odors. 

(5) Adequate, properly maintained supplies and equipment for housekeeping functions shall be onsite for designated staff to maintain cleanliness. 

(g) Maintenance. 

(1) The operator of each medical respite program shall ensure the continued maintenance of the facility in accordance with this Section. 

(2) The building and grounds shall be maintained in a clean, orderly condition and in good repair. 

(3) All equipment and furnishings shall be maintained in a clean, orderly condition and in good working order. 

(4) Electrical systems, including appliances, cords and switches, shall be maintained in good working order. 

(5) Entrances, exits, steps and outside walkways shall be in good repair and shall be kept free from ice, snow and other hazards. 

(h) Space requirements. 

(1) Medical respite services. The facility shall have appropriate space for recipients to meet privately with staff or external service providers for purposes of eligibility assessments, developing and monitoring of service plans, care coordination, and, as applicable, the on-site provision of health services.  

(2) Bath and toilet facilities. 

(i) There shall be a minimum of one toilet and one sink for each four recipients, and one tub or shower for each four recipients. 

(ii) Toilet and shower areas must be accessible and in working order with hot and cold water 24 hours a day. 

(iii) Hot water for bathing and washing must be maintained at no less than 110 degrees Fahrenheit. 

(iv) All toilet and showers shall be vented by means of natural or mechanical ventilation to the outside air. 

(v) All toilet and shower areas shall be properly enclosed and separated from other areas by ceiling-high partitions and doors. 

(3) Bedrooms in medical respite programs. 

(i) In single occupancy sleeping rooms, a minimum of 80 square feet per recipient shall be provided. 

(ii) In sleeping rooms for two recipients, a minimum of 60 square feet per recipient shall be provided. No more than two recipients shall share a sleeping room.

(iii) A minimum of three feet, which is included in the per recipient minima, shall be maintained between beds and for aisles. 

(iv) If partitions are used to subdivide sleeping areas within the same room, their minimum height shall be sufficient to afford individual privacy, approximately four feet. 

(v) Partitions separating sleeping rooms from other rooms shall be ceiling high and smoke-tight. 

(vi) Bedrooms or sleeping areas must open directly into exit corridors. 

(vii) A passageway or corridor may not be used as a bedroom. 

(viii) With the exception of single bedrooms with locking doors, bedrooms shall have individual, lockable storage lockers for recipient belongings. Each locker shall be large enough to accommodate winter clothing. 

(i) Kitchens in living areas. 

(1) Kitchens or food preparation areas, if any, must be well-lighted and ventilated, and comply with all State and local codes and regulations including, but not limited to, those relating to fire protection, safety, sanitation and health. 

(j) Reporting. 

(1) In the event of a heating, water, or electrical failure that is more than four hours in duration, the discovery of an environmental hazard such as lead paint or asbestos, or the discovery of a defect in the physical plant or structure of a facility that may threaten the health and well-being of recipients, the operator will immediately notify the Department of Health by e-mail or telephone.