Variations of Patient Room Size and/or Beds Per Room

7014.3 - Variations of Patient Room Size and/or Beds Per Room (Rev. 244; Issued: 06-26-26; Effective: 06-26-26; Implementation: 06-26-26) Resident rooms may have no more than four beds per room. However, for facilities that receive approval of construction or reconstruction plans by State and local authorities or are newly certified after November 28, 2016, bedrooms must accommodate no more than two residents. All resident rooms must afford a minimum of 80 square feet per bed in multi-patient rooms. Single rooms must measure at least 100 square feet. In 42 CFR 483.90(e)(3) variations may be permitted in individual cases where the facility demonstrates in writing that the variations are in accordance with the special needs of the residents and will not adversely affect their health and safety. • If a facility has never been granted a waiver under this section, or was granted a waiver in the past, but did not have a waiver after the last standard survey: the facility is cited for noncompliance with the applicable requirements, and the state agency will then determine if the facility meets the requirements to qualify for a waiver. • If a facility was granted a waiver on the last standard survey: the surveyor will determine if the facility continues to meet the requirements to qualify for a waiver. o If the facility continues to meet the requirements, the facility is not cited, and another waiver may be granted. o If the facility no longer meets the requirements for a waiver, the facility is cited, and a waiver is not granted. The facility must correct the noncompliance to meet the requirements at §483.90 (e)(1)(i) or (ii). The CMS Location has jurisdiction to approve such waivers or variances and are subject to annual review by CMS. The State has jurisdiction to approve them in Medicaid-only NF cases. In either case, the approved waiver for the requirements at §483.90(e)(1)(i) and (ii) must be accurately documented in the CMS survey and certification system, such as ACO/ARO, or subsequent approved CMS system. When CMS or the state agency denies the request or terminates a variation / waiver under §483.90(e)(1)(i) or (ii), the state agency or the CMS Location must include the reason for the denial or termination in the Statement of Deficiencies form CMS-2567. The state agency determines that a variation/waiver will not endanger the health or safety of the residents in the facility by completing a standard survey. Based on their assessment, the survey team will determine if the variations of the patient room size or beds per room endanger the health or safety of the residents in the facility. The State Agency and CMS Location must accurately document any variation / waiver granted under §483.90(e)(1)(i) or (ii).