HAR §11-95-9. Construction requirements

(a) The facility shall be constructed and maintained in accordance with state and county zoning, building, fire safety, and sanitation laws, ordinances, and rules. New construction and remodeling shall be guided by "Minimum Requirements of Construction & Equipment for Hospital & Medical Facilities" DHEW Publication No. (HRA) 79-14500 as it existed on December 31, 1984. (b) The facility shall be accessible to and functional for physically handicapped persons. (c) There shall be adequate space to allow free movement of occupants using wheelchairs, walkers, canes and crutches to and from exits, post-operative recovery areas, bathrooms, closets, dressing areas, and common hall areas. (d) Provision shall be made for each patient to have use of a lockable closet, dressing cubicle, or dressing room. (e) A waiting room of appropriate size shall be provided and toilet rooms, separate from patient toilets, shall be easily accessible to those in the waiting area. (f) Suitable dressing areas and toilet facilities for staff use, separate from patient use, shall be provided. (g) One or more examining rooms separate from recovery and operating rooms shall be provided. (h) Grab bars shall be provided in patient and waiting room toilets. Each bathroom shall provide at least one washbasin and one commode. (i) Operating and recovery rooms shall be located so as to prevent through traffic except in the case of emergency. Entrance and exits to these rooms shall be by means of interior doors except for emergency outdoor exit doors which may be provided as needed. (j) There shall be adequate scrub-up facilities and work areas for the preparation, sterilization, and storage of instruments and supplies. (k) Each patient toilet and bathroom facility shall have a suitable nurses' call system for signalling the need for assistance. (l) Adequate supply of hot and cold potable running water must be supplied at all times. Temperature of hot water at plumbing fixtures used by patients shall be automatically regulated and shall not exceed 110˚F. (m) Bedpans and urinals shall be available for use as well as suitable methods and equipment for cleaning and sterilizing same. (n) In the event that a sexually mixed recovery room is utilized, suitable screens or curtains shall be provided to ensure privacy for each patient. (o) Patient beds, wherever located, shall be surrounded by at least three feet of clear floor area. (p) All rooms in which patient care is carried out shall be on or above grade level. (q) Floors and walls. (1) Floors shall be of slip resistant material, flush at doorways. (2) Floors shall be of material which does not retain odors. (3) Scatter rugs shall not be used. (4) Walls, floors, ceilings and decorative items in rooms shall be made of material which permit washing, cleaning, and painting. (r) Where appropriate, screening of doors and windows shall be provided using screening having sixteen meshes per inch. (s) Neither sliding doors nor folding doors shall be used as room or building exit doors. All double-acting doors shall be provided with vision panels. (t) The minimum clear width of corridors shall be forty-four inches, except when a general anesthetic is used in the facility. In the latter case, corridors which serve non-ambulatory patients shall be a minimum of eight feet wide. (u) Suitable locked storage space shall be available for storing of maintenance equipment and supplies. (v) The water supply shall comply with chapter 340E, HRS. (w) Ventilation shall comply with chapter 11-39, relating to air conditioning and ventilating. (x) Additions, alterations, and all repairs to existing buildings. (1) Where the structure was in use for this type of occupancy prior to the effective date of this chapter, the director may waive or modify any portion of these construction standards, provided the exceptions do not create a hazard to patients personnel or public. In no case shall any fire safety standards, as determined by the county fire marshal, be waived or modified; (2) Drawings and specifications for all new construction or additions, alterations, or repairs to existing buildings subject to the provisions of this chapter shall be submitted to the licensing branch of the department for review, and a certificate of need where applicable, shall also be submitted. (3) Construction shall not commence prior to the department's approval of construction drawings. Specifications shall comply with this chapter, the county fire marshal's rules, and with county building codes and ordinances; (4) The department shall review each submittal and advise the applicant, in writing, of its findings, within a reasonable time, with respect to approval, disapproval, or any mandatory changes required; (5) Unless construction is commenced within one year of the approval of final construction drawings and specifications, the latter with the previously approved application, shall be resubmitted for review and reapproval; (6) Minor alterations which do not affect structural integrity or fire safety and do not change functional operation and do not increase beds or services over that for which the facility is licensed, may be submitted either by freehand drawings or by the more conventional drawings and specifications. (y) There shall be appropriately equipped utility rooms, at least one clean and one soiled for each operating suite. [Eff March 3, 1986] (Auth: HRS §§321-9, 321-10) (Imp: HRS §§46-4, 62-34, 64-91, 65-71, 66-71, 70-71, 132-3, 321-10, 340E-1 to 340E-9)