77 Ill. Adm. Code 250.2440
General Hospital Standards
Section 250
Section 250.2440Â General
Hospital Standards
Minimum Requirements in the
General Hospital
a)Â Â Â Â Â Â Â Â Administration and Public Areas
1)Â Â Â Â Â Â Â Â Main Entrance:Â Designed to accommodate persons with physical
disabilities;
2)Â Â Â Â Â Â Â Â Lobby:Â A reception and information counter or desk, waiting
space, public toilet facilities, public telephones and drinking fountain;
3)Â Â Â Â Â Â Â Â Interview Space:Â Space for private interviews relating to
social service, credit or admissions;
4)Â Â Â Â Â Â Â Â General or Individual Office:Â Office for business
transactions, medical and financial records, and administrative and
professional staffs.
5)Â Â Â Â Â Â Â Â Multipurpose Room:Â For conferences, meetings and education
purposes including provision for the use of visual aids;
6)Â Â Â Â Â Â Â Â Medical Library Facilities; and
7)Â Â Â Â Â Â Â Â Storage Areas.
b)        Medical Records Unit. Adequate space for the reviewing,
dictating, sorting, recording and storage of medical records shall be provided.
c)Â Â Â Â Â Â Â Â Adjunct Diagnostic and Treatment
1)        Laboratory Suite. Laboratory facilities shall be provided to
meet the work load described in the program narrative. These may be provided
within the hospital or through an effective contract arrangement with a nearby
laboratory service. If laboratory services are provided by contractual
arrangement, then at least the following minimum services shall be available
within the hospital (for additional requirements, see Subpart E of this Part):
A)Â Â Â Â Â Â Â A laboratory work counter with appropriate services;
B)Â Â Â Â Â Â Â A lavatory or counter sink equipped for hand-washing;
C)Â Â Â Â Â Â Â A storage cabinet or closet;
D)Â Â Â Â Â Â Â Blood storage facilities; and
E)Â Â Â Â Â Â Â Specimen and sample collection facilities, urine collection
rooms equipped with a water closet and lavatory, and blood collection facilities
with space for a chair and work counter.
2)Â Â Â Â Â Â Â Â Morgue and Autopsy Suite
A)Â Â Â Â Â Â Â The morgue and autopsy suite shall be accessible to an outside
entrance and shall be located to avoid movement of bodies through public areas.
B)Â Â Â Â Â Â Â The following shall be provided when autopsies are performed
within the hospital:
i)Â Â Â Â Â Â Â Â Â Refrigerated facilities for body holding; and
ii)        An autopsy room. This room shall contain a work counter with
sink equipped for hand-washing; storage space for supplies, equipment and specimens;
and an autopsy table.
C)Â Â Â Â Â Â Â If no autopsies are performed in the hospital, a
well-ventilated body-holding room shall be provided.
3)Â Â Â Â Â Â Â Â Radiology Suite
A)Â Â Â Â Â Â Â Facilities shall be provided for radiology purposes as required
by the program narrative. (For additional requirements see Subpart F of this
Part.)
B)Â Â Â Â Â Â Â The suite shall contain the following elements:
i)Â Â Â Â Â Â Â Â Â A radiographic room;
ii)Â Â Â Â Â Â Â Â Film processing facilities, if necessary;
iii)Â Â Â Â Â Â Â A viewing and administration area;
iv)Â Â Â Â Â Â Â Film storage facilities, if necessary;
v)Â Â Â Â Â Â Â Â A toilet room with hand-washing facilities, directly
accessible from each fluoroscopy room without entering the general corridor
area;
vi)Â Â Â Â Â Â Â A dressing area with access to toilets and facilities for patients'
belongings; and
vii)Â Â Â Â Â Â A waiting room or alcove.
C)Â Â Â Â Â Â Â Radiation protection requirements for X-ray and gamma ray
installations shall conform with National Council on Radiation Protection and
Measurements (NCRP), Report 49: Structural Shielding Design and Evaluation for
Medical Use of X-rays and Gamma Rays of Energies up to 10 MeV and Report 102:
Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50 MeV
(Equipment Design, Performance and Use). Provisions shall be made for testing
the completed installation and correcting defects before use.
D)Â Â Â Â Â Â Â X-ray installations for fixed and mobile X-ray equipment: shall
conform to Article 660, X-ray Equipment, of NFPA 70.
4)        Pharmacy Suite. The size and type of services to be provided
in the pharmacy will depend upon the type of drug distribution system to be
used in the hospital and whether the hospital proposes to provide, purchase, or
share pharmacy services with other hospitals or other medical facilities. This
shall be explained in the program narrative. (For additional requirements see
Subpart R.) Provisions shall be made for the following:
A)Â Â Â Â Â Â Â Administrative functions, including requisitioning, recording
and reporting, receiving, storage (including refrigeration), and accounting;
B)       A quality control area (if bulk compounding or packaging functions
are performed);
C)Â Â Â Â Â Â Â Locked storage for drugs and biologicals;
D)Â Â Â Â Â Â Â A dispensing area; and
E)       Hand-washing facilities. If required by the program,
provisions shall be made for the following:
i)Â Â Â Â Â Â Â Â Â A drug information area for reference materials and personnel;
and
ii)        A sterile products area for compounding I.V. admixtures and
other sterile dosage forms. A separate sink for hand-washing shall be provided
in this area.
5)Â Â Â Â Â Â Â Â Physical Therapy Suite
A)Â Â Â Â Â Â Â Appropriate services may be planned and arranged for shared use
by occupational therapy patients and staff.
B)Â Â Â Â Â Â Â If a physical therapy suite is required by the program
narrative, the following shall be provided:
i)Â Â Â Â Â Â Â Â Â Office space;
ii)Â Â Â Â Â Â Â Â Waiting space;
iii)Â Â Â Â Â Â Â A treatment area for modalities such as thermotherapy,
diathermy, ultrasonics and hydrotherapy. Cubicle curtains shall be provided
around each individual treatment area. Hand-washing facilities shall be
provided. One lavatory or sink may serve more than one cubicle;
iv)Â Â Â Â Â Â Â Facilities for the collection of wet and soiled linen and
other material;
v)Â Â Â Â Â Â Â Â An exercise area;
vi)Â Â Â Â Â Â Â Storage space for clean linen, supplies and equipment;
vii)Â Â Â Â Â Â Patients' dressing areas and toilet rooms, for both men and
women;
viii)Â Â Â Â Â Wheelchair and stretcher storage; and
ix)Â Â Â Â Â Â Â Showers, lockers and service sinks, as required by the program
narrative.
6)Â Â Â Â Â Â Â Â Occupational Therapy Suite
A)Â Â Â Â Â Â Â Appropriate elements may be planned and arranged for shared use
by physical therapy patients and staff.
B)Â Â Â Â Â Â Â If an occupational therapy suite is required by the program
narrative, the following elements shall be provided:
i)Â Â Â Â Â Â Â Â Â Office space;
ii)Â Â Â Â Â Â Â Â An activities area equipped with a sink or lavatory;
iii)Â Â Â Â Â Â Â Storage space for supplies and equipment; and
iv)Â Â Â Â Â Â Â Patients' toilet rooms.
d)Â Â Â Â Â Â Â Â Nursing Unit. The requirements in this subsection (d) do not
apply to special care areas such as recovery rooms, intensive care areas and
newborn care areas.
1)Â Â Â Â Â Â Â Â Patient Rooms
A)       Each patient room shall be an outside room. Windows shall be
provided for each patient room and shall be of a size not less than 7.5% of the
square footage of the floor of the room.
B)Â Â Â Â Â Â Â Minimum room areas shall be 100 square feet clear in one-bed
rooms and 80 square feet clear per bed in multi-bed rooms (no rooms shall have
more than four beds). Clear is defined as the usable dimensions of the room,
excluding the vestibule, toilet areas, and closets.
C)Â Â Â Â Â Â Â A minimum of 3 feet clear at the foot and sides of each bed
shall be provided.
D)Â Â Â Â Â Â Â Each patient room shall have access to a toilet room without
entering the corridor.
E)Â Â Â Â Â Â Â One toilet room shall serve not more than four beds and not
more than two patient rooms.
F)Â Â Â Â Â Â Â Â The toilet room shall contain a water closet and a lavatory.
The lavatory may be omitted from a toilet room that serves not more than two
single bedrooms if each such single bedroom contains a lavatory.
G)Â Â Â Â Â Â Â Each patient shall have a wardrobe, locker, or closet that is
suitable for hanging and storing personal effects.
H)Â Â Â Â Â Â Â Visual privacy shall be provided each patient bed in multi-bed
rooms.
2)Â Â Â Â Â Â Â Â Nurses' Service Center. The requirements in this subsection
(d)(2) shall be provided either as part of a centralized cluster serving more
than one nursing unit or shall be used as supportive areas within a
self-contained nursing unit.
A)Â Â Â Â Â Â Â A nurses' station with a work counter, storage areas, and
communications equipment shall be provided.
B)Â Â Â Â Â Â Â A nurses' office shall be provided.
C)Â Â Â Â Â Â Â Hand-washing facilities convenient to both the nurses' station
and the drug distribution station shall be provided.
D)Â Â Â Â Â Â Â Charting facilities shall be provided for nurses and doctors,
including a work counter and charting racks.
E)Â Â Â Â Â Â Â A lounge and men's and women's toilet rooms for staff shall be
provided.
F)Â Â Â Â Â Â Â Â Closets or compartments for the safekeeping of coats and
personal effects of nursing personnel.
G)Â Â Â Â Â Â Â A multipurpose room shall be provided for conferences,
demonstrations, and consultation. This room may be located outside the nursing
unit, but within the hospital.
H)Â Â Â Â Â Â Â Accessibility to a room for the examination and treatment of
patients shall be provided. This room may be omitted if all patient rooms are
single bedrooms. This room shall have a minimum floor area of 100 square feet
excluding spaces for vestibules, toilet rooms (if provided), and work
counters. The room shall contain a lavatory, a work counter, storage
facilities, and a writing space.
I)Â Â Â Â Â Â Â Â At least one tub or shower shall be provided for each 12 beds
that do not have bathing facilities within the patients' rooms. Each tub or
shower shall be in an individual room or enclosure that provides space for the
private use of the bathing fixture and for drying and dressing.
J)Â Â Â Â Â Â Â Â A nourishment station with a sink equipped for hand-washing,
equipment for serving nourishment between scheduled meals, a refrigerator,
storage cabinets, and units to provide ice for patient's service and treatment
shall be provided.
K)Â Â Â Â Â Â Â A drug distribution station shall be provided for convenient
and prompt 24-hour distribution of medicine to patients. This may be from a
medicine preparation room or unit, a self-contained medicine dispensing unit,
or by another approved system. If a medicine preparation room or unit is used,
it shall be under the nursing staff's visual control and contain a work
counter, refrigerator, and locked storage for biologicals and drugs. A
medicine dispensing unit may be located in an alcove under direct control of
the nursing or pharmacy staff.
3)Â Â Â Â Â Â Â Â Service Area
A)Â Â Â Â Â Â Â A clean work room or a clean holding room shall be provided in
each nursing unit. The clean work room shall contain a work counter, hand-washing
facilities, a nurse signal, and storage facilities. The clean holding room
shall be part of a system for storage and distribution of clean and sterile
supplies and materials.
B)Â Â Â Â Â Â Â A separate designated area within the clean work room shall be
provided for clean linen storage. If a cart system is used, the storage of the
cart may be in an adjacent alcove.
C)Â Â Â Â Â Â Â Parking shall be provided for stretchers and wheelchairs out of
the path of normal traffic.
D)Â Â Â Â Â Â Â A soiled work room or soiled holding room shall be provided.
The soiled work room shall contain a clinical sink or equivalent flushing rim
fixture, a nurse signal, a hand-washing sink, a waste receptacle, and a linen
receptacle. The soiled holding room shall be part of a system for the
collection and disposal of soiled materials. If bed pan flushing attachments
are used on every patient room toilet, a clinical sink is not required in the
soiled work room.
E)Â Â Â Â Â Â Â Room for the storage of equipment such as I.V. stands,
inhalators, mattresses and walkers shall be provided.
F)Â Â Â Â Â Â Â Â Space shall be provided for the storage of required emergency equipment,
such as a crash cart. This equipment shall be under the direct control of the
nursing staff.
G)Â Â Â Â Â Â Â Sitz baths shall be provided when required by the program
narrative.
4)        Isolation Room. There shall be a room or rooms as required by
the program narrative for the isolation of patients with known or suspected
communicable diseases. Each isolation room shall have an individual toilet
equipped with a bedpan flushing attachment and a lavatory. Isolation rooms
shall be provided with an anteroom equipped with a hand-washing sink, trimmed
with valves that can be operated without the use of hands, storage spaces for
clean and soiled materials, and a space for gowning. There shall be only one
patient per room. All isolation rooms shall be otherwise planned as required
for a standard patient room.
5)        Rooms for Disturbed Patients. Every hospital that does not
have a psychiatric nursing unit shall provide facilities for the care of
disturbed patients, usually for a duration of less than 24 hours. The design
shall provide for close observation and shall minimize the dangers of patient
escape, suicide or injury. This may be provided in a special care room used
for multiple purposes. This room shall be located either in the emergency unit
or in a private room in a medical nursing unit, or as otherwise provided by the
program narrative.
e)Â Â Â Â Â Â Â Â Intensive Care Units
1)        A means of controlling unnecessary noise shall be provided. A
means of providing temporary privacy for each patient shall be provided.
Windows shall be provided so that each patient may observe the outdoor
environment. Beds may be arranged so that one window may serve more than one
patient.
2)Â Â Â Â Â Â Â Â Intensive Care Units shall provide the following:
A)       Patient Rooms. Cardiac intensive care, medical intensive care,
and surgical intensive care patients may be housed in either single bedrooms or
multi-bed rooms; however, at least one single bedroom shall be provided. All
beds shall be arranged to permit visual observation by nursing staff. Patient
rooms shall meet the following requirements:
i)         Clearance between beds shall be not less than 6 feet. Single
bedrooms shall have a minimum area of 120 square feet and a minimum dimension
of 10 feet.
ii)Â Â Â Â Â Â Â Â Viewing panels shall be provided for nursing staff
observation of patients. Curtains or other means shall be provided to cover
the viewing panels when the patient requires visual privacy. Glazing in
viewing panels shall be safety glass, wire glass, or clear plastic to reduce
the hazard from accidental breakage, except that wire glass is required in
glazed openings to corridors or passageways used as means of egress for fire
safety purposes.
iii)       An I.V. solution support shall be provided for each patient
so that the solution is not suspended directly over the patient.
iv)Â Â Â Â Â Â Â A lavatory equipped for hand-washing shall be provided in each
private patient room. In multi-bed rooms, no fewer than one lavatory for each
six beds shall be provided.
v)Â Â Â Â Â Â Â Â A nurses' call system shall be provided. (See Section
250.2500(g).)
vi)Â Â Â Â Â Â Â Each cardiac intensive care patient shall be provided with a
toilet facility that is directly accessible from the bed area. The water closet
shall have sufficient clearance around it to facilitate its use by patients
needing assistance. Portable water closet units are permitted within patient
rooms. If portable units are used, facilities for servicing and storing them
shall be conveniently located to the cardiac care unit.
B)       Service Areas. The following service areas shall be located in
or readily available to each Intensive Care Unit. One area may serve two or
more adjacent Intensive Care Units. The size and location of each service area
shall depend upon the number of beds to be served.
i)Â Â Â Â Â Â Â Â Â A nurses' station shall be located to permit monitoring or
visual observation of each patient served.
ii)Â Â Â Â Â Â Â Â Hand-washing facilities shall be convenient to the nurses'
station and drug distribution station.
iii)Â Â Â Â Â Â Â Charting facilities shall be furnished with work counters and
charting racks.
iv)Â Â Â Â Â Â Â A staff toilet room shall contain a water closet and a
lavatory equipped for hand-washing.
v)Â Â Â Â Â Â Â Â Closets or compartments for the safekeeping of coats and
personal effects of nursing personnel shall be provided at or near the nurses'
station.
vi)Â Â Â Â Â Â Â A clean work room (or a system for storage and distribution of
clean and sterile supply materials) shall contain a work counter, a
hand-washing facility, and storage facilities.
vii)Â Â Â Â Â Â The soiled work room or soiled holding room shall contain a
clinical sink or equivalent flushing rim fixture, sink equipped for hand-washing,
work counter, waste receptacle, and linen receptacle. A soiled holding room
shall be part of a system for collection and disposal of soiled materials and
shall be similar to the soiled work room except that the clinical sink and work
counter may be omitted.
viii)Â Â Â Â Â Facilities for washing or flushing bedpans shall be provided
within the unit.
ix)Â Â Â Â Â Â Â A drug distribution station shall be provided for convenient
and prompt 24-hour distribution of medicine to patients either from a medicine
preparation room or unit, a self-contained medicine dispensing unit, or by
another approved system. If used, a medicine preparation room or unit shall be
under the nursing staff's visual control and shall contain a work counter, a
sink, refrigerator, and locked storage for biologicals and drugs. A medicine
dispensing unit may be located at the nurses' station, in the clean work room,
or in an alcove or other space under direct control of the nursing or pharmacy
staff.
x)        Clean Linen Storage. A storage closet or a designated area
within the clean work room shall be provided. If a closed cart system is used,
storage may be in an alcove.
xi)Â Â Â Â Â Â Â A nourishment station shall contain a sink equipped for hand-washing,
equipment for serving nourishment between scheduled meals, refrigerator, storage
cabinets, and units to provide ice for patients' service and treatment.
xii)      Emergency Equipment Storage. Space shall be provided for a
"crash cart" and similar emergency equipment.
xiii)     Equipment Storage Room. Space for necessary equipment shall
be provided.
xiv)Â Â Â Â Â Patients' storage facilities shall be provided for the storage
of patients' personal effects. These may be located outside the intensive care
unit.
C)Â Â Â Â Â Â Â A waiting room shall be provided for family members and others
who may be permitted to visit the intensive care patients. A toilet room,
public telephone, and seating accommodations for long waiting periods shall be
provided.
f)Â Â Â Â Â Â Â Â Pediatric Nursing Unit. Young children and adolescents shall
be housed in a nursing unit separate from adults unless special allowance has
been made in the program narrative. This unit shall meet the following
requirements:
1)        General Unit Requirements Including Patient Rooms. The
requirements noted in subsection (d) of this Section shall be applied to a pediatric
and adolescent nursing unit containing hospital beds, youth beds or cribs.
2)        Nursery as Specified in the Program Narrative. Each nursery
serving pediatric patients shall contain no more than eight bassinets. The
minimum clear floor area per bassinet shall be 40 square feet. Each room shall
contain a lavatory equipped for hand-washing, a nurses' emergency calling
system as provided in Section 250.2500(g), and glazed viewing windows for
observing infants from public areas and the work room.
3)Â Â Â Â Â Â Â Â Nursery Work Rooms as Specified in the Program Narrative.Â
Each nursery shall be served by a connecting work room. One work room may
serve more than one nursery. It shall contain gowning facilities for staff and
housekeeping personnel.
4)        Examination and Treatment Room. The examination and treatment
room shall contain a work counter, storage facilities, and a lavatory equipped
for hand-washing.
5)Â Â Â Â Â Â Â Â Service Areas. The service areas in the pediatric and
adolescent nursing unit shall conform to the conditions listed in subsection (d)(3)
and shall meet the following additional conditions:
A)Â Â Â Â Â Â Â Multipurpose or individual areas shall be provided for dining,
educational, and play, or other patient care purposes.
B)Â Â Â Â Â Â Â Space for preparation or storage of infant formula shall be
provided in the unit or in a convenient location nearby.
C)Â Â Â Â Â Â Â Patients' toilet rooms shall be provided convenient to
multipurpose areas and central bathing facilities.
D)Â Â Â Â Â Â Â Storage closets or cabinets for toys and for educational and
recreational equipment shall be provided.
E)Â Â Â Â Â Â Â Storage space shall be provided for replacement of youth and
adult beds to provide flexibility for interchange of patient accommodations.
6)Â Â Â Â Â Â Â Â Fixtures and Accessories
A)Â Â Â Â Â Â Â Attention shall be given to other details affecting small
children as required by the program.
B)Â Â Â Â Â Â Â Switches and plugs for critical equipment shall be designed to
preclude shock and located for inaccessibility by small children.
C)Â Â Â Â Â Â Â Toilets and washbasins shall be suitable for use by small
children as described in the program narrative.
g)Â Â Â Â Â Â Â Â Psychiatric Nursing Unit
1)Â Â Â Â Â Â Â Â Units intended for psychiatric or other types of disturbed
patient nursing care shall provide a safe and secure facility for patients
needing close supervision to minimize hiding, escape, injury, or suicide. The
unit shall be designed to facilitate care of ambulatory inpatients, to permit
flexibility in arranging various types of therapy, and to present as non-institutional
an atmosphere as possible.
2)Â Â Â Â Â Â Â Â Each nursing unit shall provide the following:
A)       Patient Rooms and Nurses' Service Center. The requirements
noted in subsection (d) shall be applied to patient rooms and nurses' service
center in psychiatric nursing units except as follows:
i)         A nurses' calling system is not required. Other types of
communications systems may be utilized.
ii)Â Â Â Â Â Â Â Â Provision for visual privacy is not required.
B)Â Â Â Â Â Â Â Service Areas. The service areas noted in subsection (d)(3)
shall be provided or made available to each Psychiatric Nursing Unit except
that space for stretchers and wheelchairs is not required and clinical sinks or
equivalent may be installed but are not required. The following elements shall
be provided within and for the exclusive use of the unit:
i)Â Â Â Â Â Â Â Â Â Consultation room.
ii)Â Â Â Â Â Â Â Â Space for dining, recreation, and occupational therapy. The
total area for these purposes shall not be less than 40 square feet per
patient.
iii)Â Â Â Â Â Â Â Storage closets or cabinets for recreational and occupational
therapy equipment.
iv)Â Â Â Â Â Â Â Storage for patients' clothing.
C)       Additional Services. Appropriate additional services shall be
provided as determined by the program narrative.
h)        Newborn Care Unit. Newborn infants shall be housed in
nurseries that are conveniently located to the postpartum nursing unit and
obstetrical facilities. The nurseries shall be located and arranged to
preclude unrelated traffic. No nursery shall open directly into another
nursery. Subpart O shall apply. Additionally:
1)Â Â Â Â Â Â Â Â Each nursery shall contain:
A)Â Â Â Â Â Â Â Lavatory trimmed with valves that are aseptically operated (for
example, knee or foot controls) at the rate of one for each eight bassinets.
B)Â Â Â Â Â Â Â A nurses' emergency calling system.
C)Â Â Â Â Â Â Â Bassinets in a number at least equal to the number of
postpartum beds.
D)Â Â Â Â Â Â Â Glazed observation windows to permit the viewing of infants
from public areas and from work rooms.
2)        Full-Term Nursery. The full-term nursery shall contain no
more than 12 bassinets; however, this number may be increased to 16 if the
extra bassinets are of the isolation type. The minimum floor area shall be 30
square feet for each regular bassinet and 40 square feet for each isolation
type bassinet. When a "rooming-in" program is used, the total number
of bassinets provided in these units may be reduced by no more than 50%, but
the full-term nursery shall not be omitted.
3)Â Â Â Â Â Â Â Â Special Care and Observation Nursery
A)Â Â Â Â Â Â Â A hospital shall make available a nursery to provide special
care for infants in distress if the hospital has 25 or more maternity beds,
unless equivalent facilities for these infants are conveniently available
elsewhere. The floor area per bassinet shall be as determined by the program narrative
but shall not be not less than 40 square feet. Additional area shall be
provided to accommodate work room functions if these are located within the
nursery area.
B)Â Â Â Â Â Â Â When a separate special care nursery is provided, it shall have
its own work room areas.
4)        Work Room. Each nursery shall be served by a connecting work
room. It shall contain gowning facilities at the entrance for staff and
housekeeping personnel, work space with counter, refrigerator, and lavatory or
sink equipped for hand-washing, and storage. One work room may serve more than
one nursery. The work room that serves the special care nursery may be omitted
if equivalent work area and facilities are provided within the nursery, in
which case the gowning facilities shall be located near the entrance to the
nursery and shall be separated from the work area.
5)        Examination and Treatment Room or Space for Infants. The
examination and treatment room or space for infants shall contain a work
counter, storage, and lavatory equipped for hand-washing trimmed with valves
that are aseptically operated (for example, knee or foot controls), and shall
be located so that doctors need not enter nurseries. It may serve more than one
nursery and may be located in the work room. If the examination and treatment
of infants will take place in the individual bassinets, space for physicians'
and nurses' gowning shall be provided as well as a conveniently accessible hand-washing
sink trimmed with valves that are aseptically operated (for example, knee or
foot controls).
6)        Infant Formula Facilities. When the program narrative
requires it, the hospital shall provide the following:
A)Â Â Â Â Â Â Â On-site Formula Preparation
i)Â Â Â Â Â Â Â Â Â Clean-up facilities for washing and sterilizing supplies.
These shall consist of a lavatory or sink equipped for hand-washing, a bottle
washer, work counter space, and an equipment sterilizer.
ii)        A separate room for preparing infant formula. It shall
contain a lavatory or sink equipped for hand-washing, refrigerator, work
counter, formula sterilizer, and storage facilities. It may be located near
the nurseries or at another appropriate place within the hospital. Direct
access from the formula room to a nursery or to a nursery work room shall not
be permitted.
B)       Commercially Prepared Formula. If a commercial infant formula
is used, the storage and handling may be done in the nursery work room or in
another appropriate room that has a work counter, a sink equipped for hand-washing,
and storage facilities.
7)        Janitors' Closet. A closet for exclusive use of the
housekeeping staff in maintaining the nursery unit shall be provided. It shall
contain a floor receptor or service sink and storage space for housekeeping
equipment and supplies.
8)Â Â Â Â Â Â Â Â Gowning and Scrubbing Areas. Gowning and scrub areas shall be
equipped with lockers for doctors' and nurses' belongings, cabinets for clean
gowning, receptacles for used gowns, and hand-washing sinks aseptically
operated without the use of hands.
9)Â Â Â Â Â Â Â Â Clean Utility Area. Clean utility area with work counter and hand-washing
sink shall be provided.
10)Â Â Â Â Â Â Â Â Soiled Utility Area. Soiled utility area with work counter, hand-washing
sink, clinical service sink or equivalent flushing rim fixture, and space for storage
hamper (one for diapers and one for soiled linen provided at a ratio of one for
each four bassinets or fraction thereof) shall be provided.
11)Â Â Â Â Â Â Â Â Storage Areas. Storage space for replacement bassinets,
phototherapy units, and other large items shall be provided. These storage
areas may be located either within the unit or in the central supplies storage.
i)         Surgical Suite. The number of operating rooms and recovery
beds and the sizes of the service areas shall be based on the expected surgical
work load. The surgical suite shall be located and arranged to preclude
unrelated traffic through the suite. The requirements of Section 250.1300
shall be used for the surgical suite wherever applicable. The suite shall
provide the following elements:
1)        General Operating Rooms. Each room shall have a minimum clear
area of 360 square feet exclusive of fixed cabinets and shelves. The minimum
dimension shall be 18 feet. A communications system shall be provided
connecting with the surgical suite control station. At least two x-ray film
illuminators shall be provided in each room.
2)Â Â Â Â Â Â Â Â Rooms for Surgical Cystoscopic and Other Endoscopic
Procedures. These rooms shall have a minimum clear area of 250 square feet
exclusive of fixed cabinets and shelves. If necessary to accommodate special
functions in one or more of these rooms, additional clear space shall be
required by the program narrative. A communications system connecting with the
surgical suite control station shall be provided. Facilities for the disposal
of liquid wastes shall be provided.
3)        Fracture Rooms. Fracture rooms shall be provided with an
adjacent splint room. The fracture room may be located in the emergency
department, the surgical suite, or as indicated in the program narrative.
4)        Recovery Room. The recovery room may be part of an approved
combined surgical/obstetrical program as provided in Section 250.1300.
A)Â Â Â Â Â Â Â The postoperative recovery room shall be located within or
adjacent to the surgical suite. A separate entrance and exit doors remote from
each other shall be provided to facilitate a one-way traffic flow within the
recovery room.
B)Â Â Â Â Â Â Â A minimum of one recovery room bed shall be provided for each
operating room.
C)Â Â Â Â Â Â Â A minimum of 70 square feet per bed shall be provided in open
units. This area shall exclude the nursing station, work space, and storage
area. In addition, a minimum of 4 feet shall be maintained between the sides
of the beds, at least 3 feet between the side of any bed and any wall or other
fixed device, and at least six feet between the foot end of any bed and any
other equipment or fixed device.
D)Â Â Â Â Â Â Â The recovery room shall have adequate lighting to allow
accurate observation of the patients.
E)Â Â Â Â Â Â Â A lavatory trimmed with valves operated without the use of
hands, and a clinical sink, shall be provided.
F)Â Â Â Â Â Â Â Â A soiled holding area shall be provided.
G)Â Â Â Â Â Â Â A nursing station shall be provided within the postoperative
recovery room. Facilities for medical storage and preparation shall be
provided.
H)Â Â Â Â Â Â Â Adequate storage and work space within or adjacent to the
recovery room shall be available for necessary supplies and equipment.
I)Â Â Â Â Â Â Â Â Each bed site shall be adequately equipped with oxygen,
suction and at least two duplex electrical outlets.
5)        Stage II Recovery Room. If outpatient surgery services are
provided in the surgical suite, a Stage II recovery room shall be provided for
outpatient observation prior to discharge. The Stage II recovery area may be
combined with an outpatient receiving and preparation area and may be located
at a site remote from the recovery room. Additionally, it shall contain the
following elements:
A)Â Â Â Â Â Â Â A
minimum of four recovery stations per operating room;
B)Â Â Â Â Â Â Â Lounge chairs at each recovery station with a minimum clear
area of 50 square feet and a minimum clearance around three sides of the chairs
of 4 feet;
C)Â Â Â Â Â Â Â A nurses' station with a work counter and space for
communications equipment and charting;
D)Â Â Â Â Â Â Â A drug distribution station with a work counter, locked storage
for narcotics, refrigerator, and hand-washing sink;
E)Â Â Â Â Â Â Â A toilet space for the exclusive use of the Stage II recovery
area. The toilet shall be equipped with a gray diverter valve; and
F)Â Â Â Â Â Â Â Â Clean and soiled utility rooms.
6)        Service Areas. Individual rooms shall be provided, or alcoves
or other open spaces that will not interfere with traffic may be used.Â
Services may be shared with, and organized as part of, the obstetrical
facilities, if the approved program narrative reflects this sharing concept. Cross-circulation
between the surgical and delivery suites when using shared service areas shall
not be permitted. The following services shall be provided:
A)Â Â Â Â Â Â Â A control station located to permit direct visual surveillance
of all traffic that enters the operating suite;
B)Â Â Â Â Â Â Â A supervisor's office or station;
C)Â Â Â Â Â Â Â Sterilizing facilities with high speed autoclaves conveniently
located to serve all operating rooms. When the program narrative indicates
that adequate provisions have been made for replacement of sterile instruments
during surgery, sterilizing facilities in the surgical suite will not be
required;
D)       A drug distribution station. An area shall be provided for
preparation of medication to be administered to patients;
E)Â Â Â Â Â Â Â Two scrub stations, conveniently located near each operating
room. Scrub facilities shall be arranged to minimize any incidental splatter
on nearby personnel or supply carts. A scrub sink or sinks shall be provided
that shall be aseptically operated without the use of hands (wrist blades are
not acceptable);
F)Â Â Â Â Â Â Â Â A soiled work room for the exclusive use of the surgical suite
staff (or a soiled holding room that is part of a system for the collection and
disposal of soiled materials). The soiled work room shall contain a clinical
sink or equivalent flushing type fixture, work counter, sink equipped for hand-washing,
waste receptacle, and linen receptacle. A soiled holding room shall be similar
to the soiled work room except that the clinical sink and work counter may be
omitted;
G)       Fluid waste disposal facilities. These shall be conveniently
located with respect to the general operating rooms. A clinical sink or
equivalent equipment in a soiled work room or in a soiled holding room meets
this requirement;
H)       A clean work room or a clean supply room. A clean work room is
required when clean materials are assembled within the surgical suite prior to
use. A clean work room shall contain a work counter, a sink equipped for hand-washing,
and space for clean and sterile supplies. A clean supply room shall be
provided when the program narrative defines a system for the storage and
distribution of clean and sterile supplies that would not require the use of a
clean work room;
I)        Anesthesia storage facilities. The use and storage of
anesthetic gases shall be in accordance with NFPA 99. Areas for cleaning,
testing and storing anesthesia equipment shall be provided;
J)Â Â Â Â Â Â Â Â An anesthesia work room for cleaning, testing and storing
anesthesia equipment. It shall contain a work counter and sink;
K)       Medical gas storage. Space for reserve storage of nitrous
oxide and oxygen cylinders shall be provided;
L)Â Â Â Â Â Â Â Storage space for splints and traction equipment for operating
rooms equipped for orthopedic surgery;
M)Â Â Â Â Â Â Equipment storage rooms for equipment and supplies used in the
surgical suite;
N)Â Â Â Â Â Â Â Staff clothing change areas, including appropriate areas for
male and female personnel (orderlies, technicians, nurses and doctors) working
within the surgical suite. The areas shall contain lockers, showers, toilets,
lavatories and space for donning scrub suits and boots. These areas shall be
arranged to provide a one-way traffic pattern so that personnel entering from
outside the surgical suite can change, shower, gown and move directly into the
surgical suite. Space for removal of scrub suits and boots shall be designed so
that personnel using it will avoid physical contact with clean personnel;
O)       Outpatient surgery change areas. If the program requires
outpatient surgery, a separate area shall be provided where outpatients change
from street clothing into hospital gowns and are prepared for surgery. This
shall include a waiting room, lockers, toilets, and clothing change or gowning
area with a traffic pattern similar to that of the staff clothing change area;
P)        Patients' holding area. In facilities with two or more
operating rooms, a room or alcove shall be provided to accommodate stretcher
patients waiting for surgery. This waiting area shall be under control of the
surgical suite control station;
Q)       Stretcher storage area. This area shall be out of the direct
line of traffic;
R)       Lounge and toilet facilities for surgical staff. These
facilities shall be provided in hospitals having three or more operating rooms
and shall be located to permit use without leaving the surgical suite. A
nurses' toilet room shall be provided near the recovery room; and
S)        Janitors' closet. A closet containing a floor receptor or
service sink and storage space for housekeeping supplies and equipment shall be
provided exclusively for the surgical suite.
7)        Central Sterilizing and Supply Room. The central sterile
supplies shall be located either within the surgical suite or provided as a
separate department within the hospital. The following shall be provided:
A)Â Â Â Â Â Â Â A receiving and clean-up room containing work space and
equipment for cleaning medical and surgical equipment, and for disposal or
processing of unclean material. Hand-washing facilities operated without the
use of hands shall be provided;
B)Â Â Â Â Â Â Â A clean work room containing work space and equipment for
sterilizing medical and surgical equipment and supplies;
C)Â Â Â Â Â Â Â Storage areas for clean supplies and for sterile supplies
(these may be in the clean work room);
D)Â Â Â Â Â Â Â Unsterile supplies storage room (this may be located in another
department);
E)Â Â Â Â Â Â Â Separate storage area for soiled or contaminated supplies and
equipment, separate from the clean or sterilized supplies and equipment; and
F)Â Â Â Â Â Â Â Â Cart storage areas. Â Cart storage areas and facilities for
cleaning and sanitizing carts may be centralized or departmentalized.
j)         Obstetrics and Neonatal Suite. The number of delivery rooms,
labor rooms and recovery beds, and the sizes of the service areas shall depend
upon the estimated obstetrical work load and the program narrative. The
obstetrical and neonatal suite shall be located and arranged to preclude
unrelated traffic through the suite. The requirements of Subpart O shall
apply.
1)        Delivery Rooms. Each delivery room shall have a minimum clear
area of 300 square feet exclusive of fixed and movable cabinets and shelves.Â
The minimum dimension shall be 16 feet clear. The communications system shall
be connected with the obstetrical suite control station. Separate resuscitation
facilities (electrical outlets, oxygen, suction, and compressed air) shall be
provided for newborn infants.
2)        Labor Rooms. These rooms shall be single or two-bed rooms
with a minimum clear area of 80 square feet per bed. Labor beds shall be provided
at the rate of two for each delivery room. In facilities having only one
delivery room, two labor rooms shall be provided, one of which shall be large
enough to function as an emergency delivery room. Each labor room shall
contain a lavatory equipped for hand-washing. Labor rooms shall be arranged so
that they are accessible from a nurses' work station and shall also be
accessible to facilities for medication, hand-washing, charting, and storage
for supplies and equipment.
3)        Recovery Room. The recovery room may be part of an approved
combined surgical/obstetrical program as provided in Section 250.1820(g).
A)Â Â Â Â Â Â Â The postpartum recovery room shall be located within or
adjacent to the obstetrics and neonatal suite. A separate entrance and exit
doors remote from each other shall be provided to facilitate a one-way traffic
flow within the recovery room.
B)       A minimum of 70 square feet per bed shall be provided. This
area shall exclude the nurses' station, work space and storage area. In
addition, a minimum of 4 feet shall be maintained between the sides of the
beds, at least 3 feet between the side of any bed and any wall or other fixed
device, and at least 6 feet between the foot end of any bed and any other
equipment or fixed device.
C)Â Â Â Â Â Â Â The recovery room shall have adequate lighting of the type to
allow accurate observation of the patients.
D)Â Â Â Â Â Â Â A lavatory operable without the use of hands, and a clinical
sink shall be provided.
E)Â Â Â Â Â Â Â A soiled holding area shall be provided.
F)Â Â Â Â Â Â Â Â A nurses' station shall be provided within the postoperative
recovery room. Facilities for medical storage and preparation shall be
provided.
G)Â Â Â Â Â Â Â Adequate storage and work space within or adjacent to the recovery
room shall be available for necessary supplies and equipment.
H)Â Â Â Â Â Â Â Each bed site shall be adequately equipped with oxygen, suction
and at least two duplex electrical outlets.
4)        Service Areas. Individual rooms shall be provided, or alcoves
or other open spaces that will not interfere with traffic may be used.Â
Services may be shared with and organized as part of the surgical facilities if
the approved program narrative reflects this sharing concept. Service areas
shall be arranged to avoid direct traffic between the operating and the
delivery rooms. The following services shall be provided:
A)Â Â Â Â Â Â Â Control station, located to permit direct visual surveillance
of all traffic that enters the obstetrics suite;
B)Â Â Â Â Â Â Â Supervisor's office or station;
C)Â Â Â Â Â Â Â Sterilizing facilities with high speed autoclaves conveniently
located to serve all delivery rooms. When the program narrative indicates that
adequate provisions have been made for replacement of sterile instruments
during delivery, sterilizing facilities in the delivery suite will not be
required;
D)       Drug distribution station. An area shall be provided for
preparation of medication to be administered to patients;
E)Â Â Â Â Â Â Â Two scrub stations, which shall be conveniently located near
each delivery room. Scrub facilities shall be arranged to minimize any
incidental splatter on nearby personnel or supply carts. Scrub sinks,
aseptically operated without the use of hands, shall be provided (wrist blades
are not acceptable);
F)Â Â Â Â Â Â Â Â Soiled work room for the exclusive use of the obstetrical
suite staff (or a soiled room that is part of a system for the collection and
disposal of soiled materials). The soiled work room shall contain a clinical
sink or equivalent flushing rim fixture, work counter, sink equipped for hand-washing,
waste receptacle and linen receptacle. A soiled holding room shall be similar
to the soiled work room except that the clinical sink and work counter may be
omitted;
G)       Fluid waste disposal facilities. These shall be conveniently
located with respect to the delivery rooms. A clinical sink or equivalent
flushing rim equipment in a soiled work room or in a soiled holding room would
meet this requirement;
H)       Clean work room or a clean supply room. A clean work room is
required when clean materials are assembled within the obstetrical suite prior
to use. A clean work room shall contain a work counter, a sink equipped for hand-washing,
and space for clean and sterile supplies. A clean supply room shall be
provided when the program narrative defines a system for the storage and
distribution of clean and sterile supplies that would not require the use of a
clean work room;
I)        Anesthesia storage facilities. The use and storage of
anesthetic gases shall be in accordance with NFPA 99. Areas for cleaning,
testing and storing anesthesia equipment shall be provided;
J)Â Â Â Â Â Â Â Â Anesthesia work room for cleaning, testing and storing
anesthesia equipment, containing a work counter and sink;
K)       Medical gas storage. Space for reserve storage of nitrous
oxide and oxygen cylinders shall be provided;
L)Â Â Â Â Â Â Â Equipment storage rooms for equipment and supplies used in the
obstetrical suite;
M)      Staff clothing change areas. Appropriate areas shall be
provided for male and female personnel (orderlies, technicians, nurses, and
doctors) working within the obstetrical suite. The areas shall contain
lockers, showers, toilets, lavatories equipped for hand-washing and space for donning
scrub suits and boots. These areas shall be arranged to provide a one-way
traffic pattern so that personnel entering from outside the obstetrical suite
can change, shower, gown, and move directly into the obstetrical suite. Space
for removal of scrub suits and boots shall be designed so that personnel will
avoid physical contact with clean personnel;
N)       Stretcher storage area. This area shall be out of the direct
line of traffic;
O)       Lounge and toilet facilities for obstetrics staff. These facilities
shall be provided in hospitals having three or more delivery rooms and shall be
located to permit use without leaving the obstetrics suite. A nurses' toilet
room shall be provided near the recovery rooms; and
P)        Janitors' closet. A closet containing a floor receptor or
service sink and storage space for housekeeping supplies and equipment shall be
provided exclusively for the obstetrical suite.
k)        Emergency Suite. Facilities for emergency care shall be
provided in each hospital. The extent of the emergency services to be provided
in the hospital will depend upon community needs and availability of other
organized programs for emergency services within the community. Hospitals
having a program narrative calling for a minimum level of emergency services
shall provide at least the facilities indicated in subsections (k)(1), (k)(4)
and (k)(10) with back-up facilities within the hospital capable of furnishing
the necessary support for facilities not provided in the emergency suite.Â
Other hospitals shall provide all of the following to the degree called for in
the program narrative:
1)Â Â Â Â Â Â Â Â An entrance at grade level, sheltered from the weather with
provision for ambulance and pedestrian access;
2)Â Â Â Â Â Â Â Â A reception and control area conveniently located near the
entrance, waiting area and treatment rooms;
3)Â Â Â Â Â Â Â Â Public waiting space with men's and women's toilet facilities,
public telephone and drinking fountain;
4)        Treatment area. The treatment area shall contain hand-washing
facilities trimmed with valves that are aseptically operated (for example, knee
or foot controls), general storage cabinets, medication cabinets, work
counters, medical suction outlets, x-ray film illuminators as necessary, and
space for storage of emergency equipment such as defibrillators, cardiac
monitors and resuscitators;
5)Â Â Â Â Â Â Â Â A holding area adjacent to the treatment rooms, as required by
the program narrative;
6)Â Â Â Â Â Â Â Â A storage area, out of the line of traffic, for stretchers and
wheelchairs;
7)        Staff work and charting areas. This may be combined with the reception
and control area or located within the treatment area;
8)Â Â Â Â Â Â Â Â Clean supply storage, which may be separate or located within
the treatment area;
9)Â Â Â Â Â Â Â Â Soiled work room or area containing a clinical sink, work
counter and sink equipped for hand-washing, waste receptacle and linen
receptacle; and
10)Â Â Â Â Â Â Â Â Toilet facilities convenient to the treatment area.
l)Â Â Â Â Â Â Â Â Â Outpatient Department
1)Â Â Â Â Â Â Â Â The outpatient department, if provided, should be located on
an easily accessible floor convenient to the radiology, pharmacy and laboratory
departments.
2)Â Â Â Â Â Â Â Â Size will vary in different locations with the availability of
other examination and diagnostic facilities, and is not necessarily
proportionate to the size of the hospital. The estimated patient load shall
determine the number, size and scope of individual facilities in the outpatient
department.
3)Â Â Â Â Â Â Â Â Required facilities include:
A)Â Â Â Â Â Â Â Waiting room with men's and women's public toilets;
B)Â Â Â Â Â Â Â Information, appointments and records;
C)Â Â Â Â Â Â Â Medical social services;
D)Â Â Â Â Â Â Â Examination rooms;
E)Â Â Â Â Â Â Â Dressing booths;
F)Â Â Â Â Â Â Â Â Utility rooms;
G)Â Â Â Â Â Â Â Storage room; and
H)Â Â Â Â Â Â Â Janitors' closet.
m)Â Â Â Â Â Â Â Service Departments
1)Â Â Â Â Â Â Â Â Dietary Facilities
A)Â Â Â Â Â Â Â General. Construction, equipment and installation shall comply
with the standards specified in the Department's Food Service Sanitation Code
and the Food Service Sanitation Manual, P.H.S. 93. Food service facilities
shall be designed and equipped to meet the requirements of the program
narrative. These may consist of an on-site conventional food preparing system,
a convenience food service system, or an appropriate combination of the two.
B)       Functional Elements. The following facilities shall be provided
as required to implement the type of food service selected:
i)         Control Station. For receiving food supplies;
ii)        Storage Space. Adequate to provide normal and emergency
supply needs, including food requiring cold storage and day storage;
iii)       Food Preparation Facilities. Conventional food preparation
systems require space and equipment for preparing, cooking and baking.
Convenience food service systems, such as frozen prepared meals, bulk packaged
entrees, and individual packaged portions, or systems using contractual
commissary service, require space and equipment for thawing, portioning,
heating, cooking and baking;
iv)       Hand-washing Facilities. Located in the food preparation area;
v)        Patients' Meal Service Facilities. Examples are those required
for tray assembly and distribution;
vi)       Dining Space. For ambulatory patients, staff and visitors;
vii)      Ware-Washing Space. Located in a room or an alcove separate
from food preparation and serving areas. Commercial-type dishwashing equipment
shall be provided. Space shall also be provided for receiving, scraping,
sorting, and stacking soiled tableware and for transferring clean tableware to
the using areas. A hand-washing lavatory shall be conveniently available;
viii)Â Â Â Â Â Pot-Washing Facilities;
ix)       Storage Areas. For cans, carts and mobile tray conveyors;
x)        Waste Storage Facilities. Located in a separate room easily
accessible to the outside for direct pickup or disposal;
xi)       Offices or Desk Spaces. For dieticians and the dietary
service manager;
xii)      Men's and Women's Toilets Accessible to the Dietary Staff. Hand-washing
facilities shall be immediately available;
xiii)     Janitors' Closet. Located within the dietary department. It
shall contain a floor receptor or service sink and storage space for
housekeeping equipment and supplies;
xiv)Â Â Â Â Â Self-dispensing Ice-making Facilities; and
xv)Â Â Â Â Â Â Adequate Can, Cart and Mobile Tray Washing Facilities.
2)        Central Stores. The following shall be provided:
A)Â Â Â Â Â Â Â Off-street unloading facilities;
B)Â Â Â Â Â Â Â Receiving area;
C)       General storage rooms. These facilities shall have storage
spaces adequate to meet the needs of the hospital. They shall be concentrated
in one area, but in a multiple building complex, they may be in separate
concentrated areas in more than one individual building; and
D)Â Â Â Â Â Â Â Office space.
3)Â Â Â Â Â Â Â Â Linen Services
A)       On-site Processing. If linen is to be processed at the
hospital site, the following shall be provided:
i)Â Â Â Â Â Â Â Â Â Soiled linen receiving, holding and sorting room with hand-washing
facilities;
ii)Â Â Â Â Â Â Â Â A laundry processing room, including hand-washing facilities,
with commercial-type equipment that can process seven days' needs within a
regularly scheduled work week;
iii)Â Â Â Â Â Â Â A separate clean linen storage and issuing room or area;
iv)Â Â Â Â Â Â Â A clean linen inspection and mending room or area;
v)Â Â Â Â Â Â Â Â Storage for laundry supplies;
vi)Â Â Â Â Â Â Â A janitors' closet containing a floor receptor or service sink
and storage space for housekeeping equipment and supplies;
vii)Â Â Â Â Â Â Cart storage; and
viii)Â Â Â Â Â Office space.
B)       Off-site Processing. If linen is processed off the hospital
site, the following shall be provided:
i)Â Â Â Â Â Â Â Â Â A soiled linen holding room with facilities for hand-washing;
ii)Â Â Â Â Â Â Â Â Clean linen, receiving, inspection and storage rooms;
iii)Â Â Â Â Â Â Â Cart storage; and
iv)Â Â Â Â Â Â Â Office space.
4)        Facilities for Cleaning and Sanitizing Carts. Facilities
shall be provided to clean and sanitize carts serving the central medical and
surgical supply department, dietary facilities, and linen services. These may
be centralized or departmentalized.
5)        Employees' Facilities. In addition to the employees'
facilities such as locker rooms, lounges, toilets, or shower facilities called
for in certain departments, a sufficient number of these facilities as required
to accommodate the needs of all personnel and volunteers shall be provided.
6)        Janitors' Closets. In addition to the janitors' closets
called for in certain departments, sufficient janitors' closets shall be
provided throughout the facility as required to maintain a clean and sanitary
environment. Each shall contain a floor receptor or service sink and storage
space for housekeeping equipment and supplies. Space for large housekeeping
equipment and for back-up supplies may be located in other areas.
7)Â Â Â Â Â Â Â Â Engineering Service and Equipment Areas. Â The following shall
be provided:
A)Â Â Â Â Â Â Â Rooms or separate buildings for boilers, mechanical equipment,
and electrical equipment;
B)Â Â Â Â Â Â Â Engineer's space;
C)Â Â Â Â Â Â Â A maintenance shop;
D)Â Â Â Â Â Â Â A storage room or rooms for building maintenance supplies; and
E)       Yard equipment storage. Yard maintenance equipment and
supplies may be stored in a separate room or building.
8)Â Â Â Â Â Â Â Â Waste Processing Services
A)       Storage and Disposal. Space and facilities shall be provided
for the sanitary storage and disposal of waste by incineration, mechanical
destruction, compaction, containerization, removal, or by a combination of
these techniques. Proper handling and disposal of radioactive waste substances
shall be provided.
B)       Incineration. A gas, electric or oil-fired incinerator shall
be provided for the complete destruction of pathological and infectious waste.Â
Infectious waste shall include, but shall not be limited to, dressings and
material from open wounds, laboratory specimens, and all waste material from
isolation rooms.
i)Â Â Â Â Â Â Â Â Â The incinerator shall be in a separate room or placed
outdoors.
ii)Â Â Â Â Â Â Â Â Design and construction of incinerators and trash chutes
shall be in accordance with NFPA 82, Standard on Incinerators and Waste and
Linen Handling Systems and Equipment.
iii)Â Â Â Â Â Â Â Incinerators shall be designed and equipped to conform to
requirements prescribed by air pollution regulations in the area.
9)        Storage. In addition to the storage areas called for in
certain departments of the hospital, suitable additional storage shall be
provided.