Nursing Unit

Section 300 Section 300.2860  Nursing Unit a)         The number of resident beds in a nursing unit shall not exceed 75 beds. 1)         Not less than 60 percent of the resident beds shall be in one or two bed rooms. 2)         Not less than three percent of the total number of the beds in the facility shall be located in single bed rooms with a private bath, water closet and lavatory. b)         General Requirements for Bedrooms 1)         Resident bedrooms shall have an entrance directly off a corridor with an entrance door which swings into the room. 2)         Resident bedrooms shall have adequate and satisfactory artificial light and be equipped in accordance with Section 300.2940(a)2) and (e)(1). 3)         Residents shall have access to a toilet room without entering the general corridor area. 4)         The facility shall provide a closet or wardrobe of at least four square feet for each resident. 5)         Resident bedroom floors shall be at or above grade level. 6)         Each room used as a resident bedroom shall have at least one outside window, and a total window area to the outside equal to at least one-tenth the floor area of the room. 7)         A nurses' call system shall be provided in accordance with Section 300.2940(g).  (B) 8)         Complete visual privacy shall be provided for each resident in multibed rooms.  Design for privacy shall not restrict resident access to the entry, lavatory, nor toilet. 9)         No resident bedroom shall be located more than 120 feet from the nurses' station, clean utility room, and soiled utility room. c)         Resident Bedrooms 1)         Single resident bedrooms shall contain at least l00 square feet. Multiple resident bedrooms shall contain at least 80 square feet per bed. Minimum usable floor area shall be exclusive of toilet rooms, closets, lockers, wardrobes, alcoves, vestibules, or clearly definable entryways. 2)         Multiple resident bedrooms shall not have more than four beds nor more than three beds deep from an outside wall.  All beds shall have a minimum clearance of three feet at the foot and sides of the bed. d)         Special Care Room 1)         The facility shall provide a special care room for each nursing unit. 2)         This room shall be provided with a private toilet room containing water closet, lavatory, bathtub or shower and all other necessary facilities to meet the resident's needs. (B) 3)         This room shall be located to allow direct visual supervision from the nurses' station. 4)         This room shall be included in the authorized maximum bed capacity for the facility. 5)         It is permissible for the room to be occupied by a resident, not in need of special care, provided the resident is clearly informed and understands he or she will be immediately transferred out of the room any time of day or night, whenever the room is needed to care for a resident requiring special care. e)         Nurses' Station  (B) 1)         The facility shall provide a minimum of one nursing station per unit with direct access to the corridor for each nursing unit.  The location of this station shall allow visual control without the use of mirrors of each resident sleeping corridor.  Separation shall be provided from the utility rooms. 2)         One or more nursing units may be combined at a central nursing station if sufficient space is provided for all nursing functions. 3)         A lounge with toilet room shall be provided near each station for nursing staff. Lockers for safekeeping of coats and personal effects may be provided within this space or in a convenient central location. f)         Bath and Toilet Rooms 1)         The resident bedroom toilet room shall serve no more than two resident rooms nor more than eight beds.  The toilet room shall contain a water closet and a lavatory.  The lavatory may be omitted from the toilet room when the resident room contains a lavatory. 2)         The facility shall provide one wheelchair resident toilet room for each sex residing in a nursing unit. The room shall be accessible from the corridor.  This room shall contain a water closet and lavatory. 3)         Wheelchair resident toilet rooms are not required when all resident toilet rooms can accommodate wheelchair residents. 4)         The facility shall provide one training toilet room on each nursing floor, which is accessible from the corridor.  Three-foot clearance at the front and both sides of the water closet shall be provided.  This room shall contain a lavatory accessible for wheelchair use. 5)         The facility shall provide one bathtub or shower for each ten resident beds per nursing unit which are not served by bathing or showering facilities in resident rooms. 6)         All shower stalls for residents not needing assistance shall be at least three feet square and shall have no curb. 7)         The facility shall provide at least one bathtub for assisted bathing per nursing unit.  There shall be a clear area at least three feet wide at both sides and one end of the tub. 8)         The facility shall provide at least one shower stall for assisted showering per nursing unit.  The shower stall shall be at least four feet square with no curb. 9)         The facility shall provide a toilet room with a water closet and lavatory, accessible to the assisted bathtub and shower without entering the general corridor.  This room may be arranged to serve as the training toilet facility. 10)         Grouped bathing and toilet facilities shall be partitioned or curtained for privacy. g)         Utility Rooms 1)         The clean utility room shall have direct access to a corridor or access may be through the nurses' station entrance.  This room shall contain work counters, single or double compartment sink with integral drainboard, storage cabinets, and an autoclave. (Autoclave may be waived in lieu of other methods if sterilization is approved by Department.) 2)         A clean linen storage room or closet within the clean utility room shall be provided. If a closed cart system is used, storage may be in an alcove. 3)         The soiled utility room shall have direct access to a corridor.  This room shall contain work counters, storage cabinets, and a clinical rim flush sink.  The room shall also contain a three compartment sink with integral drainboard if chemical sanitizing procedures are used, or a double compartment sink with integral drainboard if a utensil sanitizer is used (See Section 300.2430). 4)         The charging room for a linen chute shall be large enough to unload the collecting cart with the door closed. h)         Medication Facilities 1)         A medication station shall be provided for convenient and prompt 24 hour distribution of medicine to residents.  The medicine preparation room shall be under the nursing staff's visual control and contain a work counter, refrigerator, and locked storage for biologicals and drugs. A sink for handwashing and preparation of medication shall be provided in the medication preparation room. 2)         If medicine dispensing carts are used, a specific storage space for the cart shall be provided, which may be located in the nurses' station or in an alcove or other space under the direct control of the nursing staff.  A sink for handwashing and preparation of medication shall be provided in the nurses' station. i)          A nourishment station shall be provided with a handwashing sink and equipment including refrigerator, and storage cabinets for serving nourishment between scheduled meals.  Ice for residents' use shall be provided only by icemaker dispenser units. j)          A room for examination and treatment of residents shall be provided and shall have a minimum floor area of 100 square feet, excluding space for vestibule, closets and work counters (whether fixed or movable).  The minimum room dimension shall be ten feet.  The room shall contain a lavatory or sink equipped for handwashing; a work counter; storage facilities; and a desk, counter, or shelf space for writing. k)         An equipment storage room shall be provided for storage of equipment such as I.V. stands, inhalators, air mattresses, walkers, and wheelchairs. l)          Parking space for wheelchairs shall be provided and located out of path of normal traffic.