Physical Site

(A) Physical Site. The MassHealth agency or its designee approves each DH site and census. A DH provider must provide DH at a site that meets all of the requirements in 130 CMR 419.432(B)(1) through (17). (B) In the event of a site change, renovation, new construction, or change in census, the DH provider must forward a copy of all plans to the MassHealth agency or its designee for approval. (1) The site must be designed with adequate space for the provision of all DH, with a minimum of 50 square feet of programming space per participant. This minimum does not include offices (except nurses’ offices if used for member treatment), hallways, storage areas, reception areas, and other areas not used for the provision of DH. For sites with kitchens used for activities other than meal preparation, 100% of the kitchen floor area is counted as part of the participant space requirement. (2) When located in a building or facility housing other services, the DH provider may utilize all available space but must have separate and distinct staff for each service. (3) As of September 7, 2018, a newly enrolled DH provider site must be in a location that complies with the Americans with Disabilities Act (ADA) and ADA Standards for Accessible Design that include but are not limited to (a) the site is on-ground level with at least two means of egress; (b) the site is free of architectural barriers; (c) the site is designed to meet the needs of people with disabilities; and (d) the site is in compliance with local health, fire, and safety codes. (4) For sites approved on or before September 7, 2018, that occupy multi-level space, the site must have at a minimum one elevator for egress, and evacuation plans must include specific procedures for evacuation of those in wheelchairs and comply with local and state evacuation requirements. (5) The site must include adequate outdoor space for members to safely arrive at and depart from the DH provider site. (6) DH providers must provide a protected and secure environment for members, including members who wander or require increased supervision and security. (7) The site must include sufficient parking capacity to satisfy the needs of members, staff, and the public. (8) The site must include a clean and sanitary food preparation area equipped with a refrigerator, a sink, adequate counter space, and adequate storage space. (9) Adequate artificial lighting must be available in all rooms, stairways, hallways, corridors, bathrooms, and offices. (10) A DH provider site serving five or more unrelated participants must comply with the Massachusetts State Building Code, 780 CMR 3.00: Use and Occupancy Classification. (11) The MassHealth agency must approve each DH site. In the event of a site change, renovation, or new construction, the provider must forward a copy of all plans to the MassHealth agency for approval. Upon completion of renovations, moves, or new construction, the MassHealth agency or its designee must view the site to determine compliance with the requirements. (12) The kitchen and bathrooms must be designed and equipped for teaching ADL skills to all participants. (13) In at least one participant area, the site must have a fire extinguisher and a first aid kit, easily accessible to staff. (14) The site must meet the requirements of all state and local building, sanitary, health, fire, and zoning codes, and all other requirements pertaining to health, safety, and sanitation. (15) The participants must have access to hand sanitizer dispensers and to at least one handwashing station. Hand sanitizer dispensers and hand washing stations must be conveniently placed and accessible to staff. Hand sanitizer dispensers and handwashing stations must be placed with consideration for participant safety and accessibility. (16) Participants must have access to natural light and outside views. (17) Participants must have adequate lighting, heating, and ventilation so that participants are comfortable in all seasons of the year.