Plans and specifications

1. Hospitals shall contact the department prior to any substantial changes in or alterations to any portion of the structure to determine to what extent they are subject to review. A substantial change must include any alterations affecting the fire safety or structural integrity of the building, changes in service areas or services provided within a service area, changes in bed capacity, or any other changes that may be governed by the standards of this article. The department may request plans, specifications, or other information as may be required and shall make the final determination on those areas subject to review. 2. Hospitals shall submit plans and specifications to the department for all construction, remodeling, and installations subject to review. The plans and specifications must be prepared by an architect or engineer, as appropriate, licensed in North Dakota. 3. Start of construction prior to completion and approval by the department of the final plans and specifications is not permitted. 4. Routine maintenance does not require the submission of plans and specifications. For purposes of this subsection, "routine maintenance" includes repair or replacement of existing equipment, room finishes, and furnishings and similar activities. 5. All construction, remodeling, and installations must be in accordance with the final plans and specifications as approved by the department. Modifications or deviations from the approved plans and specifications must be submitted to and approved by the department. 6. The department may make inspections of construction, remodeling, or installations and arrange conferences with the hospital to assure conformance with the approved plans and specifications. 7. The construction specifications must require the contractor to perform tests to assure that all systems conform to the approved plans and specifications.