HEALTH CARE FACILITIES

A. General 517-1. Scope. The provisions of this article shall apply to electrical construction and installation criteria in health care facilities. (FPN No. 1): This article is not intended to apply to veterinary facilities. (FPN No. 2): For information concerning performance, maintenance, and testing criteria, refer to the appropriate health care facilities documents. 517-2. General. The requirements in Parts B and C apply not only to single-function buildings, but are also intended to be individually applied to their respective forms of occupancy within a multifunction building (e.g., a doctor's examining room located within a limited care facility would be required to meet the provisions of Section 517-10). 517-3. Definitions. Alternate Power Source: One or more generator sets, or battery systems where permitted, intended to provide power during the interruption of the normal electrical services or the public utility electrical service intended to provide power during interruption of service normally provided by the generating facilities on the premises. ARTICLE 517 - HEALTH CARE FACILITIES 70-531 Anesthetizing Location: Any area of a health care facility that has been designated to be used for the administration of any flammable or nonflammable inhalation anesthetic agent in the course of examination or treatment, including the use of such agents for relative analgesia. Critical Branch: A subsystem of the emergency system consisting of feeders and branch circuits supplying energy to task illumination, special power circuits, and selected receptacles serving areas and functions related to patient care, and which are connected to alternate power sources by one or more transfer switches during interruption of the normal power source. Electrical Life-Support Equipment: Electrically powered equipment whose continuous operation is necessary to maintain a patient's life. Emergency System: A system of feeders and branch circuits meeting the requirements of Article 700, and intended to supply alternate power to a limited number of prescribed functions vital to the protection of life and patient safety, with automatic restoration of electrical power within 10 seconds of power interruption. Equipment System: A system of feeders and branch circuits arranged for delayed, automatic or manual connection to the alternate power source and which serves primarily 3-phase power equipment. Essential Electrical System: A system comprised of alternate sources of power and all connected distribution systems and ancillary equipment, designed to assure continuity of electrical power to designated areas and functions of a health care facility during disruption of normal power sources, and also designed to minimize disruption within the internal wiring system. Exposed Conductive Surfaces: Those surfaces which are capable of carrying electric current and which are unprotected, unenclosed, or unguarded, permitting personal contact. Paint, anodizing, and similar coatings are not considered suitable insulation, unless they are listed for use. Flammable Anesthetics: Gases or vapors, such as fluroxene, cyclopropane, divinyl ether, ethyl chloride, ethyl ether, and ethylene, which may form flammable or explosive mixtures with air, oxygen, or reducing gases such as nitrous oxide. Flammable Anesthetizing Location: Any area of the facility which has been designated to be used for the administration of any flammable inhalation anesthetic agents in the normal course of examination or treatment. Hazard Current: For a given set of connections in an isloated power system, the total current that would flow through a low impedance if it were connected between either isolated conductor and ground. FAULT HAZARD CURRENT: The hazard current of a given isolated system with all devices connected except the line isolation monitor. MONITOR HAZARD CURRENT: The hazard current of the line isolation monitor alone. 70-532 NATIONAL ELECTRICAL CODE TOTAL HAZARD CURRENT: The hazard current of a given isolated system with all devices, including the line isolation monitor, connected. Health Care Facilities: Buildings or portions of buildings that contain, but are not limited to, occupancies such as: hospitals; nursing homes; limited care; supervisory care; clinics; medical and dental offices; and ambulatory care, whether permanent or movable. Hospital: A building or part thereof used for the medical, psychiatric, obstetrical, or surgical care, on a 24-hour basis, of four or more inpatients. Hospital, wherever used in this Code, shall include general hospitals, mental hospitals, tuberculosis hospitals, children's hospitals, and any such facilites providing inpatient care. Isolated Power System: A system comprising an isolating transformer or its equivalent, a line isolation monitor, and its ungrounded circuit conductors. Isolation Transformer: A transformer of the multiple-winding type, with the primary and secondary windings physically separated, which inductively couples its secondary winding to the grounded feeder systems that energize its primary winding. Life Safety Branch: A subsystem of the emergency system consisting of feeders and branch circuits, meeting the requirements of Article 700 and intended to provide adequate power needs to ensure safety to patients and personnel, and which are automatically connected to alternate power sources during interruption of the normal power source. Limited Care Facility: A building or part thereof used on a 24-hour basis for the housing of four or more persons who are incapable of selfpreservation because of age, physical limitation due to accident or illness, or mental limitations, such as mental retardation/developmental disability, mental illness, or chemical dependency. Line Isolation Monitor: A test instrument designed to continually check the balanced and unbalanced impedance from each line of an isolated circuit to ground and equipped with a built-in test circuit to exercise the alarm without adding to the leakage current hazard. (FPN): "Line isolation monitor" was formerly known as "ground contact indicator." Nursing Home: A building or part thereof used for the lodging, boarding and nursing care, on a 24-hour basis, of four or more persons who, because of mental or physical incapacity, may be unable to provide for their own needs and safety without the assistance of another person. Nursing home, wherever used in this Code, shall include nursing and convalescent homes, skilled nursing facilities, intermediate care facilities, and infirmaries of homes for the aged. Nurses' Stations: Areas intended to provide a center of nursing activity for a group of nurses serving bed patients, where the patient calls are received, nurses are dispatched, nurses' notes written, inpatient charts ARTICLE 517 - HEALTH CARE FACILITIES 70-533 prepared, and medications prepared for distribution to patients. Where such activities are carried on in more that one location within a nursing unit, all such separate areas are considered a part of the nurses' station. Patient Bed Location: The location of an inpatient sleeping bed or the bed or procedure table used in a critical patient care area. Patient Care Area: Any portion of a health care facility wherein patients are intended to be examined or treated. (FPN): Business offices, corridors, lounges, day rooms, dining rooms, or similar areas typically are not classified as patient care areas. Patient Care Areas of a Hospital: Areas of a hospital in which patient care is administered are classified as general care areas, or critical care areas, either of which may be classified as a wet location. The governing body of the facility shall designate these areas in accordance with the type of patient care anticipated and with the following definitions of the area classification. (1) General care areas are patient bedrooms, examining rooms, treatment rooms, clinics, and similar areas in which it is intended that the patient shall come in contact with ordinary appliances such as a nurse call system, electrical beds, examining lamps, telephone, and entertainment devices. In such areas, it may also be intended that patients be connected to electromedical devices (such as heating pads, electrocardiographs, drainage pumps, monitors, otoscopes, ophthalmoscopes, intravenous lines, etc.). (2) Critical care areas are those special care units, intensive care units, coronary care units, angiography laboratories, cardiac catheterization laboratories, delivery rooms, operating rooms, and similar areas in which patients are intended to be subjected to invasive procedures and connected to line-operated, electromedical devices. (3) Wet locations are those patient care areas that are normally subject to wet conditions while patients are present. These include standing fluids on the floor or drenching of the work area, either of which condition is intimate to the patient or staff. Routine housekeeping procedures and incidental spillage of liquids do not define a wet location. Patient Equipment Grounding Point: A jack or terminal bus which serves as the collection point for redundant grounding of electric appliances serving a patient vicinity or for grounding other items in order to eliminate electromagnetic interference problems. Patient Vicinity: In an area in which patients are normally cared for, the patient vicinity is the space with surfaces likely to be contacted by the patient or an attendant who can touch the patient. Typically in a patient room, this encloses a space within the room not less than 6 feet (1.83 m) beyond the perimeter of the bed in its nominal location, and extending vertically not less than 7½ feet (2.29 m) above the floor. Psychiatric Hospital: A building used exclusively for the psychiatric care, on a 24-hour basis, of four or more inpatients. 70-534 NATIONAL ELECTRICAL CODE Reference Grounding Point: The ground bus of the panelboard or isolated power system panel supplying the patient care area. Selected Receptacles: A minimum number of electric receptacles to accommodate appliances ordinarily required for local tasks or likely to be used in patient care emergencies. Task Illumination: Provision for the minimum lighting required to carry out necessary tasks in the described areas, including safe access to supplies and equipment, and access to exits. Therapeutic High-Frequency Diathermy Equipment: Therapeutic highfrequency diathermy equipment is therapeutic induction and dielectric heating equipment. X-Ray Installations (Long-Time Rating): A rating based on an operating interval of 5 minutes or longer. X-Ray Installations (Mobile): X-ray equipment mounted on a permanent base with wheels, casters, or a combination of both to facilitate moving the equipment while completely assembled. X-Ray Installations (Momentary Rating): A rating based on an operating interval that does not exceed 5 seconds. carried. X-Ray Installations (Portable): X-ray equipment designed to be hand X-Ray Installations (Transportable): X-ray equipment to be installed in a vehicle or that may be readily disassembled for transport in a vehicle. B. Wiring and Protection 517-10. Applicability. Part B shall apply to all health care facilities. Exception No. 1: Part B shall not apply to business offices, corridors, waiting rooms, and the like in clinics, medical and dental offices, and outpatient facilities. Exception No. 2: Part B shall not apply to patient sleeping areas in nursing homes and residential care facilities wired in accordance with Chapters 1 through 4 of this Code. Exception No. 3.x Part B shall not apply to freestanding buildings used as nursing homes and residential care facilities provided: a. It maintains admitting and discharge policies that preclude the provision of care for any patient or resident who may need to be sustained by electrical life-support equipment, and b. Offers no surgical treatment requiring general anesthesia, and c. Provides an automatic battery-operated system(s) or equipment that shall be effective for at least 1½ hours and is otherwise in accordance with Section 700-12 and that shall be capable of supplying lighting for exit lights, exit corridors, stairways, nursing stations, medical preparation areas, boiler rooms, and communication areas. This system shall also supply power to operate all alarm systems. (FPN): See Life Safety Code, NFPA 101-1991 (ANSI). ARTICLE 517 - HEALTH CARE FACILITIES 70-535 517-11. General Installation/Construction Criteria. It is the purpose of this article to specify the installation criteria and wiring methods that will minimize electrical hazards by the maintenance of adequately low-potential differences only between exposed conductive surfaces that are likely to become energized and could be contacted by a patient. (FPN): In a health care facility, it is difficult to prevent the occurrence of a conductive or capacitive path from the patient's body to some grounded object, because that path may be established accidentally or through instrumentation directly connected to the patient. Other electrically conductive surfaces that may make an additional contact with the patient, or instruments that may be connected to the patient, then become possible sources of electric currents that can traverse the patient's body. The hazard is increased as more apparatus is associated with the patient, and, therefore, more intensive precautions are needed. Control of electric shock hazard requires the limitation of electric current that might flow in an electric circuit involving the patient's body by raising the resistance of the conductive circuit that includes the patient, or by insulating exposed surfaces that might become energized, in addition to reducing the potential difference that can appear between exposed conductive surfaces in the patient vicinity, or by combinations of these methods. A special problem is presented by the patient with an externalized direct conductive path to the heart muscle. The patient may be electrocuted at current levels so low that additional protection in the design of appliances, insulation of the catheter, and control of medical practice are required. 517-12. Wiring Methods. Except as modified in this article, wiring methods shall comply with the applicable requirements of Chapters 1 through 4 of this Code. 517-13. Grounding of Receptacles and Fixed Electric Equipment. (a) Patient Care Area. In an area used for patient care, the grounding terminals of all receptacles and all noncurrent-carrying conductive surfaces of fixed electric equipment likely to become energized that are subject to personal contact, operating at over 100 volts, shall be grounded by an insulated copper conductor. The grounding conductor shall be sized in accordance with Table 250-95 and installed in metal raceways with the branch-circuit conductors supplying these receptacles or fixed equipment. Exception No. 1: Metal raceways shall not be required where Type MI cable, and Types MC and AC cables where the outer metal jacket is an approved grounding means of a listed cable assembly. Exception No. 2: Metal faceplates shall be permitted to be grounded by means of a metal mounting screw(s) securing the faceplate to a grounded outlet box or grounded wiring device. (b) Methods. In addition to the requirements of Section 517-13(a), all branch circuits serving patient care areas shall be provided with a ground path for fault current by installation in a metal raceway system or cable assembly. The metal raceway system, or cable armor or sheath assembly, shall qualify as an equipment grounding return path in accordance with