La. Admin. Code tit. 48 § I-8429

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-8429 - Physical Plant Requirements

A. For licensing, an ESRD treatment facility applicant shall have architectural plans and specifications reviewed by the DHH Division of Engineering and Architectural Services using the current edition of the American Institute of Architect's Guidelines for Construction for Hospital and Health Care Facilities.

B. The Office of the State Fire Marshal shall determine fire safety review requirements based upon applicable regulations.

C. Required Inspections

1. The facility shall pass all required inspections and keep a current file of reports and other documentation needed to demonstrate compliance with applicable laws and regulations. The inspections must be signed, dated, and free of any outstanding violations/citations. The following inspections are required:

a. annual fire marshal inspection;

b. annual inspection by the Office of Public Health (local health unit);

c. annual inspection and maintenance of fire extinguishers by personnel licensed or certified to perform those duties; and

d. regular inspections of elevators, if applicable.

2. The following documentation shall be on file in the facility:

a. certificate of occupancy as required by the local authorities;

b. DHH approval of the water supply/system; and

c. documentation that any liquefied petroleum supply has been inspected and approved.

D. Exterior Space Requirements. The facility shall:

1. ensure that all structures on the grounds of the facility that are accessible to patients are maintained in good repair and are free from identified hazards to health or safety;

2. maintain the grounds of the facility in an acceptable manner and ensure that the grounds are free from any hazard to health or safety;

3. store garbage and rubbish securely in non-combustible, covered containers that are emptied on a regular basis;

4. separate trash collection receptacles and incinerators from patient activity areas and locate all containers so that they are not a nuisance to neighbors; and

5. store and dispose of all medical waste in accordance with local, state, and federal guidelines.

E. Interior Space Requirements

1. Bathrooms. Minimum facilities shall include:

a. adequate operational fixtures that meet Louisiana State Plumbing Code. All fixtures must be functional and have the appropriate drain and drain trap to prevent sewage gas escape back into the facility;

b. an adequate supply of hot water. Hot water temperature at the point of service to patients shall be between 105 ° F and 120 ° F;

c. toilets with seats;

d. an adequate supply of toilet paper, towels, and soap;

e. doors to allow for individual privacy;

f. external emergency release mechanism;

g. safe and adequate supply of cold running water; and

h. functional toilets, wash basins, and other plumbing or sanitary facilities which shall be maintained in good operating condition and kept free of any materials that might clog or otherwise impair their operation.

2. Administrative and Counseling Space

a. Administrative office(s) for records, secretarial work and bookkeeping shall be separate and secure from patient areas.

b. Space shall be designated to allow for private discussions and counseling sessions.

3. Doors and Windows. Outside doors, windows and other features of the structure necessary for the safety and comfort of patients shall be secured for safety within 24 hours after they are found to be in a state of disrepair. Total repair should be completed as soon as possible.

4. Storage. The facility shall:

a. ensure that there are sufficient and appropriate storage facilities; and

b. secure all potentially harmful materials.

F. Exits

1. Exit doors and routes shall be lighted and unobstructed at all times.

2. There shall be an illuminated "EXIT " sign over each exit. Where the exit is not visible, there shall be an illuminated "EXIT " sign with an arrow pointing the way.

3. Rooms for 50 or more people shall have exit doors that swing out.

4. No door may require a key for emergency exit.

5. In facilities initially licensed after March 20, 2004, at least one window shall be provided in every treatment area.

6. Every building shall have at least two exits that are well separated.

7. Every multiple-story building shall have at least two fire escapes (not ladders) on each story that are well separated. Fire escapes shall:

a. be made of non-combustible material;

b. have sturdy handrails or walls on both sides; and

c. provide a safe route to the ground.

8. Stairs and ramps shall be permanent and have non-slip surfaces.

9. Exit routes higher than 30 inches (such as stairs, ramps, balconies, landings, and porches) shall have full-length side guards.

G. Electrical Systems. All electrical equipment, wiring, switches, sockets and outlets shall be maintained in good order and safe operating condition. All rooms, corridors, stairways and exits within a facility shall be sufficiently illuminated.

1. The facility shall have an illuminating system that provides lighting levels to support tasks performed by staff and the independent functioning of patients without the need for additional lighting.

2. Lighting shall be provided outside the building and in parking lots.

3. Light bulbs shall have shades, wire guards or other shields.

4. Emergency lighting shall illuminate A EXIT @ routes.

H. Ventilation

1. The facility shall not use open flame heating equipment, floor furnaces, unvented space heaters, or portable heating units.

2. Occupied parts of the building shall be air conditioned and the temperature should remain between 65 E F and 85 E F.

3. The entire facility shall be adequately ventilated with fresh air. Windows used for ventilation shall be screened.

4. The facility shall take all reasonable precautions to ensure that heating elements, including exposed hot water pipes, are insulated and installed in a manner that ensures the safety of patients and staff.

I. Plumbing. The plumbing systems shall be designed, installed, operated and maintained in a manner that ensures an adequate and safe supply of water for all required facility operations and to facilitate the complete and safe removal of all storm water and waste water.

J. Finishes and Surfaces

1. Lead-based paint or materials containing asbestos shall not be used.

2. Floor coverings must promote cleanliness, must not present unusual problems for the handicapped and have flame-spread and smoke development ratings appropriate to the use area (e.g. patient's room versus exit corridor).

3. All variances in floors shall be easily identified by markings, etc. to prevent falls.

La. Admin. Code tit. 48, § I-8429

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 28:2196 (October 2002), amended LR 30:432 (March 2004).

AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153 and R.S. 40:2117.4.