Section 11-93-6 - Construction requirements(a) The hospital shall be accessible to and functional for physically handicapped patients, hospital personnel, and the general public.(b) Accessibility to living and service areas. (1) There shall be adequate space to allow free movement of persons using wheelchairs, walkers, canes, and crutches to bed, bathroom, closet, and common hallway areas.(2) Areas used for recreation, cooking, dining, storage, bathrooms, laundries, foyers, corridors, lanais, libraries, and other areas not suitable for sleeping shall not be used as bedrooms.(3) Access from each bedroom to a bathing facility, toilet, corridor, central utility or other areas of the hospital shall not require passing through a sleeping, cooking, dining, or recreation area.(c) Toilet and bath facilities. (1) Each toilet shall serve no more than eight beds.(2) The toilet room shall contain a toilet and a washbasin. The washbasin may be omitted from a toilet room which serves single and multi-bed rooms if each such patient's room contains a washbasin.(3) There shall be one shower or tub for each fourteen beds which are not otherwise served by a bathing facility within a patient's room.(4) Appropriately placed grab bars shall be provided for each toilet, bathtub, and shower.(5) Curtains or doors to insure privacy shall be provided.(6) Separate toilet and bathing facilities for each sex, except where couples occupy a semi-private room with a bathroom, shall be provided.(7) An adequate supply of hot and cold potable running water must be provided at all times. Temperatures of hot water at plumbing fixtures used by patients shall be automatically regulated and shall not exceed 120°F.(8) Each toilet and bath facility shall have a call system which permits the occupant to signal the nursing station in an emergency.(9) Where bedpans are used, equipment for their care shall be provided in an appropriate area of the hospital. Where toilets adjoin patient's bedroom and are used for bedpan cleaning, they shall be equipped with bedpan flushing attachments with vacuum breaker.(10) Provision must be made for terminal sterilization of permanent personal care equipment.(11) Toilet facilities solely for the use of hospital personnel and toilet facilities solely for the use of the public shall be provided.(d) Patient bedrooms. (1) Each room shall be at or above grade level.(2) Windows in each bedroom shall have adequate means of insuring privacy.(3) Bedrooms to be occupied by patients shall have no more than four beds.(4) Rooms for a single patient shall measure at least one hundred square feet of usable space, excluding closets, bathrooms, alcoves, and entryways.(5) Rooms for more than one patient shall measure eighty (80) square feet per bed excluding closets, bathrooms, alcoves, and entryways.(6) Bedside screens or curtains shall be provided in rooms to be occupied by more than one patient to insure privacy for each patient.(7) Beds shall be placed at least three feet apart and three feet from the wall at the side of the bed.(8) Each patient shall be provided with: (A) A bed of proper size and height for the convenience of the patient and permitting an individual in a wheelchair to get in and out of bed unassisted.(B) A comfortable mattress with impermeable mattress cover, and a pillow.(C) Sufficient clean bed linen and blankets to meet the patient's needs.(D) Appropriate furniture such as a chair and individual storage for personal clothing and belongings.(E) An effective signal call system at the patient's bedside.(9) No patient's bedroom shall be located more than one hundred twenty feet from a nurses' station, measured along the line of travel.(10) All occupants of any bedroom shall be of the same sex except for: (A) Those semi-private rooms which may be occupied by couples upon request;(B) Special intensive care units.(e) Floors and walls. (1) Floors shall be of slip resistant material which does not retain odors.(2) Walls, floors and ceilings of rooms used by patients shall be made of materials which are in compliance with section 11-93-15(e) and (g).(f) Windows and lighting. (1) Each bedroom shall have at least one outside window sufficient to provide outside visibility to bed and wheelchair patients.(2) A habitable room shall have an aggregate window area of not less than one-tenth of the gross floor area.(3) Each bedroom shall have artificial light adequate for reading at bedside.(4) There shall be night lighting in bedrooms, rooms with toilets, and service areas.(g) Screening of doors and windows shall be provided, where appropriate, using screening having sixteen meshes per inch.(h) Doors. (1) Sliding doors or folding doors shall not be used as exit doors and, if used in other areas, shall be of light material and easy to handle.(2) Double acting doors, if used, shall be provided with vision panels.(i) The minimum clear width of a corridor shall be forty-four inches except that corridors serving one or more non-ambulatory or semi-ambulatory patients shall be not less than eight feet in width.(j) Storage space. (1) Locked space shall be provided for janitorial supplies and equipment.(2) Space for other equipment shall be provided and conveniently located.(k) The water supply shall be in accordance with chapter 340E, HRS.(l) Chapter 11-39, Administrative Rules, relating to air conditioning and ventilation shall be followed.(m) Additions and alterations or repairs to existing buildings. (1) Where the structure was in use as a hospital prior to the effective date of this chapter, the director may waive or modify any portion of the construction standards, provided such exceptions do not create a hazard to patients, hospital personnel, or the general public.(2) Drawings and specifications for all new construction or additions, alterations, or repairs to existing buildings subject to this chapter shall be submitted to the licensing branch of the department for review. Construction shall not commence prior to the department's approval of construction drawings. Drawings and specifications shall comply with the rules of the county building ordinances, fire codes, and zoning codes.(3) The department shall review drawings and specifications and advise the applicant in writing of its determination.(4) The department may make written recommendations to the applicant but the recommendations shall not be mandatory.(5) Construction shall commence within one year of the approval of final construction drawings and specifications. If construction does not commence within one year, the construction drawings and specifications together with the application for a license shall be resubmitted for the department's review and approval.(6) Minor alterations which do not affect structural integrity, fire safety, functional operation, or increase beds or services which the facility is licensed to operate may be submitted either by free hand drawings or by more conventional architectural drawings and specifications.(7) Maintenance and repair routinely performed by the facility shall not require review or approval by the department.(8) Facilities shall be constructed and maintained in accordance with provisions of state and county zoning, building, fire safety and sanitation laws and rules applicable in the State of Hawaii.[Eff. 3/3/86; am AUG 3, 1992] (Auth: HRS §§ 321-9, 321-11) (Imp: HRS §§ 321-9, 321-11)