Md. Code Regs. 10.07.02.49

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.07.02.49 - Resident Bedroom in Nursing Home

A. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home unless a waiver has been granted by the Office of Health Care Quality in accordance with Regulation .03G of this chapter.

B. Bedroom Accommodations.

(1) Bedroom.

(a) A resident's room shall have direct access to an exit in accordance with the requirements applicable to nursing homes specified in NFPA 101 Life Safety Code.

(b) A room that opens into the kitchen may not be used as a resident bedroom.

(c) A room may not be used as a resident bedroom if it can only be reached by passing through a kitchen.

(d) Residents may not occupy rooms extending below the ground level.

(e) No more than four individuals may occupy a multiple occupancy bedroom.

(f) Residents' beds may not be located near radiators, registers, or sources of draft.

(g) Adequate storage space shall be provided in each bedroom to allow each resident to keep necessary items of clothing, including items that need to be hung.Adequate storage space shall be provided for residents' personal possessions, including the storage of seasonal clothing.

(h) All occupants of any bedroom shall be of the same sex, except in the case of a two-bed room occupied by:

(i) Siblings;

(ii) A parent and child;

(iii) A married couple; or

(iv) Consenting residents.

(2) Bedroom - New Construction. A nursing home shall provide cubicle curtains and tracks in multiple occupancy bedrooms between beds to ensure privacy of residents.

(3) Bedroom - Existing Construction. In an existing nursing home, curtains or screens shall be acceptable.

C. Floor and Window Space.

(1) Floors.

(a) A distance of at least 3 feet shall be maintained between each bed. Beds are to be placed so that all sides of the bed are at least 18 inches from heating units.

(b) The following shall be considered a minimum allowance of floor space:

(i) 100 square feet, single-bed room; and

(ii) 80 square feet, per bed, for multiple-bed rooms.

(c) The following floor areas may not be included in the calculation of floor space:

(i) Toilet rooms and bathing facilities;

(ii) Closets;

(iii) The floor area occupied by wardrobes, bureaus, or lockers, when permanently installed as part of walls or ceilings and as a permanent component of a bedroom;

(iv) HVAC equipment, including any steam, water, or electrical supply or return lines that may run parallel to the floor or interrupt the floor surface;

(v) Support columns, pipe chases, or other structures, whether free-standing or as an integral part of a wall; and

(vi) The arc of any doors that open into the room, excluding closet doors.

(d) The minimum horizontal dimensions of a bedroom shall be 10 feet to:

(i) Facilitate the placement of beds as required in Regulation .44 of this chapter; and

(ii) Maintain a minimum clearance of 3 feet at the foot of the bed.

(e) In an existing nursing home, the usable floor area for rooms having a bedroom shall have a finished ceiling height of 8 feet. For a bedroom that has sloping walls, only 50 percent of the floor area with a ceiling height between 4 feet and 7 feet, 6 inches, shall be credited, provided that at least 50 percent of the total area of the bedroom has a ceiling height of 8 feet.

(2) Windows.

(a) The window area within each bedroom shall be at least 10 square feet per bed. The window opening shall be at least 28 inches so that the total area equals 10 square feet per bed.This is to allow entry of fire fighters, removal of smoke, and emergency evacuation.

(b) The maximum height from the floor to the top of a window sill shall be 44 inches above the finished floor.

(c) A portable window air-conditioning unit may not block window space. The installation of a portable air-conditioning unit shall be approved by the:

(i) Local fire authorities; and

(ii) Department.

(d) If windows cannot be opened for ventilation, a central HVAC system shall be provided and maintained.

(e) If windows can be opened, but the nursing home has concern over the window being opened due to resident safety issues and elopement, the window sash may be restricted by hardware as approved by the Department.

D. Furnishings.

(1) Furnishings.

(a) The nursing home shall provide residents with their own bed. The bed shall be at least 36 inches wide and be substantially constructed. Rollaway type beds, cots, or folding beds may not be used.

(b) Bed.

(i) Each bed provided shall be in good repair, with a clean and comfortable standard size mattress and foundation.

(ii) To avoid injury to the resident, the mattress and foundation shall fit the bed.

(iii) Clean linen and a clean, comfortable pillow shall be provided. Extra pillows shall be available.

(c) Bedroom Furniture. A resident shall be provided with the following furnishings, which shall be convenient to the resident:

(i) Bedside stand with a drawer;

(ii) Towel hanger;

(iii) A comfortable chair;

(iv) A chest of drawers with at least one locking drawer;

(v) Enclosed space for hanging clothing;

(vi) A wall mirror in each room, unless contraindicated by physician's order; and

(vii) A bedside lamp, over-bed lamp, or other directional light source for resident reading and bedside care.

(d) Resident's Personal Furnishings.

(i) A nursing home shall develop policies and procedures to give residents the opportunity to use the resident's own furnishings as detailed in this chapter.

(ii) The nursing home shall make its resident's personal furnishing policies available for review by residents and the resident's representative.

(iii) These policies shall address the condition of the personal furnishings, presence of insects or vermin, and overall safety to ensure that the use of the resident's belongings does not create any safety or health issues.

(iv) Personal furnishings that are allowed shall be appropriate for the resident's use.

(e) Windows shall be provided with shades or draperies adequate to control glare and maintain privacy.

(f) Each living room for residents' use shall be provided with a sufficient number of reading lamps, tables, and comfortable chairs or sofas.

(2) Furnishings - New Construction. A bedroom shall be provided with a hand-washing sink with both hot and cold running water unless a toilet or bathroom facility with a sink is connected to the bedroom.

(3) Medication Storage Cabinets.

(a) Medication storage cabinets with locks shall be permitted for the storage of resident medications that do not require refrigeration within a resident bedroom.

(b) Controlled medications to be stored within medication storage cabinets in a resident's room shall be held within a separate compartment that is locked and inside of the larger medication storage cabinet in that room.

Md. Code Regs. 10.07.02.49

Regulations .49 adopted effective January 7, 1991 (17:26 Md. R. 2975)
Regulations .49 repealed as an emergency provision effective January 1, 2001 (28:4 Md. R. 414); repealed permanently effective May 14, 2001 (28:9 Md. R. 885)
Regulations .49 adopted as an emergency provision effective January 1, 2001 (28:4 Md. R. 414); adopted permanently effective May 14, 2001 (28:9 Md. R. 885)
Regulation .49D amended effective September 16, 2002 (29:18 Md. R. 1442); amended effective 46:12 Md. R. 541, eff. 6/17/2019