Section 175-16-007 - PHYSICAL PLANT Physical plant requirements in 175 NAC 1 and 175 NAC 16 do not apply to hospice services provided in the consumer's home. An inpatient hospice facility must meet all physical plant requirements shown at 175 NAC 1 and the additional requirements shown below. All buildings must be designed, constructed, and maintained in a manner that is safe, clean and functional for the care, treatment and services provided.
007.01DIETARY. If food preparation is provided on site, there must be dedicate space and equipment for the preparation and serving of meals. Such food preparation, serving, physical environment, and equipment must comply with the Food Code007.02DINIING AREAS. Dining areas must have an outside wall with windows for natural light and ventilation and meet the following requirements: (A) Dining areas must be furnished with tables and chairs that accommodate or conform to consumer needs;(B) Dining areas must have a floor area of 15 square feet per consumer in existing facilities and 20 square feet per consumer in new construction;(C) Dining areas must allow for group dining at the same time in either separate dining areas or a single dining area, or dining in 2 shifts, or dining during open dining hours; and(D) Dining areas must not be used for sleeping, offices or corridors.007.03LAUNDRY. Laundry services must be provided. These service may be provided by contract or on-site by the licensee.007.03(A)CONTRACT. If contractual laundry services are used, areas for soiled linen awaiting pickup and separate areas for storage and distribution of clean linen must be utilized.007.03(B)ONSITE. If onsite laundry services are provided there must be areas dedicated to laundry that include a washer and dryer. In new construction, there must be a conveniently located sink for soaking and hand washing of laundry.007.03(C)SANITATION. When bed and bath linens are cleaned, water temperatures to laundry equipment must be 160 degrees Fahrenheit or higher. Laundry may be appropriately sanitized or disinfected by another acceptable method in accordance with the manufacturer's instructions or other documentation.007.04LINENS. There must be an adequate supply of bed, bath, and other linens as necessary for each consumer. The linen must be clean and in good repair.007.05WASTE PROCESSING. There must be areas to collect, contain, process, and dispose of medical and general waste produced in a manner that prevents the attraction of vermin, and to minimize the transmission of infectious diseases.007.06COSMETOLOGY AND BARBER. If cosmetology and barber services, as defined in the Cosmetology, Electrology, Esthetics, Nail Technology; and Body Art Practice, Neb. Rev. Stat. §§ 38-1001 to 38-10,171 and the Practice of Barbering, Neb. Rev. Stat. §§ 71-201 to 71-248 must be provided such services must be provided in conformance with those statutes.007.07PHARMACY. If pharmacy or pharmaceutical services are provided they must be provided in conformance with the statutes and regulations governing such practice.007.08HOUSEKEEPING ROOM. There must be a room with a service sink and space for storage of supplies and housekeeping equipment.007.09CARE AND TREATMENT AREAS. The following care and treatment areas cannot be shared among detached structures or with other licensed health care facilities or services. Care and treatment areas must comply with the following standards. 007.09(A)STAFF AREAS. There must be the following support areas for each distinct care and treatment suite of bedrooms: 007.09(A)(i)CONTROL POINT. An area for charting, consumer records, and call and alarm annunciation systems.007.09(A)(ii)MEDICATION STATION. A medication station for storage and distribution of drugs and routine medications. Distribution may be done from a medicine preparation room or unit, from a self-contained medicine-dispensing unit, or by another system. If used, a medicine preparation room or unit must be under visual control of nursing staff and must contain a work counter, sink, refrigerator, and double-locked storage for controlled substances.007.09(A)(iii)CONSUMER FACILITIES. Space for consumer care, treatment, services, and consultation, and a visiting area allowing for consumer privacy.007.09(A)(iv)UTILITY AREAS. A work area where clean materials are assembled. The work area must contain a work counter, a handwashing fixture, and storage facilities for clean and sterile supplies. If the area is used only for storage and holding as part of a system for distribution of clean and sterile supply materials, the work counter and handwashing fixtures may be omitted. There must be separate work areas or holding rooms for soiled materials. A workroom for soiled materials must contain a fixture for disposing of wastes and a hand washing sink.007.09(B)EQUIPMENT AND SUPPLY. There must be services and space to distribute, maintain, clean, and sanitize durable medical instruments, equipment, and supplies required for the care, treatment, and services performed. 007.09(B)(i)DURABLE MEDICAL. hospice must ensure that the Durable medical equipment must be tested and calibrated in accordance with the manufacturer's recommendations.007.09(B)(ii)STERILE PROCESSING. There must be areas for decontamination and sterilizing of durable medical instruments and equipment. Separate central sterile processing and waste processing facilities must be used. There must be separate soiled rooms for sorting and decontamination, and clean rooms for sterilizing and processing) rooms. There must be hand washing sinks in both clean and soiled rooms.007.09(B)(iii)EQUIPMENT STORAGE. There must be space to store equipment, stretchers, wheel chairs, supplies, and linen out of the path of normal traffic.007.09(B)(iv)EQUIPMENT. There must be equipment adequate for meeting the consumer's needs as specified in the contracts, consumer service agreements, and consumer care plans.007.10BATHING ROOMS. There must be a bathing room consisting of a tub or shower adjacent to each bedroom or provide a central bathing room on each floor. Tubs and showers regardless of location must be equipped with hand grips or other assistive devices as needed or desired by the consumer. In new construction a central bathing room must open off the corridor and contain a toilet and sink or have an adjoining toilet room. There must be at least 1 bathing fixture for each 8 licensed beds in new facilities and new construction.007.11TOILET ROOMS. Existing or new facilities must have a toilet and sink adjoining each bedroom or shared toilet facilities with a minimum number of 1 toilet and sink fixture per 2 licensed beds. New construction must have a toilet and sink fixture provided adjoining each consumer bedroom or in each apartment or dwelling.007.12SLEEPING ROOMS. There must be bedrooms which allow for sleeping, afford privacy, provide access to furniture and belongings, and accommodate the care and treatment provided to the consumer. 007.12(A)BEDROOMS. Bedrooms must:(i) Be a single room located within an apartment, dwelling, or dormitory-like structure;(ii) Not be accessed through a bathroom, food preparation area, laundry or another bedroom;(iii) Be located on an outside wall or an atrium with an operable window opening to allow natural ventilation with a minimum glass size of 10% of the required bedroom floor area for the number of room consumers. The window must provide an unobstructed view of at least 10 feet;(iv) Contain at least 25 cubic feet of enclosed storage volume per consumer in dressers, closets, or wardrobes;(v) Allow for an accessible arrangement of furniture; which provides a minimum of three feet between beds in rooms with multiple beds; and(vi) Be separate from a room containing a water closet, lavatory, and bathtub or shower; and separate from a kitchen area with a sink, cooking appliance, and refrigeration equipment when located in an apartment or dwelling.007.12(B)EXISTING OR NEW FACILITY. Sleeping areas in existing and new facilities must have at least the following floor areas.(i) Floor areas for single bed sleeping rooms must be 100 square feet.(ii) Floor areas for multiple bed sleeping rooms must be 80 square feet per consumer with a maximum of 2 beds.007.12(C)NEW CONSTRUCTION. Sleeping areas in new construction must have at least the following floor areas.(i) Floor areas for single bed sleeping rooms must be 120 square feet.(ii) Floor area for apartments or dwellings must have 150 square feet for one consumer plus 110 square feet for each additional consumer with a maximum of 1 consumer in any single bedroom.007.13ISOLATION ROOMS. The licensee must have the capability to provide isolation rooms based on infection control risk assessment of the consumers. There must be provisions for isolating consumers with infectious diseases. In new construction, the inpatient hospice facility must equip isolation rooms with hand washing and gown changing facilities at the entrance of the room.007.14CORRIDORS. Corridors must be wide enough to allow passage and be equipped with safety and assistive devices to minimize injury and to meet the needs of the consumer. All stairways and ramps must have handrails.007.15DOORS. Doors must be wide enough to allow passage and be equipped for privacy, safety, and with assistive devices to minimize consumer injury. All bedroom, toilet, and bathing room doors must provide privacy yet not create seclusion or prohibit staff access for routine or emergency care. In new construction, all consumer-used toilet and bathing rooms with less than 50 square feet of clear floor area must not have doors that swing inward.007.16OUTDOOR AREAS. An outdoor area for consumer usage must be provided. It must be equipped and situated to protect consumers and to promote the abilities of consumers.007.17HAND WASHING SINKS. A hand washing facility equipped with sink, disposable towels, and soap dispenser must be in all examination, treatment, isolation, and procedure rooms.007.18PRIVACY. Visual privacy and window curtains must be provided for each consumer. In new facilities the curtain layout must totally surround each care and treatment location which will not restrict access to the entrance to the room, lavatory, toilet, or enclosed storage facilities.007.19FINISHES. Room finishes must meet the following: (A) Washable room finishes provided in existing isolation rooms, clean workrooms, and food-preparation areas must have smooth, non-absorptive solutions and methods. Acoustic lay-in ceilings, if used, must not interfere with infection control. Perforated, tegular, serrated cure, or highly textured tiles are not acceptable; and(B) Scrubbable room finishes provided in new isolation rooms must have smooth, non-absorptive, non-perforated surfaces that are not physically affected by harsh germicidal cleaning solutions and methods.007.20ADDITIONAL SERVICES. If additional medical or therapy services are provided there must be adequate space provided to assure privacy and provision of appropriate care, treatment and services.007.21BUILDING SYSTEMS. Building systems must be designed, installed and operated in a manner to provide for the safety, comfort, and well-being of the consumer and must include at a minimum, the following: 007.21(A)CALL SYSTEMS. Call systems must be operable from procedure, treatment, operating rooms, recovery areas, toilet rooms and bathing rooms. The system must transmit a receivable, tactile, visual or other type of signal to on-duty staff which readily notifies staff to the location where the call was activated. When wireless call systems are used, they must have dedicated devices in all consumer toilet and bathing areas to promptly summon staff to the call location.007.21(A)(i)NEW CONSTRUCTION. New construction in locations where consumers are unable to activate the call system must have a device where staff can summon other staff for assistance as needed.007.21(B)ELECTRICAL SYSTEM. The electrical system must have the capacity to maintain the care and treatment services that are provided and that properly grounds care and treatment areas.007.21(B)(i)NEW CONSTRUCTION. New construction and new facilities must have ground fault circuit interrupters protected outlets in all wet areas and within 6 feet of all hand washing sinks.007.21(C)ESSENTIAL POWER SYSTEM. All existing and new facilities must maintain an emergency power system for all essential care and treatment areas, lighting, medical gas systems, nurse call systems, and any general anesthetics or electrical life support systems.007.21(D)ELECTRICAL SUPPORT EQUIPMENT. Facilities with electrical support equipment must maintain essential power systems and must have an on-site fuel source. The minimum fuel source capacity must allow for non-interrupted system operations.007.22HOT WATER SYSTEM. There must be hot and cold water to all hand washing and bathing locations.007.23HEATING AND COOLING SYSTEMS. Airflow must move from clean to soiled locations. Floors in operating, procedure and other locations subject to wet cleaning methods or body fluids must not have opening to the heating and cooling system.007.23(A)CENTRAL AIR DISTRIBUTION. In new construction, central air distribution and return systems must have the following dust rated filters: (i) General areas: 30 +%; and(ii) Procedure and operating rooms: 90 +%.007.23(B)AIR MOVEMENT. In new construction, air movement must be designed to reduce the potential of contamination of clean areas.007.24ILLUMINATION LEVELS. All facilities must provide minimum illumination levels which are measured at 30 inches above the floor in multiple areas in the room as follows: (A) Toilet Rooms | 30 foot candles; |
(B) Corridors | 10 foot candles; |
(C) Laundry | 30 foot candles; |
(D) Medication station | 75 foot candles; |
(E) Care and treatment locations | 70 foot candles; |
(F) Procedure task lighting | 200 foot candles; and |
(G) Surgery | 1000 foot candles. |
007.25MEDICAL GAS SYSTEMS. The facility must safely provide medical gas and vacuum by means of portable equipment or building systems as required by the type of care and treatment provided at the clinic. All medical gas systems must comply with the requirements of 153 NAC 1.007.26VENTILATION SYSTEM. All facilities must provide exhaust and clean air to prevent the concentrations of contaminants which impair health or cause discomfort to consumers and employees. 007.26(A)MECHANICAL EXHAUST VENTILATION. New construction must provide mechanical exhaust ventilation system at a rate of 10 air exchanges per hour for the following areas:007.26(B)MECHANICAL VENTILATION SYSTEM. New construction must provide mechanical ventilation system air exchanges per hour at the following rates: (i) Care and treatment areas 5 ACH;(ii) Procedure and isolation areas 15 ACH; and(iii) Operating rooms 20 ACH.007.27WATER AND SEWER SYSTEMS. There must be an accessible and safe potable supply of water. Where a public water supply system is available, the facility must be connected to it and must use it exclusively. All water distribution systems must be protected with anti-siphon devices and air-gaps to prevent contamination. All facilities must maintain a sanitary and functioning sewage system and the following: (A) If the facility operates its own water supply system it must be operated as if it is a public water supply system and in compliance with The Nebraska Safe Drinking Water Act and Title 179, Regulations Governing Public Water Systems; and(B) Continuously circulated filtered and treated water systems must be provided as required for care and treatment equipment used in the facility.175 Neb. Admin. Code, ch. 16, § 007
Amended effective 6/2/2024