175 Neb. Admin. Code, ch. 18, § 007

Current through September 17, 2024

Section 175-18-007 - PHYSICAL PLANT STANDARDS

The licensee must ensure that the facility is designed, constructed, and maintained in a manner that is safe, clean, and functional for the type of services to be provided. The physical plant standards are set forth below.

007.01SHARING SPACE. A mental health substance use treatment center may share physical space with another licensed or unlicensed entity when:

(A) The spaces are clearly identified in a manner so that a client or their designee is fully aware of the specific licensed facility where they are receiving care and treatment;

(B) Medical records, staffing, and administration are clearly separated and not shared by the two entities; and

(C) The two facilities are not providing care and treatment in the same space at the same time.

007.02DIETARY. For facilities licensed for 16 or fewer clients or for areas of the facility used only for training or activity purposes, the facility may follow the Food Code or must develop policies and procedures to ensure the following:

(A) Automatic dishwasher final rinse cycle temperature of not less than 150 degrees Fahrenheit;

(B) Foods are stored, prepared, transported, and served at proper temperatures;

(C) Temperatures of potentially hazardous foods must be 45 degrees Fahrenheit or below or 140 degrees Fahrenheit or above at all times;

(D) Food preparation and eating areas are maintained in a sanitary manner; and

(E) All equipment and utensils, including dishes, glassware, and silverware used in the serving or preparation of food or drink for individuals is thoroughly cleaned after each use and stored in a manner to ensure they are kept free of dust, vermin, and contamination.

007.03LAUNDRY. Each mental health substance use treatment center must establish, implement, and revise as necessary, written procedures for the storage and handling of soiled and clean laundry and linens in accordance current, accepted standards of practice and in a manner to reduce any risk of cross-contamination and or infections. Laundry may be completed onsite or by contract with an outside entity.

007.03(A)CONTRACT. If contractual services are used, the facility must have areas for soiled laundry awaiting pickup and separate areas for storage and distribution of clean laundry.

007.03(B)ON-SITE. If on-site services are provided, the facility must have areas dedicated to laundry and must include the following:

(i) A washer and dryer;

(ii) Be divided into separate soiled areas for sorting and washing and separate clean areas for drying, folding, and mending. In new construction, the facility must provide a conveniently located sink for soaking and hand washing of laundry and a housekeeping room; and

(iii) Water temperatures in the laundry must exceed 160 degrees Fahrenheit, or the facility must use an acceptable sanitizer or disinfectant in accordance with the manufacturer's instructions.

007.04WASTE PROCESSING. The facility must provide areas to collect, contain, process, and dispose of waste produced within the facility in a manner to prevent the attraction of vermin and to minimize the transmission of infectious diseases.

007.05COSMETOLOGY AND BARBER SERVICES. When provided, cosmetology and barber services must be in conformance with the Nebraska Cosmetology Act, Neb. Rev. Stat. §§ 340 to 3,238 and the Barber Act, Neb. Rev. Stat. §§ 71-201 to 71-248.

007.06PHARMACEUTICAL. If the facility provides pharmacy services, the services must be provided in conformance with Neb. Rev. Stat. §§ 71-1,142 to 71-1,147.61.

007.07FLOOR AREA. Floor area is the space with ceilings at least 7 feet in height and excludes enclosed storage, toilet and bathing rooms, corridors, and halls. The space beyond the first 2 feet of vestibules and alcoves less than 5 feet in width is included in the required floor area. In rooms with sloped ceilings, at least half of the ceiling must be at least 7 feet in height. Less than 5 feet in height are not included in the required floor area.

007.08DINING AND ACTIVITY AREAS. The facility must provide adequate space for dining, socialization, and leisure activities as follows:

(A) The space must provide a minimum of 15 square feet per individual in existing facilities, and 20 square feet per individual in new construction; and

(B) Dining and activity areas must not be used for sleeping, offices, or corridors.

007.09BATHING ROOMS. The facility must provide a bathing room consisting of a tub or shower equipped with hand grips or other assistive devices as needed or desired by the client. The facility must have 1 bathing fixture per 20 licensed beds in existing facilities, and 1 fixture per 8 licensed beds in new facilities and new construction.

007.10TOILET ROOMS. The facility must provide a room with a sink and toilet for individuals' use with 1 fixture per 8 licensed beds in existing facilities, and 1 fixture per 4 licensed beds in new facilities and new construction.

007.11BEDROOMS. The facility must provide bedrooms that provide for sleeping, afford privacy, provide reasonable access to furniture and belongings, and accommodate the needs of the individual. All bedrooms must:

(A) Not be accessed through a bathroom, food preparation area, laundry, office, or another bedroom;

(B) Be located on an outside wall with an operable window with a minimum glass size of 6 square feet per individual in new construction and new facilities;

(C) Contain at least 35 cubic feet of storage volume per individual in dressers, closets, wardrobes, or other similar types of storage;

(D) Have 80 square feet of floor area for a single bed room, and 60 square feet of floor area per individual in a multiple bed room; and

(E) Not exceed 4 beds per room in existing facilities, and 2 beds per room in new construction and new facilities.

007.12CORRIDORS. The facility's corridors must be wide enough to allow passage and be equipped as needed by the individuals with safety and assistive devices to. All stairways and ramps must have handrails.

007.13DOORS. The facility doors must be wide enough to allow passage and be equipped as needed by the individuals for privacy and safety.

007.14OUTDOOR AREAS. The facility must provide an outdoor area for individual use. It must be equipped and situated to provide for safety and the abilities of the individuals.

007.15EMERGENCY TELEPHONE. The facility must provide non-coin operated telephones in working order, accessible to clients based on their needs, located on the premises for local calls and emergencies. Emergency numbers must be easily accessible near the telephone.

007.16 PRIVACY. The facility must provide window coverings to ensure visual privacy for the individuals.

007.17BUILDING SYSTEMS. The facility must have building systems that are designed, installed, and that operate in a manner to provide for the safety, comfort, and well-being of the individuals.

007.18WATER AND SEWER SYSTEMS. The facility must have and maintain an accessible, adequate, safe, and potable supply of water. Where an authorized public water supply of satisfactory quantity, quality, and pressure is available, the facility must be connected to it and its supply used exclusively. If the facility does not utilize an authorized public water supply, the facility must construct, maintain, and operate the water supply as if it were a public water system in accordance with the regulations governing Public Water Systems, 179 NAC 2. The facility must construct all water wells in accordance with 178 NAC 12, Water Well Construction, Pump Installation, and Water Well Decommissioning Standards.

007.19HOT WATER SYSTEM. The facility must maintain hot and cold water to all hand washing and bathing locations with water temperatures for the comfort and safety of each individual. Hot water temperatures must not exceed 120 degrees Fahrenheit.

007.20HEATING AND COOLING SYSTEM. The facility must provide a heating and air conditioning system for the comfort of the individuals which is capable of maintaining temperatures of at least 70 degrees Fahrenheit during heating conditions and which does not exceed 85 degrees Fahrenheit during cooling conditions.

007.21VENTILATION SYSTEM. The facility must provide exhaust and clean air to prevent the concentrations of contaminants which impair health or cause discomfort to individuals and staff.

007.22ELECTRICAL SYSTEM. The facility must have an electrical system that has sufficient capacity to maintain the services that are provided and that provides proper grounds.

007.23ILLUMINATION. Light levels are measured at 30 inches above the floor in multiple areas in the room being evaluated and the readings are averaged. All facilities must provide minimum illumination levels as follows:

(A) General purpose areas - 5 foot candles;

(B) General corridors and individuals' living areas - foot candles;

(C) Personal care and food preparation areas - 20 foot candles; and

(D) Activity areas - 30 foot candles.

007.24EMERGENCY POWER SYSTEM. If the facility provides services to clients who need electrical life support equipment, the facility must maintain an emergency power system.

007.25EMERGENCY DETOXIFICATION PROGRAMS. Beds used in an emergency detoxification program must be in a room which has:

(A) A minimum of 50 square feet per bed;

(B) A minimum of 3 feet between beds;

(C) Appropriate temperature control, ventilation, and lighting;

(D) No unsafe wall or ceiling fixtures and sharp edges;

(E) A way to observe the client, such as, an observation window or, if necessary, flat wall mirrors so that all areas of the room are observable by staff from the outside of the room; and

(F) A way to assure that the client cannot hold the door closed so as to deny staff immediate access to the room.

007.26OBSERVATION ROOMS FOR SECLUSION AND DETOXIFICATION. If the facility provides behavior intervention methods such as seclusion or time-out, the facility must provide an area which has:

(A) Appropriate temperature control, ventilation, and lighting;

(B) No unsafe wall or ceiling fixtures and sharp edges;

(C) A way to observe the client, such as, an observation window or, if necessary, flat wall mirrors so that all areas of the room are observable by staff from outside of the room; and

(D) A way to assure that the client cannot hold the door closed so as to deny staff immediate access to the room.

175 Neb. Admin. Code, ch. 18, § 007

Amended effective 3/20/2024