175 Neb. Admin. Code, ch. 6, § 007

Current through September 17, 2024

Section 175-6-007 - PHYSICAL PLANT

All buildings must be designed, constructed, and maintained in a manner that is safe, clean and functional for the specialized care and treatment provided. All buildings must comply with the Health Care Facility Licensure Act, 175 NAC 1, this chapter, and the Nebraska State Fire Code and Life Safety Code requirements. Each building must comply with the following physical plant requirements.

007.01DIETARY. If food preparation is provided on site, there must be dedicate d space and equipment for the preparation and serving of meals. Such food preparation, serving, physical environment, and equipment must comply with the Food Code.

007.02DINING AREAS. Adequate space for dining, socialization, and leisure activities must be provided. Dining areas must:

(A) Have tables and chairs that meet the consumers' needs;

(B) Not be used for offices or as a corridor; and

(C) Be arranged so that all consumers are able to eat meals at an appropriate time by having:

(i) All consumers eat at the same time;

(ii) Consumers eat in different shifts; or

(iii) Open times for consumers meals.

007.03LAUNDRY. When laundry services are provided they 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.

007.04LINENS AND CLOTHING. 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. Procedures must be implemented for the storage and handling of soiled and clean linens and consumer clothing. Covered or sealable, waterproof containers are provided for storing wet, soiled clothing.

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.

007.06HOUSEKEEPING ROOM. There must be a room with a service sink and space for storage of supplies and housekeeping equipment.

007.07PHARMACY. If pharmacy or pharmaceutical services are provided they must be provided in conformance with the statutes and regulations governing such practice.

007.08CARE 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 safeguard consumer privacy and dignity and comply with the following standards.

007.08(A)STAFF AREAS. The following support areas must be provided for each distinct care and treatment area:

(i) An area for charting and consumer records;

(ii) 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;

(iii) Space for consumer care, treatment, services, and activities allowing for consumer privacy; and

(iv) A work area where clean materials are assembled. The work area must contain a work counter, a hand washing 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 hand washing 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.

007.08(B)EQUIPMENT AND SUPPLY. The licensee must provide services and space to distribute, maintain, clean and sanitize durable medical instruments, equipment, and supplies the license has agreed to provide for the consumer and which are required for the care, treatment, and services provided by the licensee. There must be space to store equipment, wheelchairs, supplies, and linen out of the path of normal traffic.

007.09TOILET ROOMS. There must be toilet rooms with hand washing sinks located near the toilet fixtures.

007.10SLEEPING AREAS. When overnight care is provided, there must be areas which allow for sleeping and accommodate the care, treatment and services provided to the consumer. Sleeping rooms must:

(A) Not be located in an garage, storage area, shed, or similar detached buildings; and

(B) Not be accessed through a bathroom, food preparation area, laundry or bedroom.

007.11CONSUMER STORAGE. Storage for consumers' belongings must be provided and must not be the same storage area where food or medication is kept. Consumer toothbrushes, if used, must be distinctly marked with each consumer's name and stored to prevent contamination.

007.12DOORS. Doors must be wide enough to allow passage and be equipped for privacy, safety, and with assistive devices to minimize consumer injury. Toilet, changing, and bathing room doors must provide privacy yet not create seclusion or prohibit staff access to provide consumer supervision and routine or emergency care.

007.13BATHING ROOMS. If bathing services are provided there must a bathing room with a tub or shower. Tubs and showers used by consumers must be equipped with handgrips or other assistive devices as needed by the consumer. The bathing room must not open directly into a dining or kitchen area.

007.14ADDITIONAL 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.

007.15OUTDOOR AREAS. There must be an outdoor area for consumer usage. The area must be equipped and situated to allow for consumer safety, abilities and special needs.

007.16SINKS. There must be a hand washing facility equipped with sink, disposable towels, and soap dispenser in areas where hands are likely to become soiled or require frequent hand washing. Such areas include toileting, changing, and bathing areas, food preparation areas, and near rooms specifically designated for patient care, treatment and services.

007.17FINISHES. There must be washable room finishes in clean workrooms and food preparation areas that have smooth, non-absorptive surfaces which are not physically affected by routine housekeeping cleaning solutions and methods. Acoustic lay-in ceilings, if used, must not interfere with infection control. Perforated, tegular, serrated cure, or highly textured tiles must not be used.

007.18CALL SYSTEMS. Call systems, when used, must be operable from consumer-used toileting, changing, and bathing areas. The system must transmit a receivable, visual, audible, tactile 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 occupied central toilet and bathing locations to promptly summon staff to the call location.

007.19ELECTRICAL SYSTEM. The electrical system must have the capacity to maintain the care, treatment, and services that are provided and that properly grounds care, treatment, and services areas.

007.20ESSENTIAL POWER SYSTEM. All existing and new facilities must maintain an emergency power system for all essential care, treatment and service areas, when electrical life support systems are used for consumers.

007.21ELECTRICAL LIFE SUPPORT EQUIPMENT. Facilities with electrical life 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. A heating and air conditioning system must be provided, for the comfort of the consumer that is capable of producing a temperature of at least 70 degrees Fahrenheit during heating conditions and that does not exceed 85 degrees Fahrenheit during cooling conditions. Airflow must move from clean to soiled locations.

007.24VENTILATION SYSTEM. All facilities must provide exhaust and clean air to prevent the concentrations of contaminants which could impair health or cause discomfort to consumers and employees.

007.25WATER 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 operate 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 the care and treatment equipment used in the facility.

175 Neb. Admin. Code, ch. 6, § 007

Amended effective 2/20/2024