Section DHS 131.37 - Physical plant(1) GENERAL REQUIREMENTS. The building of a freestanding hospice shall be constructed and maintained so that it is functional for the delivery of hospice services, appropriate to the needs of the community and protects the health and safety of the patients. The provisions of this section apply to all new, remodeled and existing construction unless otherwise noted. Wherever a requirement in this section is in conflict with the applicable Life Safety Code under s. DHS 131.38, the Life Safety Code shall take precedence.(5) PATIENT BEDROOMS. (a)Design and location. Patient bedrooms shall be designed and equipped for the comfort and privacy of the patient and shall be equipped with or located near toilet and bathing facilities.(b)Capacity.1. A patient bedroom may accommodate no more than 2 patients. Patients of the opposite sex may not be required to occupy the same sleeping room.2. The minimum floor area per bed shall be 80 square feet in multiple patient rooms and 100 square feet in single patient rooms. The distance between patient beds in multipatient rooms shall be at least 3 feet.(c)Bed arrangements.2. There shall be at least 3 feet between beds where the space is necessary for patient or staff access.3. Visual privacy shall be provided for each patient in multibed patient rooms. In new or remodeled construction, cubicle curtains shall be provided.(d)Semiambulatory and nonambulatory patients. For rooms with semiambulatory or nonambulatory patients, mobility space at the end and one side of each bed may not be not less than 4 feet. Adequate accessible space for storage of a patient's wheelchair or other adaptive or prosthetic equipment shall be provided and shall be readily accessible to the patient.(e)Equipment and supplies. Each patient shall be provided with all of the following: 1. A separate bed of proper size and height for the convenience of the patient. Beds shall be at least 36 inches wide and shall be maintained in good condition.2. Drawer space available in the bedroom for personal clothing and possessions.3. Closet or wardrobe space with clothes racks and shelves in the bedroom.(7) WINDOWS. (a)Minimum size. Every living and sleeping room shall have one or more outside-facing windows.(b)Openable bedroom window. At least one outside window in a bedroom shall be openable from the inside without the use of tools.(c)Window screens. All openable windows in habitable rooms shall have insect-proof screens.(8) ELECTRICAL. (a) Every hospice facility shall be supplied with electrical service and shall have wiring, outlets and fixtures properly installed and maintained in good and safe working condition.(b) Extension cords shall not be used in lieu of permanent wiring.(c) Exposed wiring is prohibited.(f) There shall be a switch or equivalent device for turning on at least one light in each room or passageway. The switch or equivalent device shall be located so as to conveniently control the lighting in the area.(g) All electrical cords and appliances shall be maintained in a safe condition. Frayed wires and cracked or damaged switches, plugs and electric fixtures shall be repaired or replaced.(9) PATIENT CALL SYSTEM. A reliable call mechanism shall be provided in every location where patients may be left unattended, including patient rooms, toilet and bathing areas and designated high risk treatment areas from which individuals may need to summon assistance.(10) BEDDING AND LAUNDRY. There shall be separate clean linen and dirty linen storage areas. (b) Each patient shall have available all of the following:1. Sufficient blankets to keep warm.3. Mattress and pillow covers as necessary to keep mattresses and pillows clean and dry. Note: When plastic mattress covers are used, there shall be a mattress pad the same size as the mattress over the plastic mattress cover.
(c) Clean sheets, pillowcases, towels and washcloths shall be available at least weekly and shall be changed as necessary to ensure that at all times they are clean and free from odors. (11) DAYROOM OR LOUNGE. At least one dayroom or lounge, centrally located, shall be provided for use of the patients.(12) SIZE OF DINING ROOM. Dining rooms shall be of sufficient size to seat all patients at no more than 2 shifts. Dining tables and chairs shall be provided. Television trays or portable card tables may not be used as the primary dining tables.(13) KITCHEN. The kitchen shall be located on the premises, or a satisfactory sanitary method of transportation of food shall be provided. If there is a kitchen on the premises, it shall meet food service needs and be arranged and equipped for proper refrigeration, heating, storage, preparation and serving of food. Adequate space shall be provided for proper refuse handling and washing of waste receptacles, and for storage of cleaning compounds.(14) MULTIPURPOSE ROOM. If a multipurpose room is used for dining, diversional and social activities of patients, there shall be sufficient space to accommodate all activities and minimize their interference with each other.(15) TOTAL AREA. (a) In existing facilities, the combined floor space of dining, recreation, and activity areas shall not be less than 15 square feet per bed. Solaria and lobby sitting space may be included, but shall not include required exit paths. A required exit path in these areas shall be at least 4 feet wide.(b) In new construction, the combined floor space of dining, recreation, and activity areas shall not be less than 25 square feet per bed. Solaria and lobby areas, exclusive of traffic areas, shall be categorized as living room space.(c) All required dining and living areas within the building shall be internally accessible to every patient of the hospice.(d) Each habitable room shall contain furnishings appropriate to the intended use of the room. Furnishings shall be safe for use by patients, and shall be comfortable, clean and maintained in good repair.(e) Adequate space and equipment shall be designated to meet the needs of the patients and family members for privacy and social activities.(16) HEATING.(a) The facility shall have a heating system capable of maintaining a temperature of 72º F. (20º C.) during periods of occupancy. Temperatures during sleeping hours may be reduced to 68º F. (18º C.). Higher or lower temperatures shall be available upon request.(b) The heating system shall be maintained in a safe and properly functioning condition.(c) The use of portable space heaters is prohibited.(17) BATH AND TOILET FACILITIES.(a) Each hospice shall have at least one separate bath and one separate toilet room or one combination bath and toilet room for the use of patients which is accessible from public, non-sleeping areas, except where private bath and toilet rooms are adjacent to each sleeping room.(b) Each floor in which patient sleeping, dining and living rooms are located shall have bath and toilet facilities or one combination bath and toilet room for use of patients which is accessible from public, non-sleeping areas, except where private bath and toilet rooms are adjacent to each bedroom.(c) All bath and toilet areas shall be well lighted.(d) Toilets, bathtubs and showers used by residents shall provide for individual privacy. If door locks are used for privacy they shall be operable from both sides in an emergency.(e) All toilet and bathing areas, facilities and fixtures shall be kept clean, in good repair and in good working order.(18) WATER SUPPLY. (a) Each sink, bathtub and shower shall be connected to hot and cold water, and adequate hot water shall be supplied to meet the needs of the patients.(b) Hot water from taps accessible to patients shall not exceed 115° F.(c) Where a public water supply is not available, the well or wells shall be approved by the Wisconsin department of natural resources. Water samples from an approved well shall be tested at least annually at the state laboratory of hygiene or another laboratory approved under 42 CFR 493 (CLIA).(d) The hospice shall make provision for obtaining emergency fuel and water supplies.(20) FACILITY MAINTENANCE. (a) The building shall be maintained in good repair and free of hazards such as cracks in floors, walls or ceilings, warped or loose boards, warped, broken, loose or cracked floor covering such as tile or linoleum, loose handrails or railings, and loose or broken window panes.(b) All electrical, mechanical, water supply, fire protection and sewage disposal systems shall be maintained in a safe and functioning condition.(c) All plumbing fixtures shall be in good repair, properly functioning and satisfactorily provided with protection to prevent contamination from entering the water supply piping.(d) Rooms shall be kept clean, well ventilated and tidy.(e) All furniture and furnishings shall be kept clean and maintained in good repair.(f) Storage areas shall be maintained in a safe, dry and orderly condition. Attics and basements shall be free of accumulation of garbage, refuse, soiled laundry, discarded furniture, old newspapers, boxes, discarded equipment and similar items.(g) Abrasive strips or nonskid surfaces to reduce or prevent slipping shall be used where slippery surfaces present a hazard.(h) The grounds, yards, and sidewalks shall be maintained in a neat, orderly and safe condition.(21) FLOORS AND STAIRS. Floors and stairs shall be maintained in a nonhazardous condition.(22) EXITS. Sidewalks, doorways, stairways, fire escapes and driveways used for exiting shall be kept free of ice, snow and obstructions.(23) DOOR LOCKS. The employee in charge of the facility on each work shift shall have a key or other means of opening all locks or closing devices on all doors in the facility.(24) EMERGENCY PLAN. (a) Each hospice shall have a written plan posted in a conspicuous place which specifies procedures for the orderly evacuation of patients in case of an emergency. The plan shall include an evacuation diagram. The evacuation diagram shall in addition be posted in a conspicuous place in the facility.(b) The licensee, administrator and all staff who work in the hospice facility shall be trained in all aspects of the emergency plan.(c) The procedures for exiting or taking shelter in the event of a fire, tornado, flooding or other disaster to be followed for patient safety shall be clearly communicated by the staff to the patients within 72 hours after admission and practiced at least quarterly by staff.Wis. Admin. Code Department of Health Services DHS 131.37
CR 10-034: cr. Register September 2010 No. 657, eff. 10-1-10; correction in (1) made under s. 13.92(4) (b) 7, Stats., Register September 2010 No. 657; corrections in (4) (a) and (b), (19) (a) to (c) made under s. 13.92(4) (b) 7, Stats., Register January 2012 No. 673.Amended by, CR 19-092: r. (2) to (4), am. (5) (a), r. and recr. (5) (a), am. (5) (b) 1., r. (5) (c) 1., am. (5) (d), (e) 3., r. (6), am. (7) (a), (c), r. and recr. (8) (b), (c), r. (8) (d), (e), am. (16) (c), (17) (a) 3., r. (17) (b), am. (18) (b), r. (19), (25) Register July 2020 No. 775, eff. 8-1-20; change in numbering in (17) made under s. 13.92(4) (b) 1, Stats., Register July 2020 No. 775, eff. 8/1/2020