Section SPS 382.50 - Health care and related facilities(1) GENERAL. The provisions of this section shall set forth the requirements for the design, installation and maintenance of devices, fixtures and equipment which are installed in health care and related facilities.(2) FIXTURES AND EQUIPMENT. (a)Special fixtures and equipment.1. 'Requirements for ice manufacture and storage.' Machines for manufacturing ice or any device for handling or storage of ice shall be located in an area not subject to contamination.2. 'Sterilizers and washer sanitizers.' a. Sterilizers and washer sanitizers shall discharge by means of indirect waste.b. The indirect waste piping shall discharge by means of air-gap.3. 'Aspirators.' Aspirators which require the use of water shall be provided with approved cross connection control.(b)Spouts and actions. Except in psychiatric-care facilities in areas where patient safety is at risk with standard gooseneck spouts and actions, the selection of spouts and actions on plumbing fixtures shall comply with this section and Table 382.50-1. 1. 'Spouts'. a. Lavatories and sinks accessible to patients shall have a fixed water supply spout mounted so that its discharge point is a minimum distance of 5 inches above the flood level rim of the fixture.b. Spouts shall have laminar flow in facilities listed in par. (3) (b).2. 'Actions.' All fixtures used by medical and nursing staff, patients, residents, and food handlers shall be equipped with valves that can be operated without the use of hands and shall comply with all of the following:a. Where wrist blade handles are used for this purpose, the handles may not exceed 4 1/2 inches in length, except handles on scrub sinks and clinical sinks shall be no less than 6 inches long.b. Single lever faucet handles may be used in lieu of wrist blades.c. In lavatories with self-closing faucets accessible to patients, the flow of the hot water shall be calculated to evacuate the water distribution piping from the faucet to the recirculated hot water supply. (c)Floor drain prohibition.1. Except as provided in subd. 2., floor drains may not be installed in operating or delivery rooms.2. Floor drains may be installed in cystoscopic rooms. The drain shall contain a non-splash, horizontal-flow flushing bowl beneath the drain plate.(3) WATER SUPPLY SYSTEMS. (a)Hospital water supply systems. Water supply systems serving hospitals shall comply with all of the following:1. All hospitals shall be provided with at least 2 water services. Whenever more than one water main is available, the connections shall be made to different water mains.2. Each water service connection shall adequately serve the total building water supply demand as specified in s. SPS 382.40 (7), except for additional services supplying water to additions deemed non-essential as defined in a hospital water management plan. Note: The installation of two water services or a private water main may require the installation of a check valve. Refer to ch. NR 811 for more information.
(ag)Health care facilities. Hot and cold water shall be provided to all sinks accessible to patients and comply with all of the following: 1. Hot water shall be initiated and stored at a minimum of 140°F.2. The maximum temperature to fixture fitting outlets accessible to patients may not exceed 115°F.(b)Hospital, community-based residential facility, inpatient hospice and nursing home water supply systems.1. Water supply systems serving a hospital, community-based residential facility, inpatient hospice or nursing home shall comply with all of the following: a. Except as provided in subd. 1. b., a single control valve may serve an area where 4 or fewer patient care units exist and where each unit contains not more than 2 persons.b. A water supply serving an intensive care patient care unit shall be individually valved.2. All water distribution piping shall be insulated in accordance with chs. SPS 361 to 366.3. Cold water shall be supplied to lavatories or sinks located in patient rooms.4. A hot water distribution system shall be under constant recirculation to provide continuous hot water at each hot water outlet, except that when using thermal disinfection, under subd. 6. a. uncirculated hot water distribution piping may not exceed 3 feet in developed length. 4m. Control valves shall automatically regulate the temperature of the water supply of the distribution system that exceeds 140°F to each fixture accessible to patients.5. Water provided to patient showers, therapeutic equipment and all types of baths shall be installed with pressure balanced and thermostatically controlled control valves which automatically regulate the temperature of the water supply to the fixture fitting outlet within a temperature range of 110°F to 115°F. Such control valves shall automatically reduce flow to 0.5 gpm or less when the water supply to the fitting outlet exceeds 115°F or when loss of cold water pressure occurs. Note: See ch. SPS 382 Appendix A-382.50 (3) (b) 5. for sketches showing various design options.
6. Hot water distribution systems may not include a heat recovery system, and shall be installed and maintained to provide disinfection by one of the following methods: a. Water stored and circulation initiated at a minimum of 140°F and with a return of a minimum of 124°F.be. .5 mg/L residual chlorine.bs. Chlorine dioxide. Note: Additional information may be contained in ASHRAE Guideline, Minimizing the Risk of Legionellosis Associated with Building Water Systems. This standard is published by the American Society of Heating, Refrigerating and Air- Conditioning Engineers (ASHRAE); 1791 Tullie Circle, N.E., Atlanta, GA 30329, phone: (800) 5-ASHRAE or (404) 636-8400 ext. 507; fax: (404) 321-5478; e-mail: orders@ashrae.org; or online at www.ashrae.org.
c. Another disinfection method approved by the department or using disinfectant provided by the municipality with an approved minimum residual disinfectant concentration at all points and individual site approval by the department. Note: See ch. SPS 382 Appendix for further information.
7. A water distribution system may not be designed, installed, or maintained so that the maximum water temperature to fixture fitting outlets accessible to patients exceeds 115°F. Note: See s. SPS 382.40 (5) and ch. DHS 124 for additional requirements for circulation systems.
7m. The use of limit stops in faucets or shower or tub mixing valves to achieve a maximum temperature of 115°F is prohibited.8. Except as provided in subd. 7., a water distribution system may not be designed, installed and maintained so that the maximum temperature to fixture fitting outlets exceeds 180°F.9. Water outlets accessible to patients shall have laminar flow.10. Any portion of the water distribution system terminating by means of a plug, cap, or closed fitting and dry downstream with no outlet within the water distribution system may not exceed 6 pipe diameters.11. Where a dialysis box is installed in a patient room or a patient toilet room, all of the following shall apply:a. The dialysis box shall be lockable.b. Hose threads located within a lockable dialysis box used exclusively for the connection of portable dialysis equipment do not require a cross connection control device.c. A receptor located within a dialysis box shall be sealed when not in use.12. Hot water distribution piping shall be labeled with the disinfection method used. Labeling shall be within the water heater mechanical room on the hot water distribution piping at the point of injection, within 5 feet of the injection point, and every 25 feet thereafter within the mechanical room. The interior of all doors serving the mechanical room shall be labeled with the disinfection method. All label lettering shall be at least 1/2 inch height in clearly readable letters.13. Facilities with a population exceeding 250 occupants shall have a water management plan. The management plan shall include all of the following:a. An emergency water contingency plan program on the loss or contamination of the water supply.b. A pathogen control plan.c. The emergency and routine disinfection procedures.d. The identity of the individual responsible for the water quality.e. The provisions for the periodic flushing of the water supply system.f. Balancing valve report for the hot water distribution system.14. Expansion tanks installed in the hot water distribution system shall be of the flow-through type.(c)Adult day care centers. A water distribution system serving an adult day care center may not be designed, installed, or maintained so that the maximum water temperature to fixture fitting outlets accessible to participants exceeds 115°F. Table 382.50-1
Spouts and Actions Required in Health Care and Related Facilities
Fixture Location | Type of Spout Type of Action | Type of Spout Type of Action |
Standard | Provide a 5-inch clearance | Hand | Wrist | Foot, Knee or Electronic Sensor |
NURSING DEPARTMENT | | | | | |
Patient toilet room | | X | | X | X |
Patient toilet room, isolation | | X | | | X |
Utility room | | X | | X | X |
Treatment room | | X | | X | X |
Medicine room | | X | | X | X |
Kitchen floor lavatory | | X | | X | X |
Kitchen floor sink | X | X | | X | X |
Nurses toilet room | X | X | X | X | X |
Floor laboratory | | X | X | X | X |
NURSERY | | | | | |
Nursery | | X | | X | X |
Exam/treatment room | | X | | X | X |
Infant intensive care unit | | X | | | X |
Labor room | | X | | X | X |
SURGICAL | | | | | |
Scrub room | | Xa | | | X |
Sub-sterile room | X | X | | X | X |
Clean-up room | X | X | | X | X |
Frozen sections room | | X | X | X | X |
Surgical supply room | | X | | X | X |
Work room | X | X | | X | X |
Cystoscopic room | | Xa | | X | X |
Fracture room | X | X | | X | X |
Recovery room | | X | | | X |
CENTRAL SUPPLY | | | | | |
Work room | X | X | | X | X |
Solutions room | X | X | | X | X |
Pharmacy | | X | X | X | X |
Manufacturing | | X | | X | X |
EMERGENCY DEPARTMENT | | | | | |
Observation bedroom | | X | | X | X |
Utility room | | X | | X | X |
Operating room | | X | | | X |
Exam room | | X | | X | X |
DIAGNOSTIC AND TREATMENT | | | | | |
Occupational therapy room | | X | | X | X |
Hydro-therapy room | | X | | X | X |
Exam/treatment room | | X | | X | X |
Radium treatment/exam room | | X | | X | X |
Toilet room | | X | | X | X |
Dark room | | X | | X | X |
Autopsy room | | Xa | | | X |
Lavatory in autopsy shower room | | X | X | X | X |
Laboratory | | X | X | X | X |
CLINIC OR OUTPATIENT DEPARTMENT | | | | | |
Exam/treatment room | | X | | X | X |
Dental operating room | | X | | | X |
Dental laboratory | | X | X | X | X |
Dental recovery room | | Xa | | X | X |
Surgical room | | X | | | X |
Eye exam room | | X | | | X |
Ear, nose, and throat exam room | | X | | | X |
COMMON AREAS | | | | | |
Day rooms | | X | | X | X |
Hallways | | X | | X | X |
Patient waiting area | | X | | X | X |
Vestibule waiting area | X | | | | |
SERVICE DEPARTMENT | | | | | |
Lavatory in kitchen | X | X | | X | X |
X = Spout and action meet required type.
a Spout includes a spray head.
Wis. Admin. Code Department of Safety and Professional Services § SPS 382.50
1-2-56; am. (3) (4) and (5), Register, August, 1961, No. 68, eff. 9-1-61; r. and recr. Register, November, 1972, No. 203, eff. 12-1-72; r. and recr., Register, February, 1979, No. 278, eff. 3-1-79; renum. from H 62.16, Register, July, 1983, No. 331, eff. 8-1-83; renum. from ILHR 82.16 and am. (7) (b), (10) (a) 1. and 2., (b) 2., (f) (intro.) and (h), Register, February, 1985, No. 350, eff. 3-1-85 ; r. (10) (f) and Table 25, Register, February, 1994, No. 458, eff. 3-1-94; correction in (7) (b) made under s. 13.93(2m) (b) 7, Stats., Register, July, 2000, No. 535; am. (2) and (10) (g) Table 26, r. and recr. (10) (g) and (h), r. (10) (i), Register, December, 2000, No. 540, eff. 1-1-01; CR 02-002: r. and recr. Register April 2003 No. 568, eff. 5-1-03; CR 04-035: am. Table 82.50-1 and (3) (b) 5. Register November 2004 No. 587, eff. 12-1-04; correction in (3) (b) 2. made under s. 13.92(4) (b) 7, Stats., Register February 2008 No. 626; CR 08-055: am. (3) (b) 5. Register February 2009 No. 638, eff. 3-1-09; correction in (2) (b) (intro.), (3) (a) 2., (b) 2. made under s. 13.92(4) (b) 7, Stats., Register December 2011 No. 672.Amended by, CR 23-006: am. (2) (b) (intro.), renum. (2) (b) 1. to (2) (b) 1. a. and am., cr. (2) (b) 1. b., renum. (2) (b) 2. to (2) (b) 2. (intro.) and am., cr. (2) (b) 2. a. to c., am. (3) (a) 2., cr. (3) (ag), am. (3) (b) 4., cr. (3) (b) 4m., am. (3) (b) 5., 6. (intro.), r. (3) (b) 6. b., cr. (3) (b) 6. be. to bs., am. (3) (b) 6. c., am. (3) (b) 7., cr. (3) (b) 7, 9. to 14., (c), am. Table 382.50-1; correction in (3) (b) 4. made under s. 35.17, Stats., and correction in numbering in (3) (ag) made under s. 13.92 (4) (b) 1, Stats., Register September 2023 No. 813, eff. 10/1/2023