Title 7 . Health and Social Services

Chapter 12 . Assistance for Community Health Facilities

Section 900. Physical plant

7 AAC 12.900. Physical plant

(a) Each facility, with the exception of home health agencies and birth centers, must comply with the provisions of this section.

(b) Any renovation, expansion, or new construction must comply with

(1) the requirements of Guidelines for Design and Construction of Hospital and Health Care Facilities , American Institute of Architects, 2001 edition, adopted by reference, that are applicable to the particular facility and services provided, as follows:

(A) secs. 1 - 6 apply to all facilities;

(B) sec. 7 applies to the general acute care hospitals, rural primary care hospitals, and critical access hospitals;

(C) sec. 10 applies to rehabilitation hospitals;

(D) sec. 8 applies to intermediate care facilities for the mentally retarded and to nursing facilities;

(E) sec. 9 applies to ambulatory surgical facilities;

(F) secs. 7.1; 7.2, except 7.2.B15 and 7.2.C; 7.6; 7.17 - 7.19; 7.21; 7.22; 7.25 - 7.30, except 7.28.A; 8.3; and Table 2 apply to substance abuse hospitals; and

(G) sec. 11 applies to psychiatric hospitals.

(2) 7 AAC 09.010 - 7 AAC 09.170;

(3) AS 18.60.580 - 18.60.660;

(4) AS 18.60.705 - 18.60.740;

(5) the International Building Code , as adopted by reference in, and revised under, 13 AAC 50.020; and

(6) the International Mechanical Code , as adopted by reference in, and revised under, 13 AAC 50.023.

(c) A facility must comply with municipal fire safety regulations, with 13 AAC 50 - 13 AAC 55, and with applicable National Fire Protection Association (NFPA) standards, including the following, which are adopted by reference:

(1) NFPA 13: Standard for the Installation of Sprinkler Systems , 2002 edition;

(2) NFPA 25: Standard for the Inspection, Testing and Maintenance of Water-Based Fire Protection Systems , 2002 edition;

(3) NFPA 10: Standard for Portable Fire Extinguishers , 2002 edition;

(4) NFPA 99: Standard for Health Care Facilities , 2005 edition;

(5) NFPA 101: Life Safety Code , 2000 edition; if a waiver has been issued for a requirement of NFPA 101 under 42 C.F.R. 482.41 for a hospital, under 42 C.F.R. 485.623 for a critical access hospital, under 42 C.F.R. 483.70 for a nursing home, under 42 C.F.R. 483.470 for an intermediate care facility for the mentally retarded, or under 42 C.F.R. 416.44 for an ambulatory surgical center, the waiver will be considered a waiver of that requirement for purposes of this subsection.

(d) A facility must specify in written procedures the maximum allowable water temperature at an outlet for patient bathing, showering, and washing, not to exceed requirements specified in (b)(1) of this section. The facility must have the capability to reduce water temperatures, and must specify in written procedures the safety factor expressed in minutes required to reduce water temperature for particular patient sensitivity due to illness or medication.

(e) Bed capacity will be determined as follows:

(1) available bed space in determining bed capacity for licensure includes

(A) bed space in all nursing units, including intensive care units and minimal or self care units;

(B) isolation rooms;

(C) pediatrics units, including pediatrics bassinets and incubators located in the pediatrics department;

(D) observation units equipped and staffed for overnight use;

(E) space designed for, and which contains adequate space and equipment as described in (F) of this subsection for, inpatient bed care, even if currently closed or assigned to easily convertible, non-patient uses, office, or classrooms; and

(F) space in areas which have the necessary fixed equipment adequate for patient care, including oxygen, suction, a lavatory with fixtures, and a patient closet, and which are accessible to a nurses' station which is exclusively staffed for inpatient bed care, even if originally designed for other purposes;

(2) space which will not be counted in determining bed capacity includes

(A) nurseries for newborn in the maternity department;

(B) labor rooms;

(C) recovery rooms;

(D) emergency units;

(E) preparation or anesthesia induction rooms;

(F) rooms used for diagnostic or treatment procedures;

(G) hospital staff bed areas, including accommodations for on-call staff;

(H) corridors;

(I) solaria, waiting rooms, and similar areas which are not permanently set aside, equipped, and staffed exclusively for inpatient bed care; and

(J) unfinished space, which does not include an area which is finished except for movable equipment.

(f) Bed space which is under construction November 19, 1983 must contain, for each patient, fixed available oxygen, suction, a bedlight, a closet, cubicle curtain tracks, and for every two patients, a lavatory with fixtures and adjacent toilet.

(g) Facilities in existence before January 1, 1995, will be allowed a variance of 10 square feet from the standards for square footage of patient rooms required by Guidelines for Design and Construction of Hospital and Health Care Facilities, adopted by reference in (b)(1) of this section.

(h) Except as provided in 7 AAC 12.150(h) , the department may waive compliance with, or grant a variance from, a requirement in this section if the commissioner determines that an equivalent alternative is provided and the safety and well-being of patients is assured. If a facility wishes to obtain a waiver or variance, its governing body must apply in writing to the commissioner and must include in the application

(1) the justification for the waiver;

(2) an explanation of the reasons why the particular requirement cannot be satisfied;

(3) a description of the equivalent alternative proposed; and

(4) if the application for waiver involves fire safety or other municipal or state requirements, evidence that it has been reviewed by the appropriate municipal or state authorities.

History: Eff. 11/19/83, Register 88; am 12/31/94, Register 132; am 5/4/97, Register 142; am 9/1/2000, Register 155; am 12/17/2005, Register 176

Authority: AS 47.32.010

AS 47.32.030

Editor's note: A copy of Guidelines for Design and Construction of Hospital and Health Care Facilities , adopted by reference in 7 AAC 12.900(b) (1), may be obtained from the American Institute of Architects Press, 1735 New York Avenue, Washington, D.C. 20006. To order a prepaid copy, call (202) 626-7541 or (800) 242-3837, press 4. For an order using a purchase order or that must be billed, call (800) 365-2724.

The International Building Code and the International Mechanical Code referred to in 7 AAC 12.900(b) (5) and (b)(6), respectively, may be obtained from the International Conference of Building Officials, 5360 Workman Mill Rd., Whittier, California 90601-2298; telephone: (800) 284-4406; (562) 699-0541.

The National Fire Protection Association (NFPA) standards adopted by reference in 7 AAC 12.900(c) may be obtained from the National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02169-7471; telephone: (800) 344-3555.