No. 35468 (Amendment): Rule R432-13. Freestanding Ambulatory Surgical Center Construction Rule

(Amendment)

DAR File No.: 35468
Filed: 11/18/2011 04:19:06 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

In Section R432-13-3, updates a referenced standard that is out of date and out of print. In Section R432-13-4, renumbers to match the reformatted version of the referenced standard and elimination of a requirement that is now in the national standard. In Section R432-13-5, elimination of outdated editions of references. The referenced NFPA 70 is now adopted in the State Construction Code. In Section R432-13-7, coordinates with reformatted edition of an updated referenced standard. These changes have been vetted in two meetings with providers and interested parties and have been approved by the Health Facilities Committee.

Summary of the rule or change:

In Section R432-13-3, updates the adopted reference from the 2001 Guidelines for Design and Construction of Hospital and HealthCare Facilities to the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities. In Section R432-13-4, coordinates with a reformatted referenced standard and elimination of a requirement that is now in the referenced standard. In Section R432-13-5, eliminates reference to outdated editions of referenced standards. The referenced standard is now adopted in the State Construction Code. In Section R432-13-7, coordinates with reformatted numbers in the new edition of the referenced standard.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

This rule or change incorporates by reference the following material:

• Updates Guidelines for Design and Construction of Health Care Facilities, published by ASHE (American Society of Healthcare Engineering), 2010 edition

Anticipated cost or savings to:

the state budget:

The cost of purchasing the new referenced standard and the cost of printing and distribution of the revised rule is covered in R432-4, General Construction, which is being amended concurrent with this rule. No others costs are expected. (DAR NOTE: The proposed amendment to Rule R432-4 is under DAR No. 35459 in this issue, December 15, 2011, of the Bulletin.)

local governments:

The rule change has no impact on local government because these standards are enforced at the state level.

small businesses:

Small business ambulatory surgical centers that build new buildings or remodel existing facilities and the architects and engineers that design the buildings will have the cost of purchasing the new standards. The cost of the new standards is $168. Assuming 5 small businesses purchase copies of the updated standards the aggregate cost to small business is $840.

persons other than small businesses, businesses, or local governmental entities:

Ambulatory Surgical Centers that build new buildings or remodel existing facilities will have the cost of purchasing the new referenced standard. The cost of the new referenced standards is $168. Assuming 5 Ambulatory Surgical Centers purchase copies of the updated standard the aggregate cost to business is $840.

Compliance costs for affected persons:

The cost to ambulatory surgical center facilities constructing or remodeling buildings and architects and engineers designing them is the purchase of the new referenced standards at $168. The rule change will not increase compliance costs for providers.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule has been extensively discussed with the regulated businesses and they appear to concur that updating the rule to adopt updated federal accessibility standards and the 2010 edition of the Guidelines for Design and Construction of Health Care Facilities is appropriate. Public comment received will be carefully evaluated for any unforeseen fiscal impact.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at [e-mail]
• Andrew Baxter at the above address, by phone at 801-538-6140, by FAX at 801-538-6325, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

01/17/2012

This rule may become effective on:

01/24/2012

Authorized by:

David Patton, Executive Director

RULE TEXT

R432. Health, Family Health and Preparedness, Licensing.

R432-13. Freestanding Ambulatory Surgical Center Construction Rule.

R432-13-1. Legal Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

 

R432-13-2. Purpose.

The purpose of this rule is to establish construction and physical plant standards for the operation of a freestanding surgical facility that provides surgical services to patients not requiring hospitalization.

 

R432-13-3. General Design Requirements.

(1) Ambulatory Surgical Centers shall be constructed in accordance with the requirements of R432-4-1 through R432-4-23 and the requirements of the Guidelines for Design and Construction of [Hospital and] Health Care Facilities, Sections [9.2., 9.5]3.1 and [9.9]3.7, [including the Appendix, 2001]2010 edition (Guidelines). Where a modification is cited, the modification supersedes conflicting requirements of R432-4 or the Guidelines.

(2) Ambulatory Surgical Centers shall consist of at least two Class C operating rooms, [as outlined in the]meeting the requirements of Guidelines section [9.5.F2]3.7-3.3.4, and support facilities.

(3) Ambulatory Surgical Centers shall be equipped to perform general anesthesia. Flammable anesthetics may not be used in Ambulatory Surgical Centers.

(4) Ambulatory Surgical Centers [which are located within a building not constructed in accordance]shall comply with NFPA 101, Life Safety Code, Chapter 20[, shall be physically separated in accordance with requirements of the local building official having jurisdiction].

[(a)](5) The facility shall have at least two exits leading directly to the exterior of the building.

[(b)](6) Design shall preclude unrelated traffic through units or suites of the licensed facility.

 

R432-13-4. General Construction, Patient Facilities.

(1) Adequate sterile supplies shall be maintained in the facility to meet the maximum demands of one day's case load.

(2) Operating rooms for cystoscopic procedures shall comply with Section [7.7.A4]2.2-3.3.2.4 of the Guidelines.

(3) A toilet room shall be readily accessible to recovery rooms and recovery lounge.

[ (4) Change areas shall comply with Guidelines subsection 9.5.F5.(i) and shall be arranged to accommodate a one way traffic pattern enabling personnel to change and directly enter the operating room corridor.

] [(5)](4) Special or additional service areas such as radiology, if required by the functional program, shall comply with the requirements of the General Hospital Rules, R432-100.

 

R432-13-5. General Construction.

(1) The administration and public areas which are not part of the Ambulatory Surgical Center exiting system, may be located outside of the institutional occupancy envelope when authorized by the local building official having jurisdiction.

(2) Cubicle curtains and draperies shall be affixed to permanently mounted tracks or rods. Portable curtains or visual barriers are not permitted.

(3) An elevator shall be provided when an ambulatory surgical center is located on a level other than at grade. The minimum inside dimensions of the cab shall be at least 5'8" wide by 8'5" deep with a minimum clear door width of 3'8".

(4) Yard equipment and supply storage areas shall be located so that equipment may be moved directly to the exterior without passing through building rooms or corridors.

(5) The facility shall provide for the sanitary storage and treatment or disposal of all categories of waste, including hazardous and infectious wastes, if applicable, using procedures established by the Utah Department of Environmental Quality and the local health department having jurisdiction.

(6) All rooms shall be mechanically ventilated.

(7) Access to medical gas supply and storage areas shall be arranged to preclude travel through clean or sterile areas. There shall be space for enough reserve gas cylinders to complete at least one routine day's procedures.

(8) An on-site emergency generator shall be provided and the following services shall be connected to the emergency generator:

(a) life safety branch as defined in 517-32 of the National Electric Code NFPA 70[, 1999 edition] ;

(b) critical branch as defined in 517-33 of the National Electric Code NFPA 70[, 1999 edition];

(c) equipment system as defined in 517-34 of the National Electric Code NFPA 70[, 1999 edition].

(9) There shall be sufficient fuel storage capacity to permit at least four hours continuous operation shall be provided.

(10) Lighting shall comply with R432-4-23(21)(a).

 

R432-13-6. Extended Recovery Care Unit.

(1) A facility that provides extended recovery services shall maintain a patient care area that is distinct and separate from the post-anesthesia recovery area. The patient care area shall provide the following:

(a) a room or area that ensures patient privacy, including visual privacy;

(b) a minimum of 80 square feet of space for each patient bed with at least three feet between patient beds and between the sides of patient beds and adjacent walls.

(c) a nurse call system at each patient's bed and at the toilet, shower and bathrooms, which shall transmit a visual and auditory signal to a centrally staffed location which identifies the location of the patient summoning help;

(d) a patient bathroom with a lavatory and toilet;

(e) oxygen and suction equipment;

(f) medical and personal care equipment necessary to meet patient needs.

(2) A separate food nutrition area which shall include a counter, sink, refrigerator, heating/warming oven or microwave, and sufficient storage for food items.

 

R432-13-7. Exclusions to Guidelines.

The following sections of the Guidelines do not apply to Freestanding Surgical Center construction:

[(1) Parking, Section 9.5.C.

(2)](1) Waste [Processing Systems]Management Facilities, Section [9.2.G3]3.1-5.4.

 

R432-13-8. Penalties.

The Department may assess a civil money penalty of up to $10,000 and deny approval for patient utilization of new or remodeled areas if a health care provider does not submit architectural drawings to the Bureau of Licensing. The Department may assess a civil money penalty of up to $10,000 if the licensee fails to follow Department-approved architectural plans. The Department may assess a civil money penalty of up to $1,000 per day for each day a new or renovated area is occupied prior to licensing agency approval.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [January 5, 2010]2012

Notice of Continuation: November 24, 2009

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-16

 

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