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Utah Administrative Code (Current through November 1, 2019) |
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R432. Health, Family Health and Preparedness, Licensing |
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R432-12. Small Health Care Facility (Four to Sixteen Beds) Construction Rule |
| R432-12-1. Legal Authority |
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This rule is adopted pursuant to Title 26, Chapter 21. |
| R432-12-2. Purpose |
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This rule defines construction standards for small health care facilities which are categorized as Level I, Level II, Level III, or Level IV according to the resident's ability or capability to exit a building unassisted in an emergency. |
| R432-12-3. General Design Requirements |
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Refer to R432-4-1 through R432-4-22. |
| R432-12-4. General Construction Requirements |
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(1) Table 1 identifies the levels of care and construction requirements which apply. TABLE 1 CONSTRUCTION REQUIREMENTS SUMMARY LEVEL I LEVEL II LEVEL III LEVEL IV No. residents 1-16 4-16 4-16 4-16 Resident No, they No, they Yes, they Yes, they Capable are non are non are are of Self ambulatory ambulatory ambulatory ambulatory Preservation non-mobile non-mobile mobile mobile Unassisted Resident restricted, restricted, restricted, not Exit Ability physical physical chemical restricted in an or mental or mental or physical Emergency disability disability restraints and medical condition Accessible 100% 10% or 10% 10% Rooms 100% if Physical Rehab. Construction Requirements code or NFPA 101 NFPA 101 NFPA 101 Utah Fire regulation Prevention Board Rules IBC R-4 occupancy fire rating 1 hour 1 hour 1 hour No of const requirement sprinkler yes yes yes Only if bldg. larger than 4,500 SF smoke yes yes yes yes detector manual yes yes yes yes fire alarm above 3 yes yes yes no systems interconnected corridor 8 feet 6 feet 5 feet As required by IBC resident 44 inch 44 inch 36 inch 36 inch room door width nurse call yes yes optional yes system (2) General Requirements. (a) Level I facilities shall meet the Nursing Facility Construction standards in R432-5. (b) Level II and III facilities shall meet the construction and design requirements identified in this section, unless specifically exempted. (c) Level IV facilities shall meet the Assisted Living Facility Type I Construction standards in R432-6. (d) Level I, II, III and IV facilities shall comply with the Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines (ADA/ABA-AG). (e) Level I, II and III facilities shall conform to the life safety code requirements of NFPA 101, Chapter 18, which is adopted and incorporated by reference. (f) Level IV facilities shall conform to the fire safety provisions of R432-710-3. |
| R432-12-5. Common Areas |
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There shall be a common room or rooms for dining, sitting, meeting, visiting, recreation, worship, and other activities that is of sufficient space or separation to promote and facilitate the activity without interfering with concurrent activities or functions. (1) There shall be at least 30 square feet computed per license bed capacity but no less than a total of 225 square feet. (2) There shall be sufficient space for necessary equipment and storage of recreational equipment and supplies. |
| R432-12-6. Resident Rooms |
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(1) The maximum room capacity shall be two residents. Provisions shall be made for individual privacy. (2) There shall be at least 100 square feet for a single-bed room and 160 square feet in shared rooms, exclusive of toilets and closets. (a) Minor encroachments such as columns, lavatories, and door swings may be ignored in determining space requirements if function is not impaired. (b) In a facility licensed prior to 1977, the Department may grant a variance, pursuant to R432-2-18, to allow 80 square feet per bed for a single-bed room and 60 square feet per bed for a multiple-bed room. (3) In multiple-bed rooms there shall be enough clearance between beds to allow movement of beds, wheelchairs, and other equipment without disturbing residents. (4) No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, unfinished attic, garage, storage area, shed, or similar detached building. (5) No bedroom may be used as a passageway to another room, bath, or toilet. (6) Bedrooms shall open directly into a corridor or common living area, but not into a food-preparation area. (7) Bedrooms shall not be located in a basement or on an upper floor unless residents have access to one exit from that level leading directly to the exterior at grade level. (8) Each bedroom shall be provided with light and ventilation by means of an operable window which opens to the outside or to a court that opens to the sky. Where the window requires the use of tools or keys for operation, such devices shall be stored in a prominent location on each floor convenient for staff use. (9) Each resident shall have a wardrobe, closet, or space suitable for hanging clothing and personal belongings with minimum inside dimensions of 22 inches deep by 36 inches wide by 72 inches tall. Space accommodations shall be provided within each resident's room. Facilities serving infants or children may substitute a chest of drawers for the closet. |
| R432-12-7. Toilet and Bathing Facilities |
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Toilet rooms and bathrooms shall be mechanically exhausted, conveniently located, and accessible to, and usable by all persons accepted for care. (1) There shall be one toilet and washbasin on each floor for each four occupants, including staff and live-in family. A facility licensed for eight beds or more shall have distinct and separate toilet and bathing facilities for live-in family and staff. (2) There shall be at least one bathtub or shower for each six residents. (a) In a multi-story building there shall be at least one bathtub or shower on each floor that has resident bedrooms. (b) Each resident shall have access to at least one bathtub and one shower. (c) There shall be at least one shower or bathtub which opens from a corridor designed for use by resident using a wheelchair with room for staff assistance that meets ADA/ABA-AG standards. (3) Each central shared bathroom shall have a toilet and washbasin. (4) Toilet and bathing facilities may not open directly into food preparation areas. (5) There shall be adequate provision for privacy and safety, including grab bars, in accordance with ADA/ABA-AG, at each toilet, tub, and shower used by residents. (6) All toilets, showers, and tub facilities shall have walls of impermeable, cleanable, and easily sanitized surfaces. |
| R432-12-8. Service Areas |
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There shall be adequate space and equipment for the following services or functions. Except where the word "room" or "office" is used, service may be provided in a multi-purpose area. (1) Administrator's office with space for private interviews, storage of files and records, and a public reception or information area. (2) Telephone area for private use by residents or visitors. (3) A control station with a well-lighted desk, and equipment for keeping records and supplies. (4) Closets or compartments for the safekeeping of staff's personal items. (5) Medication preparation and storage area, including locked drug cabinets, work counter, refrigerator, and sink with running water located near the control station. (6) Clean linen storage area. (7) Soiled workroom mechanically ventilated to the outside. In a Level II facility this room shall contain a clinical sink or equivalent flushing rim fixture, handwashing facilities, work counter, waste and soiled linen receptacle. (8) Housekeeping room, which in large facilities over eight residents shall contain a service sink. (9) Equipment room or separate building for mechanical and electrical equipment. (10) Storage room for maintenance supplies. (11) General storage area within the facility or in a separate building convenient for daily access with at least five square feet of storage per bed; (12) Area outside the facility for sanitary storage and disposal of waste. |
| R432-12-9. Dietary Services |
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Food service facilities and equipment shall comply with the Utah Department of Health Food Service Sanitation Regulations. According to the size of the facility and services offered, there shall be adequate space and equipment for the following: (1) Food preparation; (2) Handwashing located in the food preparation area; (3) Serving and distributing resident meals; (4) Dining space for residents, staff, and visitors; (5) Dishwashing, receiving, scraping, sorting, and stacking soiled tableware and for transferring clean tableware to use areas; (6) Storage, including cold storage and space for at least a seven-day supply of staple foods and a three-day supply of perishable foods, shall be maintained in the facility. |
| R432-12-10. Linen Services |
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(1) Each facility shall have provisions for storage and processing of clean and soiled linen as required for resident care. Processing may be done within the facility, in a separate building on or off site, or in a commercial or shared laundry. (2) The capacity of central storage shall be sufficient for four days operation or two normal deliveries, whichever is greater. (3) Handwashing facilities shall be provided in each area where unbagged soiled linen is handled. (4) Provisions shall be made to keep soiled linen separate from clean linen. (5) Provision shall be made for storage of laundry supplies. (6) Equipment shall be arranged to permit an orderly work flow and reduce cross traffic that may mingle clean and soiled operations. (7) At least one washing machine and dryer, and ironing equipment shall be available for use by residents who wish to do their personal laundry. |
| R432-12-11. Nurse Call System |
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A nurse call system is required in Level I, II and IV facilities. A nurse call system is optional in Level III facilities. (1) Each resident's room shall be served by at least one calling station and each bed shall be provided with a call button including operating switch and cord from the wall station to each bed. (2) Two call buttons serving adjacent beds may be served by one calling station. (3) Calls shall activate a visible signal in the corridor at the resident's door and the control station. (4) The system shall be designed so that a signal light activated at the resident's station will remain lighted until turned off at the resident's calling station. (5) A system that provides two-way voice communication shall be equipped at each calling station with an indicator light that remains lit as long as the voice circuit is operating. |
| R432-12-12. Rehabilitation Therapy |
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A facility that offers on-site specialized rehabilitation services shall provide space and equipment necessary to meet the intent of the approved program. The following shall be available in the facility: (1) Supplies and equipment storage, including separate clean and soiled linen; (2) Convenient handwashing facilities; (3) Space and equipment to carry out specific types of therapy; (4) Provision for resident privacy; (5) Convenient access to a room that can be used to train and educate staff and residents; (6) Dressing rooms for residents. |
| R432-12-13. Doors and Windows |
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(1) Doors to all rooms containing bathtubs, sitz baths, showers and water closets for resident use shall be equipped with hardware which may be secured for privacy yet permit emergency access from the outside without the use of keys. (2) Each room, including all resident toilet rooms and bathing rooms that may be used by residents, staff, or employees confined to wheelchairs, shall have at least one door with a minimum clear width of 34 inches. (3) Resident-room doors and exit doors shall be at least 36 inches wide, defined by the width of the door leaf. (4) Thresholds and expansion-joint covers shall be flush with the floor surface to facilitate use of wheelchairs and carts and to prevent tripping. (5) Every room intended for 24-hour occupancy shall have a window that opens to the building exterior or to a court that is open to the sky. (6) Windows and outer doors shall have insect screens. |
| R432-12-14. Grab Bars and Handrails |
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(1) Grab bars shall meet the requirements of ADA/ABA-AG. (2) In Level I and II facilities, there shall be handrails on both sides of all corridors normally used by residents. Handrail profiles shall be graspable in accordance with NFPA 101 Chapter 7, which is adopted and incorporated by reference and the Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines. (3) Ends shall be returned to the wall or otherwise arranged to minimize potential for injury. |
| R432-12-15. Lavatories and Plumbing Fixtures |
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(1) All lavatories used by residents shall be trimmed with valves, with cross, tee or single lever devices. (2) Showers and tubs shall have slip-resistant surfaces. (3) Lavatories shall be securely anchored to withstand a vertical load of not less than 250 pounds on the front of the fixture. (4) A mirror shall be provided at each handwashing facility except as otherwise noted. (a) The tops and bottoms of mirrors may be at levels for use by sitting and standing individuals, or additional mirrors may be provided for residents using a wheelchair. (b) One separate full-length mirror in a single room may serve for wheelchair occupants in that room. |
| R432-12-16. Ceilings |
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(1) Ceiling height in the facility shall be a minimum of eight feet with the following exceptions: (a) Rooms containing ceiling-mounted equipment shall have adequate height for the proper functioning of that equipment. (b) Ceilings in corridors, storage rooms, and toilet rooms shall be at least seven feet ten inches. (c) Building components and suspended tracks, rails and pipes located in the path of normal traffic may not be less than seven feet above the floor. (2) Where existing conditions make the above impractical, clearances shall be sufficient to avoid injury and at least six feet four inches above the floor. |
| R432-12-17. Heat and Noise Reduction |
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(1) Rooms containing heat producing equipment such as a furnace, heater, washer, or dryer shall be insulated and ventilated to prevent floors of overhead occupied areas and adjacent walls from exceeding a temperature of 10 degrees Fahrenheit (6 degrees C) above the ambient room temperature of such occupied areas. (2) Recreation rooms, exercise rooms, and similar spaces where impact noises may be generated may not be located directly over resident-bed areas unless special provisions are made to minimize such noise. (3) Sound transmission limitations shall conform to Table 2. TABLE 2 SOUND TRANSMISSION LIMITATIONS IN LONG-TERM CARE FACILITIES AIRBORNE SOUND TRANSMISSIONS Class (STC)(a) Partitions Floors Residents' room to residents' room 35 40 Public space to residents' room(b) 40 40 Service areas to residents' room(c) 45 45 (a) Sound transmission class (STC) shall be determined by tests in accordance with methods set forth in ASTM Standard E 90 and ASTM Standard E 413. Where partitions do not extend to the structure above, sound transmission through ceilings and composite STC performance must be considered. (b) Public space includes lobbies, dining rooms, recreation rooms, treatment rooms, and similar space. (c) Service areas include kitchens, elevators, elevator machine rooms, laundries, garages, maintenance rooms, boiler and mechanical equipment rooms, and similar spaces of high noise. Mechanical equipment located on the same floor or above residents' rooms, offices, nurses' stations, and similarly occupied space shall be effectively isolated from the floor. |
| R432-12-18. Floor, Wall, and Ceiling Finishes |
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(1) Floor materials shall be easily cleanable and appropriate for the location. (a) Floors and floor joints in areas used for food preparation and food assembly shall be water-resistant, grease proof, and resistant to food acids. (b) In all areas subject to frequent wet cleaning, floor materials may not be physically affected by germicidal cleaning solutions. (c) Floors that are subject to traffic while wet, (such as shower and bath areas, kitchen and similar work areas), shall have a non-slip surface. (d) Carpet and carpet pads in resident areas shall be applied with adhesive or stretched taut and maintained without loose edges or wrinkles which might create hazards or interfere with the operation of wheelchairs, walkers, or wheeled carts. (2) Wall bases in areas subject to wet cleaning shall be coved and tightly sealed. (3) Wall finishes shall be washable. (a) Walls in the immediate area of plumbing fixtures shall be smooth and moisture resistant. (b) Finish, trim, walls, and floor constructions in dietary and food preparation and storage areas may not have spaces that may harbor rodents and insects. (4) Floor and wall openings for pipes, ducts, and conduits shall be sealed tightly to resist fire and smoke and to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed. (5) All exposed ceilings and ceiling structures in resident and staff work areas shall have finishes that are readily cleanable with ordinary housekeeping equipment. Ceilings in the dietary area and other areas where dust fallout might create a potential problem shall have a finished ceiling that covers all conduits, piping, duct work, and exposed construction systems. |
| R432-12-19. Heating and Cooling |
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There shall be adequate and safe heating and cooling equipment to maintain comfortable temperatures in the facility. (1) The heating system shall be capable of maintaining temperatures of 80 degrees F (27 degrees C) in areas occupied by residents. (2) The cooling system shall be capable of maintaining temperatures of 72 degrees F (22 degrees C) in areas occupied by residents. |
| R432-12-20. Ventilation |
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(1) All rooms and areas in the facility shall have provision for positive ventilation. (a) While natural window ventilation for nonsensitive areas and resident rooms may be utilized where weather permits, mechanical ventilation shall be provided for interior areas and during periods of temperature extremes. (b) Fans serving exhaust systems shall be located at the discharge end and shall be conveniently accessible for service. (2) Fresh air intakes shall be located as far as possible from exhaust outlets of ventilating systems, combustion equipment stacks, plumbing vents, or from areas which may collect vehicular exhaust or other noxious fumes. (3) Furnace rooms shall be provided with sufficient outdoor air to maintain equipment combustion rates and to limit work station temperatures to an Effective Temperature of 90 degrees F (32.5 degrees C). When the ambient outside air temperature is higher than 90 degrees F, then the maximum temperature may be 97 degrees F (36 degrees C). (4) Exhaust hoods in food-preparation centers shall comply with R392, the Utah Department of Health Food Service Sanitation Regulations. All hoods over cooking ranges shall be equipped with grease filters. (5) Non-resident as well as resident areas where specific requirements are not given shall be ventilated in accordance with ASHRAE Standard 62-2004, "Ventilation for Acceptable Indoor Air Quality Including Requirements for Outside Air." (6) Air from areas with odor problems, including toilet rooms, baths, soiled linen storage and housekeeping rooms, shall be exhausted to the outside and not recirculated. (7) In Level II facilities, fans and dampers shall be interconnected so that activation of dampers will automatically shut down all but exhaust fans. (8) Supply and return systems shall be in duct. Common returns using corridors or attic spaces as plenums are prohibited. |
| R432-12-21. Plumbing and Hot Water Systems |
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(1) Water supply systems shall be designed to supply water at sufficient pressure to operate all fixtures and equipment during maximum demand periods. (2) Water distribution systems shall be arranged to provide for continuous hot water at each hot water outlet. (3) Hot water provided to resident tubs, showers, whirlpools, and handwashing facilities shall be regulated by thermostatically controlled automatic-mixing valves at appropriate temperatures for comfortable use within a range of 105 to 115 degrees F. These valves may be installed on the recirculating system or on individual inlets to appliances. (4) As a minimum, water heating systems shall provide capacity at temperatures and amounts indicated in Table 3, Hot Water Use. Water temperature is taken at the point of use or inlet to the equipment. TABLE 3 HOT WATER USE Clinical Dietary(1) Laundry Gallons per Hour per Bed(a) 3 2 2 Temperature (C)(b) 43 49 71(b) Temperature (F)(b) 105 120 160(b) (1) Provisions shall be made to provide 180 degree F (82 degree C) rinse water at warewasher (may be by separate booster). (a) Quantities indicated for design demand of hot water are for general reference minimums and may not substitute for accepted engineering design procedures using actual number and types of fixtures to be installed. Design shall also be affected by temperatures of cold water used for mixing, length of run and insulation relative to heat loss, etc. (b) Provisions shall be made to provide 160 degree F (71 degree C) hot water at the laundry equipment when needed. |
| R432-12-22. Drainage Systems |
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(1) Drainage piping may not be installed within the ceiling or installed in an exposed location in food preparation centers, food serving facilities, food storage areas, central services, and other sensitive areas. Where overhead drain piping is unavoidable in these areas, as may occur in existing facilities, special provision shall be made to protect the space below from possible leakage, condensation, or dust particles. (2) Building sewers shall discharge into a community sewerage system. Where such a system is not available, the facility shall treat its sewage in accordance with local and state regulations. |
| R432-12-23. Electrical Systems |
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(1) All electrical materials shall be tested and approved by Underwriters Laboratory. (2) The electrical installations, including alarm and nurse call system, if required, shall be tested to demonstrate that equipment installation and operation is as intended and appropriate. A written record of performance tests of special electrical systems and equipment shall show compliance with applicable codes. (3) Switchboards and Power Panels. (a) The main switchboard shall be located in an area separate from plumbing and mechanical equipment and be accessible only to authorized persons. (b) The switchboards shall be convenient for use, readily accessible for maintenance, clear of traffic lanes, and located in a dry, ventilated space. (c) Overload protection devices shall operate properly in the ambient room temperatures, except for existing Level IV facilities. (d) Panelboards serving normal lighting and appliance circuits shall be located on the same floor as the circuits they serve. (4) Lighting. All spaces within buildings that house people, machinery, equipment, or approaches to buildings shall have fixtures for lighting. (See Table 4.) (a) Resident rooms shall have general and night lighting. (i) A reading light shall be provided for each resident. (ii) Flexible light arms, if used, shall be mechanically controlled to prevent the bulb from coming in contact with bed linen. (iii) At least one night light fixture shall be controlled at the entrance to each resident room. (iv) All controls for lighting in resident areas shall operate quietly. (b) Parking lots shall have fixtures for lighting to provide light at levels recommended in the Illuminating Engineering Society of North America (IESN) Lighting for Parking Facilities (RP-20-1998). (c) Lighting levels shown in Table 4 shall be used as minimum standards and do not preclude the use of higher levels that may be needed to insure the health and safety of the specific facility population served. Values in Table 4 are minimum maintained average illuminance measured at the task plane. Corridor lighting shall be adjustable so that light levels may be reduced at night and still provide a maximum brightness ratio of 1:10. TABLE 4 SMALL HEALTH CARE FACILITIES LIGHTING STANDARDS MINIMUM FOOT-CANDLES Physical Plant Area Level Level IV I, II, III Facilities Facilities Corridors Day 20 15 Night 10 10 Exits 20 20 Stairways 20 20 Nursing Station General 30 30 Charting 75 75 Med. Prep. 75 75 Pt./Res. Room General 10 10 Reading/Mattress Level 30 30 Toilet area 30 30 Lounge General 10 10 Reading 30 30 Recreation 30 30 Dining 30 30 Laundry 30 30 (5) Each resident room shall have duplex grounding type receptacles as follows: (a) one located on each side of the head of each bed; (b) one for television, if used; and (c) one on each other wall. (6) Receptacles may be omitted from exterior walls where construction would make installation impractical. (7) Duplex grounded receptacles for general use shall be installed in all corridors. |
| R432-12-24. Emergency Power System |
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(1) Facilities that provide skilled nursing care or care for persons who require electrically operated life-support systems, shall be equipped with an emergency power system. (2) The following services shall be connected to the emergency generator: (a) Life Safety Branch as defined in NFPA 70, section 517-32, (b) critical branch as defined in NFPA 70, section 517-33 and (c) Equipment systems defined in NFPA 70, section 517-34. (3) Power need not be provided to all building heating and ventilation equipment if it is provided to a common area sufficient in size to accommodate temporary beds on a short-term emergency basis. (4) Automatic transfer switches shall transfer essential electrical loading to the circuits described above within 10 seconds of any interruption of normal power. (5) The emergency generator shall be fueled with a storable fuel source such as diesel fuel, gasoline, or propane. At least 48 hours of fuel shall be available. (6) All other facilities shall make provision for essential emergency lighting and heating during an emergency to meet the needs of residents. All emergency heating devices shall be approved by the local Fire Marshal. |
| R432-12-25. Penalties |
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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. |