§250.2630. Existing General Hospital Requirements

Minimum requirements in the existing General Hospital are:

 

a)         Administration and Public Areas

 

1)         Lobby

            A reception and information counter or desk, waiting spaces, and access to public toilet facilities, public telephones, and drinking fountains.

 

2)         Interview Spaces

            Spaces for private interviews relating to social service, credit, or admissions.

 

3)         General or Individual Offices

            Offices for business transactions, medical and financial records, and administrative and professional staffs.

 

4)         Multipurpose Rooms

            For conferences, meetings, and education purposes.

 

5)         Medical Library Facilities.

 

6)         Storage Areas.

 

b)         Medical Records Unit

            Space for reviewing, dictating, sorting, recording, and storing of medical records.

 

c)         Adjunct Diagnostic and Treatment

 

1)         Laboratory Suite

            Laboratory facilities shall be provided to meet the workload.  These may be provided within the hospital or through an effective contract arrangement with a nearby laboratory service.  If laboratory services are provided by contractual arrangement, then at least the following minimum services shall be available within the hospital. (For additional requirements, see Subpart E of this Part.):

 

A)        Laboratory work counters with appropriate services.

 

B)        Lavatories or counter sinks equipped for hand washing.

 

C)        Storage cabinets or closets.

 

D)        Blood storage facilities.

 

E)        Specimen and sample collection facilities.  Urine collection rooms with nearby water closet and lavatory. Blood collection facilities with space for a chair and work counter.

 

2)         Morgue and Autopsy Suite

 

A)        These facilities shall be accessible to an outside entrance and shall be located to avoid movement of bodies through public areas wherever possible.

 

B)        The following shall be provided when autopsies are performed within the hospital:

 

i)          Refrigerated facilities for body holding.

 

ii)         Autopsy room:

 

            This room shall contain a work counter with sink equipped for hand washing; storage space for supplies, equipment, and specimens; and an autopsy table.

 

C)        If no autopsies are performed in the hospital, a well-ventilated body-holding room shall be provided.

 

3)         Radiology Suite

 

A)        Facilities shall be provided for radiology purposes.  (For additional requirements see Subpart F of this Part.)

 

B)        The suite shall contain the following elements:

 

i)          Radiographic rooms.

 

ii)         Film-processing facilities.

 

iii)        Viewing and administration areas.

 

iv)        Film storage facilities.

 

v)         Toilet and hand-washing facilities accessible from each fluoroscopy room.

 

vi)        Dressing areas with access to toilets, and facilities for patients' belongings.

 

vii)       Waiting room or alcove.

 

viii)      X-ray installations for fixed and mobile X-ray equipment and radiation protection, which will be checked by the Illinois Emergency Management Agency.

 

4)         Pharmacy Suite

 

A)        The size and type of services to be provided in the pharmacy will depend upon the type of drug distribution system used in the Hospital and whether the hospital provides, purchases, or shares pharmacy services with other hospitals or other medical facilities.  (For additional requirements see Subpart R of this Part.)

 

B)        The following shall be provided:

 

i)          Area for administrative functions, including requisitioning, recording and reporting, receiving, storage (including refrigeration), and accounting.

 

ii)         Quality control area. (If bulk compounding and/or packaging functions are performed.)

 

iii)        Locked storage for drugs and biologicals.

 

iv)        Dispensing area.

 

v)         Hand-washing facilities.

 

vi)        A drug information area for reference materials and personnel.

 

vii)       If I.V. admixtures and other sterile dosage forms are compounded, a sterile products area shall be provided with a separate sink for hand washing.

 

5)         Physical Therapy Suite

 

A)        Appropriate services may be arranged for shared use by occupational therapy patients and staff.

 

B)        If a physical therapy suite exists, the following shall be provided:

 

i)          Office space.

 

ii)         Waiting space.

 

iii)        Treatment areas for such modalities as thermotherapy, diathermy, ultrasonics, hydrotherapy and exercise.

 

iv)        Visual privacy for each individual treatment center.

 

v)         Hand-washing facilities.

 

vi)        One lavatory or sink in the suite

 

vii)       Facilities for collection of wet and soiled linen and other material.

 

viii)      Storage for clean linen, supplies, and equipment.

 

ix)        Patients' dressing areas and toilet facilities.

 

x)         Access to and storage for wheelchairs and stretchers.

 

xi)        Showers, lockers, and service sinks as required by the service rendered.

 

6)         Occupational Therapy Suite

 

A)        Appropriate elements may be arranged for shared use by physical therapy patients and staff.

 

B)        If an occupational therapy suite exists, the following elements shall be provided:

 

i)          Office spaces.

 

ii)         Activities areas equipped with a sink or lavatory.

 

iii)        Storage for supplies and equipment.

 

iv)        Access to patients' toilet facilities.

 

d)         Nursing Unit

            The requirements in this subsection (d) do not apply to special care areas such as recovery rooms and intensive care areas, and newborn care areas.

 

1)         Patient Rooms.

 

A)        Each patient room shall be an outside room.  Each patient room shall connect directly with an exiting corridor.

 

B)        Minimum room areas shall be:  80 square feet per bed in multi-bed rooms and 100 square feet in one-bed rooms (square footage to exclude closets, storage cabinets, bathrooms, and door swings).  In addition, a minimum of 3 feet must be maintained between the sides and foot of any bed and any wall or other fixed device.

           

C)        Each patient room shall have access to a bathroom that includes a toilet and a sink.  Toilets shall be provided at the rate of one per each eight beds.

 

D)        The bathroom shall contain a toilet and a lavatory.  The lavatory may be omitted from a bathroom that serves not more than two adjacent bedrooms if each adjacent bedroom contains a lavatory.

 

E)        Each patient shall have a wardrobe, locker, or closet that is suitable for hanging and storing personal effects.

 

F)         Visual privacy shall be provided to each patient bed in multi-bed rooms.

 

G)        At least one tub or shower shall be provided for each 30 beds that do not have bathing facilities within the patients' rooms.  Each tub or shower shall be in an enclosure that provides space for the private use of the bathing fixture and for drying and dressing.

 

2)         Nurses' station and related facilities.  A nurses'  station with a work counter, storage areas, and communications equipment shall be provided.  The following shall also be provided:

 

A)        A drug distribution station.

 

B)        Hand-washing facilities convenient to both the nurses' station and the drug distribution station.

 

C)        Charting facilities for nurses and doctors.

 

D)        Accessibility to a treatment room for multi-bed room units.  This room shall contain a lavatory, work counter, storage facilities, and a writing space.

 

3)         Service Areas

 

A)        A clean work area or a clean holding area shall be provided in each nursing unit.  The clean workroom shall contain a work surface, hand-washing facilites, and storage facilities. The clean holding area shall be part of a system for the storage and distribution of clean and sterile supplies and materials.

 

B)        A separate designated area for clean linen storage shall be provided.  If a cart system is used, the cart may be stored in an alcove.  This function may be in a clean work area.

 

C)        Parking for stretchers and wheelchairs shall be provided out of the path of normal traffic.

 

D)        A soiled workroom or soiled holding room shall be provided.  The soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, a hand-washing sink, a waste receptacle, and a linen receptacle.  The soiled holding room shall be part of a system for the collection and disposal of soiled materials.  If bedpan flushing attachments are used on every patient room toilet, a clinical sink is not required in the soiled workroom.

 

E)        Space shall be provided for the storage of equipment such as I.V. stands, inhalators, and walkers.

 

F)         Space shall be provided for the storage of required emergency equipment such as a crash cart.  This equipment shall be under the direct control of the nursing staff.

 

G)        A station with a sink equipped for hand washing, equipment for serving nourishment between scheduled meals, a refrigerator, storage cabinets, and units to provide ice for patients shall be provided.

 

4)         Isolation Rooms

            At least one room shall be provided for the isolation of patients with known or suspected communicable diesases.  Each such room shall have an individual toilet and a lavatory.  All isolation rooms shall meet requirements for a standard patient room.

 

5)         Rooms for Psychiatric Patients

            Every hospital that does not have a psychiatric nursing unit shall provide facilities for the care of psychiatric patients, usually for less than 72 hours.  The design shall provide for close observation, and shall minimize the dangers of patient escape, suicide, or injury.  Care may be provided in a special care room used for multiple purposes.  This room may be located either in the emergency unit or in a medical nursing unit, or in another similar location.

 

e)         Intensive Care Units

            Intensive care units shall provide the following:

 

1)         Patient Rooms

            Cardiac intensive care, medical intensive care, and surgical intensive care patients may be housed in either single-bed rooms or multi-bed rooms.  Patient rooms shall meet the following requirements:

 

A)        Clearance between beds shall be not less than 6 feet.  A minimum of 3 feet between the sides of bed and wall shall be provided.  Single-bed rooms shall have a minimum of 100 square feet in area and a minimum dimension of 10 feet.

 

B)        A lavatory equipped for hand washing shall be provided in each intensive care unit.

 

C)        A nurses' calling system (see Section 250.2500(g)) shall be provided.

 

D)        Cardiac intensive care patients shall be provided with a toilet facility that is directly accessible from the bed area.

 

E)        Each patient shall be visible from outside the room.

 

2)         Service Areas

            The following service areas shall be located in or readily available to each intensive care unit.  One area may serve two or more adjacent intensive care units.  The size and location of each service area shall depend upon the number of beds to be served.

 

A)        Nurses' station.

 

B)        Hand-washing facilities.  These shall be convenient to the nurses' station and the drug distribution station.

 

C)        Charting facilities with work counters.

 

D)        Staff toilet room.  A room containing a toilet and a lavatory equipped for hand-washing shall be accessible to the staff.

 

E)        Clean workroom (or a system for storage and distribution of clean and sterile supply materials).  The clean workroom shall contain a work surface, hand-washing facility, and storage facilities.

 

F)         A readily accessible soiled workroom or soiled holding room.  The soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, sink equipped for hand washing, work surface, waste receptacle, and linen receptacle.  A soiled holding room shall be part of a system for collection and disposal of soiled materials and shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

 

G)        A drug distribution station shall be provided for convenient and prompt 24-hour distribution of medicine to patients.

 

H)        A storage closet or a designated area within the clean workroom shall be provided for clean linen storage.  If a closed cart system is used, the cart may be stored in an alcove.

 

I)         A station with sink equipped for hand washing, equipment for serving nourishment between scheduled meals, a refrigerator, storage cabinets, and units to provide ice for patients shall be provided..

 

J)         Emergency equipment storage. Designated space shall be provided for a "crash cart" and similar emergency equipment.

 

K)        Space shall be provided for equipment storage.  .

 

3)         Waiting Area

            A waiting area shall be provided for family members and others who may be permitted to visit the intensive care patients.  A toilet room and public telephone shall be available.

 

f)         Pediatric Nursing Unit

            If a separate unit is provided it shall meet the following requirements:

 

1)         General unit requirements, including patient rooms.

            The requirements noted in Section 250.2630(d) shall be applied to a pediatric and adolescent nursing unit containing hospital beds.  Adequate spaces shall be provided for youth beds and cribs.

 

2)         Nursery

            Each nursery serving pediatric patients shall contain no more than 12 bassinets. The minimum clear floor area per bassinet shall be 40 square feet.  Each room shall contain a lavatory equipped for hand washing, nurses' emergency calling system and glazed viewing windows for observing infants from public areas and the workroom.

 

3)         Nursery Workrooms

            Each nursery shall be served by a connecting workroom.  One workroom may serve more than one nursery.

 

4)         Examination and Treatment Room

            The examination and treatment room shall contain a work surface, storage facilities, and a lavatory equipped for hand washing.

 

5)         Service Areas

            The service areas in the pediatric and adolescent nursing unit shall comply with Section 250.2630(d)(3) and shall meet the following additional conditions:

 

A)        Multipurpose or individual areas shall be provided for dining, educational, and play or other patient care purposes.

 

B)        Space for storage of infant formula shall be provided in the unit or in a convenient location nearby.

 

C)        Patients' toilet rooms shall be provided.

 

D)        Storage closets or cabinets for toys and for educational and recreational equipment shall be provided.

 

E)        Storage space shall be provided for replacement of youth and adult beds to provide flexibility for interchange of patient accommodations.  This storage space need not be located in the Pediatric Nursing Unit.

 

6)         Fixtures and Accessories

 

A)        Attention shall be given to other details affecting small children as required by the program.

 

B)        Switches and electrical outlets for critical equipment shall be protected to preclude shock and located for inaccessibility by small children.

 

g)         Psychiatric Nursing Unit

 

1)         Nursing units intended for psychiatric or other types of patients needing close supervision shall provide a safe and secure facility to minimize patients' hiding, escape, injury, or suicide.  The unit shall allow care of ambulatory inpatients, to permit flexibility in arranging various types of therapy, and shall present as noninstitutional an atmosphere as possible.

 

2)         Each psychiatric nursing unit shall provide the following:

 

A)        Patient Rooms

            The requirements noted in Section 250.2630(d) shall be applied to patient rooms in psychiatric nursing units except as follows:

 

i)          A nurses' calling system is not required.  Other types of communications systems may be utilized.

 

ii)         Provisions for visual privacy are not required.

 

iii)        Three feet of clearance at the foot and sides of each bed is not required.

 

B)        Service Areas

            The service areas noted in Section 250.2630(d)(3) shall be provided or made available to each psychiatric nursing unit, except that space for stretchers and wheelchairs is not required, and clinical sinks or equivalent may be installed but are not required.  The following shall be provided within and for the exclusive use of the unit:

 

i)          Consultation rooms.

 

ii)         Space for dining, recreation, and occupational therapy.

 

iii)        Storage closets or cabinets for recreational and occupational therapy equipment.

 

h)         Newborn Care Unit

            Newborn infants shall be housed in nurseries that are conveniently located to the postpartum nursing unit and obstetrical facilities.  The nurseries shall be located and arranged to preclude unrelated traffic.  Subpart O of this Part, in its entirety, shall apply to the newborn care unit.  The units shall meet the following requirements:

 

1)         Each nursery shall contain:

 

A)        At least one lavatory trimmed with valves that are aseptically operated (i.e., knee or foot controls).

 

B)        A nurses' emergency calling system.

 

C)        Bassinets in a number at least equal to the number of postpartum beds.

 

D)        Glazed observation windows to permit viewing infants from public areas and from workrooms.

 

2)        

            The full-term nursery shall contain no more than 12 bassinets; however, this number may be increased to 16 if the extra bassinets are of the isolation type.  The minimum floor area shall be 30 square feet for each regular bassinet and 40 square feet for each isolation type bassinet.  When a "rooming-in" program is used, the total number of bassinets provided in these units may be appropriately reduced, but the full-term nursery may not be omitted.

 

3)         Special Care and Observation Nursery

            If a separate special care and observation nursery is provided, it shall have its own work area, and at least 40 square feet per bassinet shall be provided in the nursery.

 

4)         Workroom

            Each nursery shall be served by a connecting workroom.  The workroom shall contain gowning facilities at the entrance for staff and housekeeping personnel, work space with a counter, a refrigerator, a lavatory or sink equipped for hand washing, and storage.  One workroom may serve more than one nursery. The workroom that serves the special care nursery may be omitted if equivalent work area and facilities are provided within the nursery in which case the gowning facilities shall be located near the entrance to the nursery and shall be separated from the work area.

 

5)         Examination and Treatment Room or Space for Infants

            The examination or treatment room or space shall contain a work counter, storage, and a lavatory equipped for hand washing trimmed with valves that are aseptically operated (i.e., knee or foot controls).  The room or space may serve more than one nursery and may be located in the workroom.  If the examination and treatment of infants will take place in the individual bassinets, space for physicians' and nurses' gowning shall be provided as well as a conveniently accessible hand-washing sink trimmed with valves that are aseptically operated (i.e., knee or foot controls).

 

6)         Infant Formula Facilities

            The hospital shall provide one of the following:

 

A)        On-site formula preparation

 

i)          Clean-up facilities for washing and sterilizing supplies.  These shall consist of a lavatory or sink equipped for hand washing, a bottle washer, work counter space, and an equipment sterilizer.

 

ii)         A separate room for preparing infant formula, which shall contain a lavatory or sink equipped for hand washing, a refrigerator, a work counter, a formula sterilizer, and storage facilities.  The room may be located near the nurseries or at another appropriate place within the hospital.  No direct access from the formula room to a nursery or to a nursery workroom shall be permitted.

 

B)        Commercially prepared formula

If a commercial infant formula is used, the storage and handling may be in the nursery workroom or in another appropriate room that has a work counter, a sink equipped for hand washing, and storage facilities.

 

7)         Janitors' Closet

            A closet shall be provided for the exclusive use of the housekeeping staff in maintaining the nursery unit.  The closet shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies.

 

8)         Storage spaces for replacement bassinets, phototherapy units, and other large items shall be provided. These storage areas may be located either within the unit or in the central supplies storage.

 

i)          Surgical Suite

            The number of operating rooms and recovery beds and the sizes of the service areas shall be based on the expected surgical workload.  The surgical suite shall be located and arranged to preclude unrelated traffic through the suite.  The requirements of Section 250.1820(h) shall be used for the surgical suite wherever applicable.  The suite shall provide the following:

 

1)         General Operating Rooms.

            Each room shall have a minimum clear area of 300 square feet exclusive of fixed cabinets and shelves.  The minimum dimension shall be 15 feet.  A communications system connecting with the surgical suite control station shall be provided.  At least two X-ray film illuminators shall be provided in each room.

 

2)         Fracture Rooms

            Fracture rooms shall be provided with accessible splint facilities.  The fracture room may be located in the emergency department, the surgical suite, or in another similar location.

 

3)         Recovery Room

            The recovery room may be part of an approved combined surgical-obstetrical program (see Section 250.1820(h)).

 

A)        The postoperative recovery room shall be located within or adjacent to the surgical suite.  If possible, separate entrance and exit doors remote from each other shall be provided to facilitate a one-way traffic flow within the recovery room.

 

B)        A minimum of one recovery room bed shall be provided for each operating room.

 

C)        A minimum of 70 square feet per bed shall be provided in open units.  This area shall exclude the nurses' station, work space, and storage area.  In addition, a minimum of 4 feet shall be maintained between the sides of the beds, at least 3 feet between the side of any bed and any wall or other fixed device, and at least 6 feet between the foot end of any bed and any other fixed equipment or device.

 

D)        The recovery room shall have adequate lighting of the type to allow accurate observation of the patients.

 

E)        A lavatory shall be provided, trimmed with valves that are operated without the use of hands.  A clinical sink shall be provided.

 

F)         A soiled holding area shall be provided.

 

G)        A nurses' station shall be provided within the postoperative recovery room. Facilities for medical storage and preparation shall be provided.

 

H)        Adequate storage and work space within or adjacent to the recovery room shall be available for necessary supplies and equipment.

 

I)         Each bed site shall be adequately equipped with oxygen, suction, and at least one duplex electrical outlet.

 

J)         Where ambulatory surgery is performed using local anesthetics in the surgery suite, a room separate from the general recovery room shall be set aside for the patients' recovery.

 

4)         Service Areas

            Individual rooms shall be provided when so noted; otherwise alcoves or other open spaces that will not interfere with traffic may be used.  Services may be shared with and organized as part of the obstetrical facilities if the approved narrative program reflects this sharing concept.  There shall be no crosscirculation between the surgical and delivery suites when using shared service areas.  The following services shall be provided:

 

A)        Control station to permit surveillance of all traffic that enters the operating suite.

 

B)        Supervisor's office or station, which may be part of the control station.

 

C)        Sterilizing facilities with high speed autoclaves conveniently located to serve all operating rooms.  If adequate provisions have been made for the replacement of sterile instruments during surgery, sterilizing facilities in the surgical suite will not be required.

 

D)        Drug distribution station for the preparation of medication to be administered to patients.

 

E)        Scrub facilities conveniently located near each operating room, and arranged to minimize any incidental splatter on nearby personnel or supply carts.  Scrub sinks,  which shall be aseptically operated without the use of hands, shall be provided.  Wrist blades are not acceptable.

 

F)         Soiled workroom or a soiled holding room that is part of a system for the collection and disposal of soiled materials.  The soiled workroom shall contain a clinical sink or equivalent flushing type fixture, a work surface, sink equipped for hand washing, a waste receptacle, and a linen receptacle.  A soiled holding room shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

 

G)        Fluid waste disposal facilities, conveniently located with respect to the general operating rooms.  A clinical sink or equivalent equipment in a soiled workroom or in a soiled holding room would meet this requirement.

 

H)        Clean workroom or a clean supply room. A clean workroom is required when clean materials are assembled within the surgical suite prior to use.  A clean workroom shall contain a work surface, sink equipped for hand washing, and space for clean and sterile supplies. A clean supply room shall be provided when the system used for the storage and distribution of clean and sterile supplies does not require the use of a clean workroom.

 

I)         Anesthesia storage facilities.  Unless official hospital governing board action prohibits in writing the use of flammable anesthetics, a separate room shall be provided for storage of flammable gases in accordance with the requirements of NFPA 99, Standard for Health Care Facilities.

 

J)         Anesthesia work area for cleaning, testing, and storing anesthesia equipment, which shall contain a work counter and sink.

 

K)        Medical gas storage.  Space for reserve storage of nitrous oxide and oxygen cylinders shall be provided.

 

L)        Storage area for splints and traction equipment for operating rooms equipped for orthopedic surgery.

 

M)       Equipment storage areas for equipment and supplies used in the surgical suite.

 

N)        Staff clothing change areas. Appropriate areas shall be provided for male and female personnel (orderlies, technicians, nurses, and doctors) working within the surgical suite.  The areas shall contain lockers, showers, toilets, lavatories, and space for donning scrub suits and boots.

 

O)        Outpatient surgery change areas.  If the program requires outpatient surgery, a separate area shall be provided where outpatients change from street clothing into hospital gowns and are prepared for surgery.  This area shall include a waiting room, lockers, toilets, and clothing change or gowning area.

 

P)         Patients' holding area.  In facilities with two or more operating rooms, space shall be provided to accommodate stretcher patients waiting for surgery.

 

Q)        Stretcher storage area.

 

R)        Janitors' closet.  A closet containing a floor receptor or service sink and storage space for housekeeping supplies and equipment shall be provided exclusively for the surgical suite.

 

5)         Central Sterilizing and Supply Room

 

A)        The central sterile supplies area shall be located either within the surgical suite or provided as a separate department within the hospital.  The following shall be provided:

 

i)          A receiving and clean-up room containing work space and equipment for cleaning medical and surgical equipment, and for disposal or processing of unclean material. Hand washing facilities operated without the use of hands shall be provided.

 

ii)         A clean workroom containing work space and equipment for sterilizing medical and surgical equipment and supplies.

 

iii)        Storage areas for clean supplies and for sterile supplies (these may be in the clean workroom).

 

iv)        Unsterile supplies storage room (this may be located in another department).

           

v)         Cart storage areas.

 

B)        Facilities for cleaning and sanitizing carts may be centralized or departmentalized.

 

C)        Soiled or contaminated supplies and equipment shall be separated from the clean or sterilized supplies and equipment.

 

j)          Obstetrics Suite

            The number of delivery rooms, labor rooms, recovery beds, and the sizes of the service areas shall depend upon the estimated obstetrical workload.  The obstetrical suite shall be located and arranged to preclude unrelated traffic through the suite. 

 

1)         Delivery Rooms

            Each delivery room shall have a minimum clear area of 300 square feet exclusive of fixed and movable cabinets and shelves.  The minimum dimension shall be 15 feet clear. The communications system shall be connected with the obstetrical suite control station. Separate resuscitation facilities (electrical outlets, oxygen, suction, and compressed air) shall be provided for newborn infants.

 

2)         Labor Rooms

            These rooms shall be single or two-bed rooms with a minimum clear area of 80 square feet per bed.  Labor beds shall be provided at the rate of two for each delivery room.  In facilities having only one delivery room, two labor rooms shall be provided, one of which shall be large enough to function as an emergency delivery room. Labor rooms shall be arranged so that they are accessible to a nurses' work station, to facilities for medication, hand washing, and charting, and storage for supplies and equipment.

 

3)         Recovery Room

            Recovery may take place in private or semiprivate patient rooms (if separate recovery rooms are not provided).  If a separate recovery room is provided, it may be part of an approved combined surgical-obstetrical program (see Section 250.1820(h)). Recovery rooms, if provided, shall meet the following requirements:

 

A)        The postpartum recovery room shall be within or adjacent to the obstetrics suite.

 

B)        The recovery room shall have adequate lighting of the type to allow accurate observation of the patients.

 

C)        A lavatory trimmed with valves operated without the use of hands shall be provided.  A clinical sink shall be made accessible.

 

D)        A soiled holding area shall be available.

 

E)        Facilities for medical storage and preparation shall be provided.

 

F)         Adequate storage and work space within or adjacent to the recovery room shall be available for necessary supplies and equipment.

 

G)        Each bed site shall be adequately equipped with oxygen, suction and at least one duplex electrical outlet.

 

4)         Service Areas

            Individual rooms shall be provided when required in this subsection (j)(4); otherwise alcoves or other open spaces that will not interfere with traffic may be used.  (Services may be shared with and organized as part of the surgical facilities if the approved narrative program reflects this sharing concept.)  Service areas shall be arranged to avoid direct traffic between the operating and the delivery rooms.  The following services shall be provided:

 

A)        Control station to permit surveillance of all traffic that enters the obstetrics suite.

 

B)        Supervisor's office or station (may be part of control station).

 

C)        Sterilizing facilities with high speed autoclaves conveniently located to serve all delivery rooms.  If adequate provisions have been made for the replacement of sterile instruments during delivery, sterilizing facilities in the delivery suite will not be required.

 

D)        Drug distribution station for preparation of medication to be administered to patients.

 

E)        Scrub facilities, which shall be conveniently located near each delivery room, and shall be arranged to minimize any incidental splatter on nearby personnel or supply carts.  Scrub sinks that may be aseptically operated without the use of hands shall be provided.  Wrist blades are not acceptable.

 

F)         Soiled workroom or a soiled room that is part of a system for the collection and disposal of soiled materials.  The soiled workroom shall contain a clinical sink or equivalent flushing rim fixture, a work surface, a sink equipped for hand washing, a waste receptacle, and a linen receptacle.  A soiled holding room shall be similar to the soiled workroom except that the clinical sink and work counter may be omitted.

 

G)        Clean workroom or a clean supply room. A clean workroom is required when clean materials are assembled within the obstetrical suite prior to use.  A clean workroom shall contain a work surface, a sink equipped for hand washing, and a space for clean and sterile supplies.  A clean supply room shall be provided when a system issued for the storage and distribution of clean and sterile supplies does not require the use of a clean workroom.

 

H)        Anesthesia storage facilities.  Unless the official hospital governing board action prohibits in writing the use of flammable anesthetics, a separate room shall be provided for storage of flammable gases in accordance with NFPA 99, Standard for Health Care Facilities.

 

I)         Anesthesia work area for cleaning, testing, and storing anesthesia equipment, which shall contain a work counter and sink.

 

J)         Medical gas storage.  Space for reserve storage of nitrous oxide and oxygen cylinders shall be provided.

 

K)        Equipment storage areas for equipment and supplies used in the obstetrics suite.

 

L)        Staff clothing change areas. Appropriate areas shall be provided for male and female personnel (orderlies, technicians, nurses, and doctors). These areas shall contain lockers, toilets, lavatories equipped for hand washing, and space for donning scrub suits and boots.

 

M)       Stretcher storage area.  This area shall be out of the direct line of traffic.

 

N)        Janitors' closet.  A closet containing a floor receptor or service sink and storage space for housekeeping supplies and equipment shall be provided exclusively for the obstetrical suite.

 

k)         Emergency Suite

            Facilities for emergency care shall be provided in each hospital.

            The extent of the emergency services to be provided in the hospital will depend upon community needs and availability of other organized programs for emergency services within the community.  Hospitals having a minimum level of emergency services shall provide at least the facilities indicated in subsections (k)(1) and (k)(4), with back-up facilities within the hospital capable of furnishing the necessary support for services not provided in the emergency suite.  Other hospitals shall provide as much of the following as is consistent with the services offered:

 

1)         An entrance sheltered from the weather with ambulance and pedestrian access.

 

2)         A reception and control area conveniently located near the entrance, waiting areas and treatment rooms.

 

3)         Public waiting space with access to toilet facilities, public telephone, and drinking fountain.

 

4)         A treatment area, which shall contain hand washing facilities trimmed with valves that are aseptically operated (i.e., knee or foot controls), general storage, medication storage, a work surface, medical X-ray film illuminators, and space for storage of emergency equipment such as defibrillators, cardiac monitors, and resuscitators (oxygen and suction may be portable).

 

5)         A holding area adjacent to the treatment rooms.

 

6)         A storage area out of the line of traffic for stretchers and wheelchairs.

 

7)         Staff work and charting areas, which may be combined with the reception and control areas or located within the treatment area.

 

8)         Clean supply storage, which may be separate or located within the treatment area.

 

9)         Soiled workroom or area containing a clinical sink, work surface, and sink equipped for hand washing, waste receptacle, and linen receptacle.

 

10)         Toilet facilities convenient to the treatment area.

 

l)          Outpatient Department

 

1)         An outpatient department, if provided, should be located on an easily accessible floor convenient to the radiology, pharmacy, and laboratory departments.

 

2)         Facilities shall include, at a minimum:

 

A)        Waiting room.

 

B)        Space for information, scheduling appointments and records.

 

C)        Medical social services.

 

D)        Examination rooms.

 

E)        Dressing booths.

 

F)         Utility rooms.

 

G)        Storage room.

 

H)        Janitors' closet.

 

I)         Public toilets (accessible to the waiting room).

 

m)        Service Departments

 

1)         Dietary Facilities

 

A)        General

            Construction, equipment, and installation shall comply with the Food Service Sanitation Code.  Food service facilities shall be designed and equipped to meet the requirements of the hospital.  These may consist of an on-site conventional food preparing system, a convenience food service system, or an appropriate combination of the two.

 

B)        Functional Elements

            The following facilities shall be provided as required to implement the type of food service selected:

 

i)          Control station for receiving food supplies.

 

ii)         Storage space adequate to provide normal and emergency supply needs, including food requiring cold storage and day storage.

 

iii)        Food preparation facilities. Conventional food preparation systems require space and equipment for preparing, cooking, and baking.  Convenience food service systems such as frozen prepared meals, bulk packaged entrees, and individual packaged portions, or systems using contractual commissary service, require space and equipment for thawing, portioning, heating, cooking, and baking.

 

iv)        Hand-washing facilities located in the food preparation area.

 

v)         Patients' meal service facilities, e.g., facilities required for tray assembly and distribution.

 

vi)        Dining space for ambulatory patients, staff and visitors.

 

vii)       Ware-washing space located in a room or an alcove separate from food preparation and serving areas.  Commercial dishwashing equipment shall be provided.  Space shall also be provided for receiving, scraping, sorting, and stacking soiled tableware and for transferring clean tableware to the use areas. A hand-washing lavatory shall be conveniently available.

 

viii)      Pot-washing facilities.

 

ix)        Storage areas for cans, carts, and mobile tray conveyors.

 

x)         Waste storage facilities located in a separate room easily accessible to the outside for direct pickup or disposal.

 

xi)        Toilets accessible to dietary staff.  Hand-washing facilities shall be immediately available.

 

xii)       Janitors' closet located within the dietary department, containing a floor receptor or service sink and storage space for housekeeping equipment and supplies.

 

xiii)      Ice-making facilities.

 

xiv)      Adequate can, cart and mobile tray washing facilities as required.

 

2)         Central Stores

            The following, including storage spaces adequate to meet the needs of the hospital, shall be provided:

 

A)        Unloading facilities.

 

B)        A receiving area.

 

C)        General storage rooms.

 

             

 

D)        Office space.

 

3)         Linen Services

 

A)        On-site Processing

            If linen is processed at the hospital site, the following shall be provided:

 

i)          Soiled linen receiving, holding, and sorting room.

 

ii)         Laundry processing room.

 

iii)        Access to hand-washing facilities.

 

iv)        Separate clean linen storage and issuing room or area.

 

v)         Clean linen inspection and mending room or area.

 

vi)        Storage for laundry supplies.

 

vii)       Janitors' closet containing a floor receptor or service sink and storage space for housekeeping equipment and supplies.

 

viii)      Cart storage.

 

ix)        Office space.

 

B)        Off-site Processing

            If linen is processed off the hospital site, the following shall be provided:

 

i)          A soiled linen holding room.

 

ii)         Access to hand-washing facilities.

 

iii)        A clean linen, receiving, inspection, and storage room.

 

iv)        Cart storage.

 

v)         Office space.

 

4)         Facilities for Cleaning and Sanitizing Carts

            Facilities shall be provided to clean and sanitize carts serving the central medical and surgical supply department, dietary facilities, and linen services.  These may be centralized or departmentalized.

 

5)         Employees' Facilities

            In addition to the employees' facilities such as locker rooms, lounges, toilets, or shower facilities required in certain departments, a sufficient number of such facilities as required to accommodate the needs of all personnel and volunteers shall be provided.

 

6)         Janitors' Closets

            In addition to the janitors' closets required in certain departments, sufficient janitors' closets shall be provided throughout the hospital as required to maintain a clean and sanitary environment. Each shall contain a floor receptor or service sink and storage space for housekeeping equipment and supplies. Spaces for large housekeeping equipment and for back-up supplies may be located in other areas.

 

7)         Engineering Service and Equipment Areas

            The following shall be provided:

 

A)        Rooms or separate buildings for boilers, mechanical equipment, and electrical equipment.

 

B)        Engineer's space.

 

C)        Maintenance shops.

 

D)        Storage room for building maintenance supplies.

 

E)        Yard equipment storage.

 

8)         Waste Processing Services

 

A)        Storage and Disposal

            Space and facilities shall be provided for the sanitary storage and disposal of waste by incineration, mechanical destruction, compaction, containerization, removal, or by a combination of these techniques. Facilities for proper handling and disposal of infectious or radioactive waste substances shall be provided.

 

B)        Incineration

            If the hospital provides its own incineration:

 

i)          The incinerator shall be in a separate room or placed outdoors.

 

ii)         Design and construction of incinerators and trash chutes shall be in accordance with NFPA  82, Standard on Incinerators and Waste and Linen Handling Systems and Equipment.

 

iii)        Incinerators shall be equipped to conform to requirements prescribed by local air pollution requirements.

 

9)         Storage

            In addition to the storage areas called for in certain departments of the hospital, suitable additional storage shall be provided.

 

(Source:  Amended at 35 Ill. Reg. 6386, effective March 31, 2011)