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01/03/2013

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Corrections to Chapter 2.

1 draft manuscript for the 2014 Guidelines for Design and Construction of Hospitals and Outpatient Facilities These changes are highlighted in pale yellow in the updated draft manuscript. 2.1-2.4.2 AII requirements Correlation with Part 3: Addition of PPE storage requirement 2.1-3.2.2 Single-Patient Examination Room Correction to Section 3.1-3.2.2.1 (2) on clearances (multiple-patient requirements accidentally placed in this section were replaced with the correct single-patient room requirements). 2.1-4.3 Food and Nutrition Services Facilities (Including associated appendix material) Insertion of text accidentally omitted from proposal that is necessary to provide complete information for rewrite of these requirements 2.1-7.2.3.2 (8) (Flooring in ORs, etc.) Correlation with Part 3: Addition of requirement for integral base and ability to withstand chemical cleaning 2.1-7.2.3.4 (5) Mechanical and electrical rooms (ceilings) Correlation with Part 3: Addition of language allowing omission of suspended ceilings in these rooms 2.1-8.4.2.5 Hot Heated potable water distribution systems (Including associated appendix material)

Clarification of requirements for hot water systems in a hospital
2.1-8.4.3.6 Scrub sinks Correlation with Part 3: Addition of exception for temperature pre-set valve 2.1-8.4.3.7 Emergency first-aid equipment Correlation with Part 3: Addition of requirement for emergency deluge shower and face/eyewash devices

10/23/12

2.1 Common Elements for Hospitals

2.1 Common Elements for Hospitals
Appendix material, shown in shaded boxes at the bottom of the page, is advisory only.

2.1-1 General 2.1-1.1 Application 2.1-1.1.1 This chapter contains elements that are common to most types of hospitals. The elements are required only when referenced in a specific hospital facility chapter. 2.1-1.1.2 Additional specific requirements are located in the facility chapters of Part 2 (facility chapters are listed below). Consult the facility chapters to determine if elements in this chapter are required. • • • • • • General hospitals (Chapter 2.2) Small primary care hospitals (Chapter 2.3) Critical access hospitals (Chapter 2.4) Psychiatric hospitals (Chapter 2.5) Rehabilitation hospitals and other facilities (Chapter 2.6) Children’s hospitals (Chapter 2.7)

2.1-1.1.3 Language from other chapters in the Guidelines is included in the criteria given in this Part when reference is made to a specific section. Such references include the section as identified by number and heading and all its subsections, unless otherwise noted. 2.1-1.2 Functional Program 2.1-1.2.1 General

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2.1-1.3 Site 2.1-1.3.1 Reserved

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*2.1-1.2.2 Size and Layout

2.1-1.2.1.1 Functional program requirement. For each project, there shall be a functional program shall be provided in accordance with for the facility. For requirements, see Section 1.2-2. 2.1-1.2.1.2 Space size. Size of spaces provided shall meet the clear floor area requirements and the clear dimensions required in the Guidelines for the specific space.

2.1-1.2.2.1 Department size and clear floor area requirements shall meet Guidelines standards as required by the functional program. depend on program requirements and organization of services within the hospital. 2.1-1.2.2.2 Combination or sharing of some functions shall be permitted when authorized by the authority having jurisdiction (AHJ). provided the layout does not compromise safety standards and medical and nursing practices.

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2.1 Common Elements for Hospitals

2.1-1.3.2 Parking Parking provided shall comply with the general requirements in Section 1.3-3.3 and the specific requirements in each chapter in this Part of the Guidelines.

2.1-2 Nursing Units and Other Patient Care Areas 2.1-2.1 General 2.1-2.1.1 The patient room or care area requirements included in this section are common to most hospitals. For requirements specific to a facility type, see the applicable hospital facility chapter in Part 2. *2.1-2.1.2 Accommodations for patient mobility and patient handling 2.1-2.2 Patient Room 2.1-2.2.1 Capacity For specific requirements, see facility chapters. *2.1-2.2.2 Space Requirements

2.1-2.2.2.1 Minor encroachments (including columns and hand-washing stations) that do not interfere with functions may be ignored shall be permitted to be excluded when determining space requirements for a patient rooms. 2.1-2.2.2.2 For specific requirements, see facility chapters. 2.1-2.2.3 Windows For specific requirements, see facility chapters.

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2.1-2.2.6.1 General

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2.1-2.2.5 Hand-Washing Stations 2.1-2.2.5.2 Design requirements 2.1-2.2.6 Patient Toilet Room

*2.1-2.2.4 Patient Privacy In multiple-bed patient rooms, means to provide visual privacy from casual observation by other patients and visitors shall be provided available for each patient. The design for privacy shall not restrict patient access to the entrance, hand-washing station, or toilet.

2.1-2.2.5.1 Location. For specific requirements, see facility chapters.

(1) For hand-washing station design details, see Section 2.1-7.2.2.8 (Hand-washing stations). (2) For sinks, see Section 2.1-8.4.3.2 (Hand-washing station sinks). (3) For electrical requirements, see Section 2.1-8.3.5.2 (Hand-washing stations and scrub sinks).

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furnishings.2.1-2. see Section 2.4 Special design elements *(2) Surfaces.1-2. 2.6. each patient shall have access to a toilet room without having to enter a corridor. See facility chapters in Part 2 for specific requirements.6. Grab bars shall be provided on both sides of the toilet. (2) Unless located in a toilet room. *(b) Grab bars. see specific facility chapters.4.3 The patient toilet room shall contain a toilet and be equipped with a hand-washing station.1-2.1-7.1 General The special patient care area requirements in this section shall apply to all facilities that include these areas.1-2.3 (Doors and door hardware).2.1-2.1 Common Elements for Hospitals (1) Where required by other sections of the Guidelines. *2.4. 2. 2.2.7 Patient Bathing Facilities For requirements. (1) Toilet room doors sh all swing outward or be equipped with emergency rescue hardware.4 Toilet room doors shall be provided in accordance with Section 2.6.1-2. T 3 2. .4.2 The patient toilet room shall serve no more than two one patient rooms and no more than two four beds. provided adequate provisions are made for emergency access from outside the room.10 (Soiled Workroom or Soiled Holding Room).1-2.1-2.1-2.2.2.2. see specific facility chapters. 2. and equipment D 2. (2) Where local requirements permit.8 Patient Storage For requirements.2. use of wall-hung sliding doors mounted on the outside of the toilet room shall be permitted.1-2.3 Reserved 2. separate from patient care areas. For requirements specific to a particular hospital type.2.4 Special Patient Care Rooms 2. Requirements for other types of special patient care rooms are also located in the facility chapters.2. and for acoustical and visual privacy. see the relevant hospital facility chapter elsewhere in Part 2. (3) Doors shall have either an undercut or a louver designed to allow for free flow of air into the bathroom.2 Airborne Infection Isolation (AII) Room (1) The AII room requirements contained in the Guidelines for particular areas throughout a facility DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities AF (1) Architectural details *(a) 2.1-2.6. bedpan-washing fixtures shall be installed in dedicated rooms.1 General R 2.2.6.1-2. for routine cleaning of the sliding mechanism. For requirements.

ceiling.4. (1) Architectural details (a) AII room perimeter walls.2. (3) (4) A separate room with a toilet.1-7. For specific requirements. D R 2. (c) Doors shall have edge seals.2. (3) An area for gowning and storage of clean and soiled materials shall be located either directly outside or inside the entry door to the patient room. AII rooms shall be located within individual nursing units or grouped as a separate isolation nursing unit. and hand-washing station shall be provided for each airborne infection isolation room. (2) Provision shall be made for personal protective equipment storage at the entrance to the room. An anteroom is not required. Placement of an additional handwashing station outside the room entrance shall be permitted.2.1-2.2-2. easy-to-clean.1-2.4.2 AII room requirements. and bathtub (or shower).3 Anteroom. nonpleated window treatments shall be used. if an anteroom is part of the design concept. *(2) Window treatments and privacy curtains shall be provided in accordance with . (2) All doors to the anteroom shall have self-closing devices. Smooth-surfaced.2. When not required for patients with airborne infectious diseases. including penetrations. (3) Location. use of these rooms for normal acute care patients shall be permitted. (b) Fabric drapes and curtains shall not be used for window treatments.3 (Window treatments). (2) Number. 2. see Section 2. it shall meet the following requirements: *(1) The anteroom shall provide space for persons to don personal protective equipment before entering the patient room.1-2.2 (Medical/Surgical Patient Room) as well as the following requirements: (2) A hand-washing station shall be located in each patient room. AF (1) Capacity. Each patient room shall contain only one bed. and floor. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 4 . (b) Based on the needs of specific community and patient populations served by an individual health care organization (see Glossary and 1.2.4.4.1 Common Elements for Hospitals shall be: (a) Predicated on an infection control risk assessment (ICRA) and designated by the functional program. In addition to the requirements below. (b) Airborne infection isolation room(s) shall have self-closing devices on all room exit doors.4 2. shall be sealed tightly so that air does not infiltrate the environment from the outside or from other spaces. wipeable. however. Each airborne infection isolation room shall comply with the requirements in 2. see facility chapters. (c) Be used for patients who require an AII room but do not need a protective environment (PE) room.4 Special design elements 2.4 [Infection Control Risk Mitigation]).4.2.1-7.2.2–3. (a) Window treatments shall be selected for ease of cleaning.

43 square meters) shall be required. The door openings to the anteroom and the toilet room shall have a minimum clear width of 3 feet 8 inches (1.4. the number of seclusion rooms shall be a function of the total number of psychiatric beds in the facility.4.4.4. A window shall be provided on the exterior wall in accordance with Section 2. 2.5 Special design elements.1 General (1) Capacity (a) (1) Each room shall be for only one patient.2 Location (a) (1) The room(s) shall be located to provide convenient access to permit observation from the nurse station.2 2. (3) For HVAC requirements. Within the psychiatric nursing unit.1-2.2. escape. (3) 2.3. A wipeable fabric with a smooth surface is preferable.57.4 Reserved R (1) Seclusion treatment rooms shall have a minimum clear floor area of 60 square feet (5.3.3.1-2.4.1-2.1-2.2.1-2. they shall meet a Class A or Class B interior finish as defined by NFPA 101.3 Space requirements D 2. 2.4. (b) (2) Seclusion rooms shall be permitted to be grouped together.57 square meters) with a minimum wall length of 7 feet (2.2.35 meters). see Section 2. (2) Where a room for restraining patients is restraint beds are required by the functional program. (c) (3) If a facility has more than one psychiatric nursing unit.3.5 (Psychiatric Hospitals: Architectural Details–Windows). 2.74 meters).3 Window.1-8. 2. Seclusion treatment rooms shall be designed and constructed to avoid features that enable prevent patient hiding.1 (Airborne infection isolation rooms).2. injury.1-2.3 Seclusion Treatment Room The A seclusion treatment room is intended for short-term occupancy shall be provided.4 Layout.3. this This space provides is intended for patients requiring security and protection.3. (b) Minimum ceiling height shall be 9 feet (2.1-2.1-2. or suicide.1-2.3. (b) (2) There shall be at least one seclusion room for each 24 beds or fewer and for each major fraction thereof on each psychiatric unit.4.4. a minimum clear floor area of 80 square feet (7.4.12 meters). (c) Doors AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 5 .1 Common Elements for Hospitals (c) Use of fabric privacy curtains shall be permitted if they are washable. ceiling. and floor of the seclusion room shall be designed to withstand direct and forceful impact. 2.2.3. (1) Architectural details (a) The walls. (2) 2.13 meters) and a maximum wall length of 11 feet (3. Seclusion treatment rooms shall be accessed by an anteroom or vestibule that also provides access to a toilet room. If padded materials are used inside the room.

HVAC grilles.2. or directly accessible to the administrative center or nurse station 2.3 (4) (Door hardware).6.2.g.3 Nurse or Supervisor Office (2) (3) Convenient access to h Hand-washing station(s) in.2.6 Support Areas for Nursing Units and Other Patient Care Areas 2. and or surveillance cameras.1-7.1-2. 2. next to.2 This area shall be permitted to be combined with or include centers for reception and communication.2. Otherwise.1. (d) Seclusion treatment rooms shall not contain outside corners or edges.5 Support Areas for Patient Care—General Identifiable spaces shall be provided for each function indicated in all sections with requirements for support areas.1-2. .1 (2) (Medication Safety Zone—Design requirements). enclosed space for the one named function shall be provided is intended. while also maintaining provisions for patient privacy.1-2..1-2.) shall be tamper-resistant and designed to prevent injury to the patient.1-2.6.2. (b) Door openings shall have a minimum clear width of 3 feet 8 inches (1. (iii) (a) The entrance door to the seclusion room shall swing out.3. 2.6.1-2. a lighting fixtures.2 The design elements of the documentation area shall comply with Section 2. including but not limited to (e. *(iv) (c) Doors shall permit staff observation of the patient through a vision panel.2.3 (2)(a) (Door openings–inpatient bedrooms) except as amended in this section.1 Common Elements for Hospitals (i) Door openings shall be provided in accordance with Section 2.6. a separate.1-2.6.4. (ii) Door hardware shall be provided in accordance with Section 2. 2.1-2. (b) Electrical switches and receptacles are prohibited within the seclusion room. sprinkler heads.6.6. AF *2.1-7.2.6 Security DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 6 (2) Building systems (a) All items that may be in the room.1-2.1-2. the described area or zone shall be permitted to be a specific space in another room or common area. ensure that staff and physicians can simultaneously chart and access information and communication systems.1 Documentation areas Charting facilities shall have sufficient work surface to support the documentation process for the number of staff required by the functional program.6.1. The vision panel shall be fixed glazing with polycarbonate or laminate on the inside of the glazing.1-2.2 Documentation Area 2.1 Administrative Center or Nurse Station 2. 2.12 meters).6.1 This area shall provide the following: D R (1) Space for counters (2) Space for storage *2. Where the word “room” or “office” is used.

1-2. (b) The number and location of medication safety zones shall be specified in the functional program. self-contained medication dispensing unit.8 (Architectural Details— Hand-washing stations) and 2. see facility chapters. and patients’ families for patient conferences.5 Hand-Washing Station 2.1-2.2 For design and plumbing fixture details.4. and consultation.1 For location and number requirements. or other system approved by the AHJ shall be permitted to serve as a medication safety zone. automated medicationdispensing station. see sections 2. (a) A medicine preparation room.5. (b) Medication safety zones shall be designed so that staff can maximize their concentration and attentiveness to the task.4. including the patient room AF 2. (c) Work space organization for medication safety zones described in USP-NF: Guidebook to Pharmaceutical Compounding—Sterile Preparations shall be ergonomically designed so that staff can access information and perform tasks safely.1-2.6.6. 2.4.1-2.1-2. training sessions.6. 2.6.2 The need for additional room(s) shall be determined by the requirements of the nursing unit or the functional program. Medication safety zones shall comply with the following: (a) Medication safety zones shall be located to minimize the potential for distraction and interruption. *(2) Design requirements.5. education. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 7 . (e) Lighting.6. Task-specific lighting levels for health care settings recommended in USP-NF shall be used to design lighting for the work areas for: (i) Designated computer entry and handwritten order-processing locations (ii) Pharmacy medication filling and checking (iii) Pharmacy patient counseling (iv) Sterile compounding and preparation (v) Storeroom for pharmacy medication (vi) Medication preparation area (vii) Medication administration work areas.4 Multipurpose Room At least one multipurpose room for each facility shall be provided for staff.1-8. Medication safety zones shall be provided as defined in this section for preparing.6. or another system approved by the authority having jurisdiction (AHJ). 2.1 This room shall be accessible to each nursing unit and shall be permitted to serve several nursing units and/or departments. dispensing.2.1 Common Elements for Hospitals For specific requirements. reports.1-2.6.1 General D R (1) Application.1-2.2. and administering medications distributed from a medicine preparation room. a selfcontained medication dispensing unit.6 Medication Dispensing Location Safety Zone 2.1-2.3.6. patients.1-7.2 (Plumbing Fixtures—Hand-washing station sinks). an automated medication-dispensing station.6.2. 2. (d) Work counters shall provide space sufficient to perform key patient-related tasks. 2. see specific facility chapters.

(c) If the unit is located in either the clean workroom or an alcove.6.) D R 2.6.1-2. sharps containers placed at a height that allows users to see the top of each container (e) Task illumination as described by the Illuminnating Engineering Society for safe identification of medication (b) (3) When a medicine preparation room is to be used to store one or more self-contained medication-dispensing units. the room shall be designed with adequate space to prepare medicines when the self-contained medicine-dispensing unit(s) are present. 2. (a) (2) This room shall contain the following: (i) (a) A work counter (ii) (b) A hand-washing station (iii) (c) A lockable refrigerator (iv) (d) Locked storage for controlled drugs (v) Where sharps are used.6.1 Medicine preparation room (1) This room shall be under visual control of the nursing staff. automated medication-dispensing stations.6. sharps containers shall be placed at a height that allows users to see the top of the container.6.1.1 Common Elements for Hospitals (f) Noise and sound attenuation (i) Medication safety zones shall meet noise and sound attenuation criteria found in Table 1. or in an alcove. (b) Task illumination as described by the Illuminating Engineering Society for safe identification of medication. in the clean workroom.. mobile medication-dispensing carts.6.7 Nourishment Area or Room AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 8 .6. provided the following requirements are met: (i) (a) The A lockable unit shall be used is locked for the security of controlled drugs.2-2 (Maximum Design Criteria for Noise in Interior Spaces Caused by HVAC and Other Building Systems). (ii) Where sharps are used. automated medicationdispensing station.1-2.1-2.1-2. (iii) If mobile medication-dispensing carts are used.1-2. (b) (2) A hand-washing station shall be located next adjacent to the stationary medicationdispensing units.6. dispensing. or another system as approved by the AHJ shall be permitted at the nurse station. and administering medications (1) 2.2 Work areas for preparing. robotic devices used in pharmacies). it shall comply with the visual control set forth in Section 2.2. space shall be provided in the patient room to accommodate the cart. or another systems approved by the AHJ (a) (1) Location of such units a self-contained medication dispensing unit. (c) When a medicine preparation room is used to compound sterile preparations.g. (Standard cup-sinks provided in many self-contained units shall not be considered adequate for hand-washing.6. or in a patient room. the following shall be met: (i) Requirements in Chapter <797> of the USP-NF: Guidebook to Pharmaceutical Compounding—Sterile Preparations (ii) Ventilation requirements in Table 7-1 (Design Parameters) in Part 6 (ANSI/ASHRAE/ASHE Standard 170) (2) 2.2 Self-contained medication dispensing units (e. *(ii) Medication safety zones shall be designed to enable a conversation sound level of no more than 50 dBA.

3 2.1 Patient nourishment facilities shall be permitted to be located in either an area or a room.6.1-2.1-2.1-2.1 Location of i Ice-making equipment shall be located in an enclosed space designed to mitigate noise. 2. (1) In public areas.3 A hand-washing station shall be located in the nourishment room or adjacent to the nourishment area. Other patient care areas shall have facilities for patient nourishment as required in facility type chapters in Part 2 of the Guidelines.2 Ice-making equipment type (2) A hand-washing station 2. (2) In areas restricted to staff only.1 Common Elements for Hospitals Each nursing unit shall have facilities for patient nourishment.4 Provisions and space shall be included for separate temporary storage of unused and soiled dietary trays not picked up at mealtime.6.1 Clean workroom. 2.7. 2. in the clean supply room. 2.6. use of storage bin-type equipment for making and dispensing ice shall be permitted. 2. it shall contain the following: AF (5) Equipment for hot and cold nourishment between scheduled meals DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 9 (3) Refrigerator .1-2.7.6.6.1-2.1-2.6.9.7. all ice-making equipment shall be of the self-dispensing type.8.6. or in the nourishment area or room. 2.6.1-2.8.8 Ice-Making Equipment D (1) A work counter R 2.1-2.2.1-2. permitted in the clean workroom.6.1-2.7.7.6.9 Clean Workroom or Clean Supply Room The clean workroom or clean supply room shall be separate from and have no direct connection with the soiled workroom or soiled holding room.2 The nourishment area or room shall have the following: (1) Sink Hand-washing station (2) Work counter (4) Microwave (5) (4) Storage cabinets (6) Space for temporary storage of unused and soiled food service implements as required by the functional program trays and dishes used for nonscheduled meal service 2. If the room is used for preparing patient care items.

. in a separate closet.2 Soiled holding room (1) Omission of the flushing-rim clinical service sink and work counter shall be permitted in this room when it is used only for temporary holding of soiled material.10.g.10. This room shall contain the following: . (2) Each nursing unit floor shall have sufficient storage room(s) or alcove(s) to keep corridors free of all equipment and supplies. Both fixtures shall have a with hot and cold mixing faucet (3) (2) A work counter (4) (3) Space for separate covered containers used for soiled linen and a variety of waste types 2.1-2. such a sink or an acceptable alternative (e. omission of the work counter or a and hand-washing station shall be permitted.1-2. (2) If a flushing-rim clinical service sink is not provided in the soiled holding room. 2.6.6.1 Soiled workroom.1-2. 2.2 Clean supply room. or using an approved covered cart distribution system on each floor. If the A room is used only for storage and holding as part of a system for distribution of clean and sterile supplies materials does not require a .6.1-2. (1) Appropriate r Room(s) or alcove(s)— sized to provide a minimum of 10 square feet (0.1 Clean linen storage. This storage shall meet the following requirements: (1) Clean linen shall be permitted to be stored in a designated area within in the clean workroom.6.6.1 Common Elements for Hospitals (3) Storage facilities for clean and sterile supplies 2.11 Equipment and Supply Storage 2. D R 2.1-2.6.11.11. storage of clean linen carts in an a corridor alcove shall be permitted.1-2.1-2.2 Equipment and supply storage room or alcove. 2. a water closet with bedpan-rinsing device located in a patient toilet room) shall be provided elsewhere on the nursing unit for the cleaning of bedpans.10 Soiled Workroom or Soiled Holding Room Such rooms shall be separate from and have no direct connection with either clean workrooms or clean supply rooms.93 square meter) per patient bed—shall be provided on the nursing unit floor for storage of equipment and supplies necessary for patient care and as required by the functional program.2.6. space for storage of Storage space for stretchers and wheelchairs shall be provided as required by the functional program out AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 10 2. (2) If a covered cart distribution system is used.1-2.3 Storage space for stretchers and wheelchairs.11. On each nursing unit. (1) A hand-washing station with hot and cold mixing faucet (2) (1) A flushing rim clinical service sink with a bedpan rinsing device and a separate hand-washing station.9.6.

1 An environmental services room shall be readily accessible to the unit or floor it serves.1 Common Elements for Hospitals of corridors.1-2. storage of coats in closets or cabinets on each floor or in a central staff locker area shall be permitted.7. *2.3.2 Staff Toilet Room(s) D R 2.6.3 Each staff toilet room shall be permitted to be unisex.4 Emergency equipment storage (1) Space under direct control of the nursing staff shall be provided on each nursing unit floor for emergency equipment such as a cardiopulmonary resuscitation (CPR) cart(s).1 Staff Lounge Facilities Lounge facilities shall be sized per the functional program but shall not be less than 100 square feet (9. 2.6.11. 2.1-2.6.7.8 Support Areas for Families.6.1-2.3 Staff Storage Facilities 2.1-2.7.7.1-2. 2.1-2. Patients.7.7.2. .12.12. 2.7 Support Areas for Staff 2.12 Environmental Services Room 2. *2.3.1-2. Size shall be determined by the functional program.2 If coat storage is provided. A designated nap room to facilitate rest for staff shall be provided in nursing units and patient care areas that have 24-hour/7-day-a-week missions.2 Each staff toilet room shall contain a toilet and a hand-washing station. and/or Visitors AF (1) A service sink or floor receptor DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 11 2. One environmental services room shall be permitted to serve more than one nursing unit on a floor.2.2.1-2. 2. they shall be large enough for purses and billfolds.1-2.1-2.1-2.7.1-2.7. At a minimum.2 In nursing locations.29 square meters).1 Securable closets or cabinet compartments for the personal articles of staff shall be located in or near the nurse station.1-2.2.1-2.1 A staff toilet room shall be readily accessible to each nursing unit. at least one Each environmental services room per floor shall be provided with contain the following: (2) Provisions for storage of supplies and housekeeping equipment (3) A hand sanitation station *2. 2. see facility chapters.7. *2.4 Staff Rest Areas For requirements.1-2. (2) This space shall be located in an area appropriate to the functional program but out of corridors.

1-3.2.1-3.1-3. 2.2.2.1-3.3 2. 2.2 The cubicle shall contain the following: DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities AF T 12 .05 meters).2 Multiple-Patient Bed Examination/Treatment Room or Area (1) Area.2.2. see facility chapters.2.3 The examination/treatment room shall contain the following: (1) An examination light D R (2) A hand-washing station (3) Storage facilities for supplies 2.2 2.2 Examination/Treatment Room or Area 2.3. (2) Clearances (a) A minimum clear dimension of 5 feet (1.1 General An examination/treatment room or area may be required in many locations in a health care facility.1-3. Room arrangement shall permit a minimum clear dimension of 3 feet (91. 2.1-3.2.1 2.2.1-3.1-3.1-3.52 meters) shall be provided between the sides of adjacent patient beds.15 square meters) with a minimum room dimension of 10 feet (3.1.1 Single-Patient Bed Examination/Treatment Room or Area 2.1 Space requirements (4) A desk. Multiple-patient bed examination/treatment rooms shall have separate patient cubicles with a minimum clear floor area of 80 square feet (7.1 Common Elements for Hospitals For requirements.2.22 meters) shall be provided between the sides of patient beds and adjacent walls or partitions.2 2.1.2.2.1-3 Diagnostic and Treatment Locations 2. (b) A minimum clear dimension of 4 feet (1.2.2.2.2.1-3.3 2.1-3.3. (2) Clearances.43 square meters) per cubicle.2.1 Reserved 2.2.2.1 Space requirements (1) Area. *2. When this an examination room or area is required by the functional program.2.1-3. Each single-patient examination/treatment room shall have a minimum clear floor area of 120 square feet (11.1-3.44 centimeters) at each side and at the foot of the bed. it shall meet the following requirements: 2.2 Provisions shall be made to address preserve patient privacy from observation from outside the examination/treatment room through an open door.1-3.1-3.2.1.2.1 2. or shelf space for writing or electronic documentation 2.2 2.1-3.1-3. counter.

plumbed.1.1-3. counter. at minimum the following laboratory work areas shall be provided: (1) Space shall be provided to accommodate equipment used and. 2.1.1.1-4.3.1-4. and blood banking to meet the workload described in as required by the functional program.2 Equipment information requirements.1 Laboratory workstation(s) 2. at minimum. shall include the following: (a) Laboratory work counter (b) Sink (2) Access to the following shall be provided as required: (a) Vacuum and gases (b) Tele/data service (c) Electrical service (d) Computer/printer AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 13 2.1-4 Patient Support Services For requirements.1-4.1-4.2 Laboratory Work Areas When laboratory services are provided by contract. a hand-washing station shall be provided in the room for each three four or fewer patient cubicles. Determination of specific testing to be done on-site with point-of-care and other laboratory instrumentation shall be reviewed with the medical staff of the hospital.1. clinical chemistry. (2) Provisions shall be made to perform testing on-site that supports acute care of patients as specified in the functional program.2.2.1.1 Application (1) Laboratory facilities shall be provided for the performance of tests in hematology.1 Laboratory Services 2.1 General *2. urinalysis.1. microbiology.1-4. or shelf space for writing or electronic documentation 2. cytology. .2.3 In a multiple-patient bed examination/treatment room.1.1 Common Elements for Hospitals (1) An examination light (2) Storage facilities for supplies (3) A desk.2.1-3. 2. The functional program shall describe the type and location of all special laboratory equipment that is to be wired. anatomic pathology. D R 2. see specific facility chapters in Part 2. (3) Provisions shall be included for specimen collection and processing.2.1-4.3 2. or plugged in as well as the utilities required to operate each.

(1) If the refrigerator is used to store blood for transfusions.4 Storage facilities (1) Proper storage for reagents. preparation of specimens or reagents.3 Refrigerated storage facilities.2.2 Hand-washing station(s) *(1) If there is one workstation. An emergency eyewash shall be provided at the hand-washing station if required by the functional program. it shall be equipped with temperaturemonitoring and alarm signals.1.1-4.1-4. and other supplies shall be provided as necessary. (1) Furnishings. facilities and equipment shall be provided for terminal sterilization of bio-hazardous waste before transport (autoclave or electric oven). a hand-washing station shall be provided within 25 feet (7.62 meters) of all testing and specimen-handling areas. (3) A hand-washing station shall be provided in each enclosed room where bio-hazardous specimens and/or hazardous chemicals are handled.1-4.2.2.1.1.2. (a) Terminal sterilization is not required for waste that is incinerated on-site. A refrigerator shall be provided.1-4. 2. 2. flammable materials. As determined by the type of chemicals in use.2. chemical safety provisions shall include the following: (a) Emergency shower (b) Eye-flushing devices (c) Appropriate storage for flammable liquids (2) Terminal sterilization provisions.6 Safety provisions (3) Vented storage shall be provided for volatile solvents. If required by the functional program. (2) If more than one workstation is provided.1-4. acids. bases. specimens.1.1. *(1) Chemical safety provisions.1 Common Elements for Hospitals *2.5 Special design elements *(2) Reagent water system *2. a hand-washing station shall be provided at the workstation. (2) Blood storage facilities shall meet the requirements of the Clinical Laboratory Improvements Act standards for blood banks.2. D R 2. *(3) Refrigerator temperature shall be monitored and alarmed. All work counters(s) in areas used for specimen handling. (2) Separate facilities shall be provided for such incompatible materials as acids and bases. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 14 . and laboratory testing shall be constructed of non-porous materials.

7 Support Areas for Staff (3) Storage spaces for specimen collection supplies (4) Work counters for labeling and computerized data energy 2. Office(s) and space for clerical work.1. 2.1 General (1) Space shall be provided for specimen collection.1-4.1.3.1.2.6 Support Areas for the Laboratory 2.1.1-4.1 Common Elements for Hospitals (b) If the facility includes a biosafety Level III lab. (3) Radioactive material-handling provisions (a) If radioactive materials are employed.7.1-4.1 Lounge. facilities for long-term storage and disposal of these materials shall be provided in accordance with requirements of authorities having jurisdiction. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities AF T 15 .1-4. (2) Location of facilities for this function outside the laboratory work area shall be permitted. 2.1-4.6.2 Location of these areas outside the laboratory area and sharing of these areas with other departments shall be permitted. an autoclave for terminal sterilization is required. (The toilet and hand-washing station shall not be required if the functional program requires remote urine and feces collection facilities. 2.1.1-4.1 Administrative areas.1-4.1. and record maintenance and storage shall be provided.5 Reserved 2. filing.1.1.1-4.1-4. Requirements of authorities having jurisdiction shall be verified. specimen collection facilities shall provide the following: (1) A blood collection area with: (a) A work counter (b) Space for patient seating (c) Hand-washing station(s) (d) Supply storage (2) A urine and feces collection facility equipped with a toilet and hand-washing station if the functional program requires a centrally located facility for this purpose.7.3.1.) D R (5) Storage for specimens awaiting pickup 2.1. locker. At minimum.2 Facility requirements.4–2. 2. and toilet facilities shall be readily accessible for male and female laboratory staff.3 Specimen Collection Facilities 2. (b) No special provisions shall normally be required for body waste products from most patients receiving low-level isotope diagnostic material.1-4.

1-4.2. the number of patients to be served.2 Manufacturing facilities (1) A bulk compounding area (2) Provisions for packaging and labeling (3) A quality control area 2.1-4.2.2. breakout. and the extent of shared or purchased services. so it is accessible to clinical areas of the hospital and to facilitate staff control. and security of the pharmacy.1. These factors shall be described in the functional program. (Satellite facilities.1-4.1 Application.2 Pharmacy Services 2.) 2. Cabinets. shall include those items required by the functional program.1-4.2.1-4. The size and type of services to be provided accommodated in the pharmacy shall depend on the type of drug distribution system used.2.1-4. and inventory control of materials used in the pharmacy (2) Work counters and space for automated and manual dispensing activities *(3) An extemporaneous compounding area. and/or separate rooms or closets shall be provided for the following as required: (4) Storage for volatile fluids and alcohol in accordance with applicable fire safety codes for the substances involved DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities AF T 16 .3 Storage.2 Pharmacy Areas Facilities and equipment shall be provided as required by the functional program. 2.2 Location.1. if one is provided D (1) Bulk storage (2) Active storage (3) Refrigerated storage R 2.2.1 General 2. 2.2. The pharmacy room or suite shall be located for convenient access. (4) An area for reviewing and recording (5) An area for temporary storage. and restocking of carts (6) Security provisions for drugs and personnel in the dispensing counter area.2. This shall include a sink and sufficient counter space for drug preparation.1 Dispensing facilities.1-4.2.1 Common Elements for Hospitals 2.1-4.2. The following shall be provided: (1) A room or area for receiving.2. exchange. shelves. if provided.

1-4.2 Office.2.1-4.1-4.6. A separate room or area shall be provided for office functions. 2. *2. and drug information centers. The pharmacy shall be laid out to preclude unrelated traffic through IV and cytotoxic IV preparation rooms. 2.2. If sterile work areas are required by the functional program. (1) The laminar-flow workstation shall include a nonhydroscopic filter rated at 99.6.1-4. A multipurpose room shared with other departments AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 17 (2) Layout.3 Provisions A room for patient counseling and instruction. (2) The laminar-flow workstation shall have a visible pressure gauge for detection of filter leaks or defects.3 Sterile Work Areas 2.5 Reserved (1) Patient information.6 Support Areas for the Pharmacy 2.1-4. D R 2.1 General (1) Application.2.2.2.1-4.1-4.1-4. (3) Where robotic systems are used in the preparation of IV solutions in either the positive pressure IV preparation room or the negative pressure cytotoxic IV prep room. (2) Pharmacological information. B1.1-4. reaction data. as tested by dioctyl-phtalate (DOP) tests.6.2. the robotics shall be separate systems and not pass through from one room to the other. communication equipment. .4 A room for education and training. and reference materials. A room separate from the pharmacy area shall be permitted to meet this requirement.3.3.2. *2.2.4–2.6.1-4. filing capabilities.3. Provision shall be made for cross-checking medication and drug profiles of individual patients.1 Access to information 2. 2.1-4.2. If intravenous (IV) solutions are prepared in the pharmacy. Provision shall be made for access to poison control. a sterile work area with a laminar-flow workstation designed for product protection shall be provided.2.3 Cytotoxic IV preparation room. This room shall include space to accommodate a desk.2.2. or B2 B3) or Class III biological safety cabinet. the requirements in this section shall be met.97 percent (HEPA). A separate room shall be provided for preparation of cytotoxic IV admixtures under a Class II (Type A2.1 Common Elements for Hospitals (5) Secured lockable storage for narcotics and controlled drugs (6) Equipment and supply storage for general supplies and equipment not in use 2.2 IV preparation area.

1-4. additional space and equipment shall be provided to accommodate supplies. The equipment and design layout shall provide a workflow that supports production of quality food and minimizes potential for cross-contamination of clean food and wares with contaminated trays from patients or retail customers.2.2 Layout.1-4. and storage.2.2. Construction.1 Common Elements for Hospitals shall be permitted to serve this purpose. Food and Drug Administration (FDA) (2) U.1 Lounge. Department of Agriculture (USDA) (3) Underwriters Laboratories. 2.6 Outpatient medication consultation/education area. 2. labeling. and toilet facilities shall be readily accessible for pharmacy staff.1.1-4.6.11 Additional equipment and supply storage. locker. 2. Inc.2.1-4.7.7.6. and patients as required by the functional program.3.S.1-4. an area for consultation and patient education shall be provided.1 General D R (1) U. *2.3 Regulations. packaging.1-4.S.1-4.3. A hand-washing station shall be provided either in an anteroom or immediately outside the room where open medication(s) are prepared.1-4.2 These areas shall be permitted to be outside the pharmacy area and shared with other departments. equipment and installation of food and nutrition service facilities within a hospital shall comply with the requirements of: (4) NSF .6. 2.1-4.3.1-4. If a unit dose procedure is used. If the functional program requires dispensing medication to outpatients.3.7 Support Areas for Staff 2.National Sanitation Foundation International AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 18 .1-4.3.8 Reserved 2.1-4.6.1 Application.2.7 through 2.2.2.2. Food service and nutrition facilities shall provide food service for staff.9 Special Design Elements For HVAC requirements.1-4.2 Food Preparation Dietary Areas *2. 2.6.1-4. 2. (UL) 2.1-4. see Part 6 (ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities).3 Food and Nutrition Dietary Services 2. including space for the carts.1. visitors.2. 2.1-4.2.2. 2.5 Hand-washing station.10 Reserved 2.1.

UL or AGA standards. protected environment.2.3.3. 2.3. dinnerware.3 If dinnerware and serving utensils are retained in patient care areas and not returned to a central ware-washing/sanitation area. Soiled patient and non-patient trays or tray carts shall not pass through preparation areas or areas of open food.1 Common Elements for Hospitals 2.3.1-4.3 Food preparation surfaces.3. the remote facility shall be provided with a NSF-listed automatic dishwashing unit. Provide hot food holding capacity to maintain a minimum consistent internal temperature of 140ºF (xxºC).3.3.3.1-4.3.3.3. When combined.1-4.2.4 Any device. transport cart. 2.1-4.1-4. Hand-washing stations shall be provided within 20 feet (xx meters) of each food preparation or serving area.3.3.1-4. 2.1 All food items shall be transported in an enclosed cart or container that maintains internal temperature controls that meet the applicable requirements of the FDA Food Code and HACCP guidelines.1-4.1-4. Commercial-grade cooking equipment shall be provided that can bring food to a minimum internal food temperatures of 165ºF (xxºC). Commercial-grade refrigeration shall be provided to hold chilled food at a temperature below 41ºF (5ºC) and to maintain a freezer temperature below 32º F (0º C) as required by HACCP Guidelines and the FDA code. (2) The drainboards shall be the same length as the sink compartment and fabricated to NSF standards.3 Assembly and Distribution Facilities 2. 2.2. utensil.2.1-4. with drainboards on each side of each sink. Food preparation surface areas shall be provided.2.2. D R 2.5 Space shall be provided for food service cart distribution to accommodate the following functions: AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 19 .3.3. 2. *2. shall be provided within easy access of food preparation/cooking areas. *2. these shall have a length equal to or greater than the length of all commercial cooking equipment. or service ware item that has held soiled patient wares shall be cleaned and sanitized before being returned to service.5 Hand-washing stations. (2) Refrigeration equipment.1-4. (3) Hot food holding equipment. and HACCP safe food preparation and holding standards.2 Food assembled for service to patients shall be assembled in a non-public.2 Sinks (1) Two-compartment food preparation sinks.1 General (1) Layout.3. while meeting National Sanitation Foundation (NSF) standards.1-4.4 Equipment (1) Cooking equipment. 2.

2.1 Dinnerware and serving utensil washing shall be accomplished in an NSF-listed automatic dishwashing unit.2. 2. and casework used for self-service shall accommodate wheelchair access. *2.3.1-4.1 Design Standards for the Disabled. 2. See Section 1.2 Hot/cold food holding and display equipment shall maintain internal temperature controls meeting the applicable FDA Food Code and HACCP guidelines. 2. D areas.5.1-4.1-4.3.4.1-4.5.3 Pot and pan washing facilities.2 Soak sinks shall be provided to pre-soak dinnerware and utensils that have encrusted material that may not be fully removed in the washing device.3. (1) Each sink compartment shall accommodate the largest utensil used in the food service facility.4 Hand-washing stations shall be located as close to the point of transition from clean to soiled items as possible without detracting from the dishwashing process.5.1-4.1-4.4 A minimum aisle spacing and chair clearance of 3 feet (xx centimeters) shall be 2.3 Single-service ice and beverage dispensing systems shall be provided in self-serve 2.3.1-4.3. tables/chairs. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 20 .4. R 2. (2) The final rinse compartment (third compartment) shall be equipped with an automatic chemical sanitizing agent injector. 2.6 Stationary or mobile serving equipment (kiosks) AF 2. a single three-compartment sink with integral sloped drain table extensions on both the clean and soiled sides shall be provided.1-4.5.4.3.1 Food shields (sneeze guards) shall be provided to protect non-covered and unpackaged foods.4.3.3.1-4.3.4 Warewashing Facilities 2.1-4. At minimum.3.5 The design of aisles.3. provided. A designated area shall be identified with a grated or sloped floor with floor drain and a source of water and sanitizing agents.5.3.1-4.5 Food Service Areas 2.1-4.1-4.1 Common Elements for Hospitals (1) Storing carts when not in use (2) Loading carts for distribution (3) Distributing meals *(4) Receiving soiled carts *(5) Sanitizing carts.5.

10 Trash storage. the menu. *(2) Refrigerated storage (a) Walk-in and reach-in refrigerators and freezers shall be thermostatically controlled to maintain desired temperature settings in increments of 2 degrees or less.1-4.3. staff. serving. The time of the alarm shall be automatically recorded.6 Dining Areas Dining space(s) shall be provided for ambulatory patients. *2. 2. as required by the functional program. (2) A hand-washing station shall be provided. *(3) Door. (ii) Freezers shall be capable of maintaining a temperature below 0° F (-2° C). *(1) General (a) Dry storage and refrigerator/freezer space shall be provided to support both patient and nonpatient food service based on the number of deliveries available.1 Receiving area (1) Location.3.3 through 2.1-4.3.1-4. and visitors.3.1-4.11 Equipment and supply storage 4.1-4. and the method of preparation. A receiving area shall be provided at the receiving entrance to the department for breakdown of boxes and vendor storage.2.3.2 Office.8.14 meters). Controls shall include audible and visible high.1-4. Space for holding covered trash containers prior to removal to dock wastehandling facilities shall be provided in food preparation. including receiving carts/jacks.8.3.3.3. The exterior door into the receiving area shall have a minimum clear width of 4 feet (xxx meters) and a minimum clear height of 7 feet (2. 2. transport carts.7 Vending Machine Areas 2.8. *(2) Space requirements.8.9 Reserved D R 2. *(b) Aisles with a minimum width of 36 inches shall be provided between storage units.3. and sanitation areas. *(c) An external temperature-indicating device shall be provided in accordance with HACCP safe food handling guidelines and verification standards. 2.1 Common Elements for Hospitals (1) At minimum.1-4. (i) Refrigerators shall be capable of maintaining a temperature below 41 degrees Fahrenheit.and low-temperature alarms.8 Support Areas for Food and Nutrition Facilities *2.8. Space shall be provided for delivery and transport equipment. Office space shall be provided for management to conduct personnel business as required by the functional program. (iii) Interior temperatures shall be indicated digitally on the exterior. these shall meet FDA and HACCP food holding temperature requirements and have NSF food shields for unwrapped products. and returnables.8.1-4. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 21 .

2. (2) If staff lockers are not convenient to the department.1-4.8. (b) Emergency utility support shall be provided for refrigerated storage and food preparation and serving areas as required by the functional program.1 Common Elements for Hospitals (d) A coved base shall be provided on the interior and exterior of walk in refrigerator and lowtemperature units.1 Toilet rooms 2. *(3) Chemical storage. (g) The interior of refrigerated storage shall be lighted. except as amended in this section.1-4. An environmental services room shall be provided in the food and nutrition services department in accordance with Section 2.3.12. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 22 .3. (e) All walk-in refrigerator and low-temperature units shall have a vision panel in the door and safety release mechanism for exit from the inside at all times. (h) The bottom shelf shall be located no less than 10 inches (xx centimeters) above the finished floor.1-4.1-2. or directly accessible to the food and nutrition services department. (2) Space requirements (a) The size of the environmental services room shall accommodate the following: (i) A utility sink (ii) Storage for general cleaning chemicals and those used for warewashing (iii) A rack for air drying mops (iv) Mobile carts with water containers and related janitorial equipment (b) Where hot water or steam is used for general cleaning. lockable storage for staff personal items shall be located in the department.9.2.6.2 Storage for staff (3) Environmental services rooms shall not be combined with locations for trash storage. (1) The environmental services room shall not be shared with nursing units or clinical departments. additional space shall be provided in the room for storage of hoses and nozzles.12 Environmental services room.3.3. Chemical storage shall be provided in a separate room or an enclosed cabinet in the food preparation area. D R 2. (4) Emergency storage (a) Storage for emergency or disaster food and water shall be provided as required by the functional program.9 Support Areas for Food and Nutrition Services Staff (1) Toilet rooms shall be provided in. 2. (1) Lockers shall be provided for food and nutrition services staff as required by the functional program. next to.1-4.9. (2) Toilet rooms in the food and nutrition services department shall not be permitted to open directly into food preparation or food storage areas. (f) Shelving in walk-in refrigerator and low-temperature units shall be non-corrosive and mobile.

11.1-7. sanitation/warewashing.2.3 (2) (Walls.3. (ii) Walls adjacent to cooking equipment shall have sealed surfaces of non-combustible materials.1-4.3. Surfaces in preparation. 2.1-7. sanitation/ware-washing. storage rooms.1-4. smooth. 2.36 centimeters) and a minimum clear height of 7 feet (2. consist of epoxy paint-covered gypboard. and wall protection: Dietary and food preparation areas) and the following requirements.1 Architectural Details *(1) Ceilings (2) Doors.1 HVAC system (1) Ventilation requirements (a) Food preparation areas shall have a minimum air change rate of 45-60 ACH.1-7. Where steam-jacketed kettles and tilt frying pans are used.4 (4) (Surfaces: Ceilings—Dietary and laundry areas).3.2 Surfaces *(2) Flooring. a floor trough shall be installed for cleaning purposes. see Section 2.3.14 meters).1 Common Elements for Hospitals 2.10. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 23 .1-4. and light in color. see Section 2. (c) Walls in non-preparation or sanitation areas (e.2. (b) Storage and office areas shall have a minimum air change rate of 10-15 ACH. See the requirements in Section 2. easily cleaned. Door openings shall have a minimum clear width of 2 feet 10 inches (86. easily cleaned. smooth.1-4. and light in color.02" WG or 5% between supply and exhaust ventilation.g.10 Special Design Elements 2. All flooring shall be smooth and easily cleaned.10. corridors. For requirements. at minimum. For further requirements. and serving areas shall be non-absorbent. ceramic tile or smooth finish concrete block).1-4. *(3) Windows (daylighting) *(4) Floors. (4) Ceilings.3.2 (Flooring). (b) Walls behind exhaust hoods (i) Fire-rated. non-combustible materials shall be used behind cooking equipment to match the width of the exhaust hood. (ii) Walls shall be flashed with 20-gauge stainless steel locked seams from floor base to exhaust hood or with material of similar durability (e. (a) Walls in food preparation. and serving areas (i) Walls shall be non-absorbent.3.2.2.. offices dining or vending) shall. D R AF (1) General.3. wall bases.g.11 Building Systems 2. *(3) Walls.3. (c) Negative air pressure in kitchen areas shall not exceed .

1-8. (b) At minimum. exhaust hoods shall meet the requirements of the following: (i) ANSI/ASHRAE Standard 154: Ventilation for Commercial Cooking Operations (ii) International Mechanical Code requirements for: • Type II Condensate Hood. but shall be at least 4 in.4. 2. canopy. (3) Kitchen and serving area lightbulbs shall have a shatterproof or protective cover. (b) Floor sinks shall have a drain sized according to capacity needs but no less than 2 inches (xx cm) in diameter. see Section 2.1 Central Services For requirements. warewashing. (2) Light levels in storage areas shall be a minimum of 70 footcandles. (xx cm) in diameter. .1 (General piping and valves). 2.1-5. used to protect ceilings and surrounding areas from highmoisture-content equipment • Type I Filter Hood with removable and washable baffle and centrifugal filters or Type I Water Wash Ventilator extractor with integral high-velocity air-directional baffles that is automatically washed at preset service intervals (c) Surface. and tray assembly areas shall be a minimum of 100 footcandles. *(d) The bottom edge of exhaust hoods shall be mounted between 6 feet 6 inches (xx meters) and 7 feet (xx meters) above the finished floor in accordance with ASHRAE 154. and duct protection shall be provided in accordance with NFPA 96: Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations and ASHRAE 154.1-4.4.2.6 (Drainage systems).2 Electrical systems (1) Light levels in food preparation.1-5 General Support Services and Facilities *2.1-4.1-8. (2) Drainage systems (a) For requirements.11. (b) Area drains in each food preparation work and sanitation area shall be flush with the finished floor. (b) A horizontal clearance of 6 inches (xx cm) above the finished floor shall be provided for all exposed connection piping. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 24 (2) Exhaust hoods in food preparation areas (a) Exhaust hoods shall be sized for capture and containment of smoke and grease-laden vapors. (3) Floor sinks (a) Floor sinks shall be furnished with sediment buckets and flush set floor grates at indirect waste connection points.11. see specific facility chapters in Part 2.3.2.1 Common Elements for Hospitals *2.3 Plumbing systems D R *(1) Piping (a) For general requirements. see Section 2.3.2. (4) Waste lines at high-volume cooking and warewashing equipment shall be sized as required to maintain proper waste flow.

1-5.1.2.3.1.2 Location.1 Application (1) Central services shall be provided as required by the functional program.2 Clean Assembly/Workroom This workroom shall contain the following: 2. but separate from.1.2.3.1-5.3 Pass-through doors and washer/sterilizer decontaminators shall deliver items into clean processing area/workrooms.1-5.2.1 Common Elements for Hospitals 2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities AF T 25 . 2.1.1. This space shall inclulde: D R (1) Work tables (2) Sinks (3) Flush-type devices (4) Hand-washing stations (5) Washer/sterilizer decontaminators 2.1-5.1.1-5.4 Equipment and Supply Storage *2.1.1 This room shall be physically separated from all other areas of the department.3 Equipment for terminal sterilization of medical and surgical equipment and supplies 2.1-5.1.2 Work space shall be provided to handle cleaning and initial sterilization/disinfection of all medical/surgical instruments and equipment.1-5.1 Hand-washing stations 2. a full central services area shall be provided as described herein.1-5. (1) This room shall be adjacent to.2 Work space 2.1 General *2.1 Clean/sterile medical/surgical supplies.1.3.1-5.3 Layout.2.3 Soiled Workroom 2.1.1-5.1. central services shall be organized as a distinct entity within the hospital or on the campus of the hospital.1.1. 2.1-5. (2) If on-site decontamination and sterilization are required by the functional program. Soiled and clean work areas shall be physically separated. 2.1-5. 2.1. the clean assembly/workroom.1-5.1. When required by the functional program.4. 2.1.1.1-5. A room for breakdown receiving/unpacking shall be provided for clean/sterile supplies received from outside the facility.

7 Support Areas for Staff (1) These shall be provided where they are readily accessible to the central services department.1-5. 2.2 Linen Services For requirements.2.1-5. If required by the functional program.7. and packaging of clean linen. holding.2. and lounge facilities . and sorting.1-5. and storage shall be provided. lockers. A separate room shall be provided for soiled linen receiving.1. assembling. this room shall be separate from all other areas and provide for staff to change from street clothes into work attire. (2) Sharing of these areas with other departments or services shall be permitted.1.7. but location outside the central services area shall be permitted.1-5. or in an off-site commercial or industrial laundry.1-5. a room or area shall be provided for inspection.1 Toilet rooms. humidity.1 Application. *2.4.1-5.2. D R AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 26 2.1 Common Elements for Hospitals (2) Storage for packs and the like shall include provisions for ventilation.2 Storage room for patient care and distribution carts.1.1-5. This room area shall be adjacent and easily available to the clean/sterile storage and close to the main distribution point to keep traffic to a minimum and ease work flow.6 Reserved 2.1-5.1-5.2 Location. 2.1-5.2.1.1-5.1 Soiled and clean linen handling areas (1) Soiled linen holding room.2 On-Site Internal Linen Processing Facilities When linen is processed within the hospital or in a separate building on the hospital campus. shelving. (b) Space for a tables. 2. at minimum the following shall be provided: 2.1. Each hospital shall have provisions for storing and processing of clean and soiled linen used for patient care and support. removal of lint.5 – 2.1-5. (2) Clean linen inspection room or area (a) If not provided elsewhere or as part of the clean linen storage room.2 Staff changing room.2.1 General 2.2.2.1. see specific facility chapters in Part 2. (a) A hand-washing station shall be provided in each room or area where soiled linen is processed or handled. mending. folding. and temperature control. 2. 2.1. in a separate building located on the hospital campus. 2.1. (b) Discharge from soiled linen chutes shall be received in a separate room adjacent to the soiled holding room. Linen processing shall be permitted to occur within the hospital.

1-5. (3) Hand-washing station. When linen processing is located in a separate building on the hospital campus. An area These shall be provided for separate parking of clean and soiled linen carts out of traffic. the following shall be provided: D DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities R 2.2.1-5.1-5. (b) Equipment shall be arranged to permit an orderly work flow and minimize cross-traffic that might mix clean and soiled operations.3 Off-Site Linen Processing When linen is processed off-site at a commercial or industrial laundry. (4) Storage for laundry supplies.2 Laundry facilities (1) General (a) Laundry facilities to accommodate the washing and drying of laundry shall include those listed in this section. A hand-washing station shall be provided in the laundry processing room. This room shall have space for commercial or industrial washing and drying equipment that can process at least a seven-day supply of laundry during the regularly scheduled work week. 2.2. A central clean linen storage and issuing room(s) shall be provided in addition to the linen storage required at individual patient units.2. (5) Service entrance. 2.1 Soiled and clean linen handling areas AF T 27 .3. a service entrance protected from inclement weather shall be provided for loading and unloading of linen.2.2. Storage shall be provided for all supplies necessary for laundry operations. (4) Cart storage area(s). *(2) Laundry processing room.1 Common Elements for Hospitals (3) Clean linen storage room.

1 Off-street unloading facilities area.3. A control station for pickup and receiving of soiled and clean linen shall be provided. 2.4 Support Areas for Staff 2.1 Common Elements for Hospitals (1) Soiled linen holding room.1.1-5.1-5.1 General D R 2. and sorting. 2. and lounge(s) (1) Toilets. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 28 . *(1) Location (a) The receiving area Dock areas shall be separated segregated from other occupied building areas and located so that noise and odors from operation will not adversely affect building occupants.2 Location. 2.2.2 Service entrance. see specific facility chapters. Adequate A receiving area shall be provided to accommodate delivery trucks and other vehicles. 2.1.1-5. 2. lockers and lounge facilities shall be readily accessible convenient to the linen services area. holding.3.2.3. *2.2.2.1-5.1 Application.2. (2) Clean linen storage room.3.3. *2. Materials management size and complexity shall be determined by the functional program but at minimum shall consist of the requirements described in this section. 2.3.1-5. A service entrance for loading and unloading linen shall be protected from inclement weather as required by the functional program. lockers.1-5.4. (3) Cart storage area(s).2.3 Control station. A separate room shall be provided for soiled linen receiving.2 Receiving Facilities 2. (a) A hand-washing station shall be provided in the soiled linen holding room. An area These shall be provided for separate parking of clean and soiled linen carts out of traffic.3.3. (b) The receiving area shall be segregated from waste staging and other outgoing materials-handling functions.1-5. (b) Discharge from soiled linen chutes shall be received in a separate room adjacent to the soiled holding room.1-5.1 Toilets.2.1-5.2 Receiving area.1-5.3 Materials Management Facilities For requirements. (2) Location of these areas outside the linen services area and sharing of these areas with other departments or services shall be permitted. Materials management facilities shall be located separately from all patient care areas. An area separated from public streets shall be provided for unloading materials for the hospital.1-5. A central clean linen storage and issuing room(s) shall be provided in addition to the linen storage required at individual patient units.

sharps containers.3.2.3 Central Storage Facilities General Stores 2. Additional storage areas for outpatient facilities shall have a total area of no less than 5 percent of the total floor area of the outpatient facilities served.3 Additional storage areas for outpatient facilities (1) Location.3.4 Waste Management Facilities *2. (c) Red bag Regulated medical waste shall be staged in enclosed and secured areas as required by AF (2) General stores Central storage facilities shall be permitted to be located in a separate building on-site with provisions for protection against inclement weather during transfer of supplies to the hospital. (2) Space requirements. General storage room(s) with a total area of no less than 20 square feet (1. 2. (1) Location (a) Locations for waste collection and storage shall be determined by the facility as a component of provided as required by the functional program. 2.1-5. balers and other devices shall be located to capture packaging for recycling or return to manufacturer or deliverer.3.3. (2) Space requirements. Central storage facilities for general storage shall consist of one or more storage rooms.3.2 Storage room(s). a central storage area facility for general stores shall be provided.1 Common Elements for Hospitals (2) Space requirements (a) Adequate space An area shall be provided to enable unpacking. (b) Off-site location for a portion of this storage shall also be permitted.3.1 General R 2. or at an off-site location shall be permitted.86 square meters) per inpatient bed shall be provided.4.1-5. (c) In facilities with centralized warehousing.1-5. and recycling container staging at docks or other waste removal areas shall be stipulated as required by the functional program. in a central area within the outpatient department. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 29 . (b) If provided. balers. or in one or more individual storage buildings on the hospital campus. (b) The location of compactors.1-5. concentrated area(s) within the hospital. (1) Location (a) Location of the general storage room(s) in a separate.1-5. The location of additional storage areas for outpatient facilities within the general storage room.1-5.1. D 2.1 General (1) In addition to supply storage facilities located in individual departments. and staging of incoming materials and supplies.1-5.1 Waste Collection and Storage 2. sorting. shall be permitted.4. space shall be provided at receiving points to permit staging of reusable transport containers for supplies moving from central warehouses to individual receiving sites.3.

2.4.2. including centralized waste collection and storage spaces. including mercury universal waste.1. regulated medical waste or infectious waste storage spaces shall have the following: (a) A floor drain (b) Cleanable. Biohazardous and environmentally hazardous materials Regulated medical waste and chemical hazardous waste.1-5. and other regulated waste types. shall be segregated and secured. and unauthorized entry. animals. (3) Refrigeration requirements for such storage facilities shall comply with state and/or local regulations. 2.3 Regulated waste storage spaces (2) Such storage facilities should shall be safe protected from weather. non-porous and seamless floor and wall surfaces (c) Lighting (d) Exhaust ventilation T .1-5.4.4 Refuse chutes D DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities R 30 AF (1) If provided.1 Common Elements for Hospitals the functional program. (2) The functional program shall outline the space requirements. Size of spaces shall be based on the volume of projected waste and length of anticipated storage.1. 2.1-5.2 Space requirements (1) The functional program shall stipulate the categories and volumes of waste for disposal and the methods of handling and disposal of waste. nuclear reagent waste.1.4.

The design and construction of incinerators shall comply with NFPA 82: Standard on Incinerators and Waste and Linen Handling Systems and Equipment.1-5. underground installations.62 meters) from inlets to HVAC systems. or all-weather enclosed shelters at an outdoor site shall be permitted. public access. and regulatory considerations. trailer-mounted units.1-5. (4) Use of mobile or portable units.1 General Each hospital shall provide environmental services rooms throughout the facility to maintain a clean and sanitary environment.1-5. from the treatment technology shall be located a minimum of 25 feet (7.1 Incineration. visitors. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 31 2.4. and operational clearances.4. The functional program shall describe waste treatment technology components.2.2. (2) (4) The minimum cross-sectional dimension of gravity chutes shall be 2 feet (60. state. and space requirements for treatment equipment shall be considered in determining the location for a nonincineration technology. Types of non-incineration technology(ies) shall be determined by the facility in conjunction with environmental.1-5. and the visual impact of medical waste operations on patients. (b) If the technology involves heat dissipation.1 Common Elements for Hospitals (1) If provided required by the functional program. noise.5.2 Other waste treatment technologies. 2. temporary storage requirements. (c) Odor. On-site hospital incinerators shall comply with federal. subject to local regulatory approvals. *2. (5) Ventilation (a) Exhaust vents.2. and local regulatory and environmental requirements.96 centimeters). distances from waste sources. if any.1-5.2 Waste Treatment and Disposal . and security shall be considered. space for hydraulic lifts.2 Facilities for Cleaning and Sanitizing Carts AF 2.1-5. : (1) Chutes shall meet the provisions described in NFPA 82. see specific facility chapters. sufficient cooling and ventilation shall be provided. (2) Service openings to chutes shall comply with NFPA 101.5 Environmental Services For requirements. (2) Space requirements for such technologies shall be determined by equipment requirements. including associated area(s) for opening waste entry doors. economic. access to control panels. (b) The location of the technology shall not cause traffic problems as waste is brought in and out. *2. refuse chutes shall meet all applicable codes and or exceed the following standards. (1) Location (a) Safe transfer routes.5. D R (3) Reserved 2.4. (3) Chute discharge into collection rooms shall comply with NFPA 101. conveyors.

6. Room(s) or separate building(s) shall be provided for boilers and mechanical and electrical equipment.1-5. state.1-5.2 Outdoor equipment storage (5) Medical gas parks and equipment (6) Air-cooled chillers where installed in a weatherproof housing (8) Site lighting.2 Mechanical and Electrical Equipment Rooms *2.1-5.2.6 Engineering and Maintenance Services For requirements.1-5. yard equipment and supply storage areas shall be provided. post indicator valves. except for the following: DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 32 .6.1 Storage for building maintenance supplies (1) A storage room shall be provided for building maintenance supplies.1-5.e.6.2 Facilities for cleaning and sanitizing carts shall be permitted to be centralized or departmentalized.1 Common Elements for Hospitals 2.3.6.1-5. and other equipment normally installed on the exterior of the building 2. (1) Rooftop air-conditioning and ventilation equipment installed in weatherproof housing (2) Emergency generators where the engine and appropriate accessories (i.3.2 Facility requirements.2.1-5. and linen services.6. see specific facility chapters.6. (2) Storage for solvents and flammable liquids shall comply with all local.2. (1) If required by the functional program. batteries) are properly heated and enclosed in a weatherproof housing (3) Cooling towers and heat rejection equipment (4) Electrical transformers and switchgear where required to serve the facility and where installed in a weatherproof housing D R (7) Trash compactors and incinerators 2.1-5. and federal code requirements. 2.1 General Reserved 2. 2.2. dietary facilities.5.3 Equipment and Supply Storage 2. 2.6.2..1-5.5.1 Facilities shall be provided to clean and sanitize carts serving the central service department. Sufficient space shall be included in all mechanical and electrical equipment rooms for proper maintenance of equipment.1 Space requirements. AF 2.1-5.

2.7.2-5. Morgue services shall be provided as required by the functional program and as referenced in the facility chapters. repair.7.1 Application. Body-holding refrigerators shall be equipped with temperature-monitoring and alarm signals that annunciate at a 24-hour staffed location.5.1-5.7.2 An autopsy room. records.1-5. 2.2-5.1-5.1 If required by the functional program. etc.7.1-5.7.1. 2. Morgue service facilities shall be accessible through an exterior entrance and shall be located to avoid the need for transporting a body through public areas to the mortuary transport vehicle. the following elements shall be provided: 2.7.6.6.1 If required by the functional program. 2.1-5.7.2. manuals. *2.2. and testing of electronic and other medical equipment.2 Autopsy Facilities If autopsies are performed in the hospital.2.1-5.6.7. D (3) An autopsy table R (4) A deep sink for washing specimens 2.5.1-5.1-5.1-5.6.1 General 2.1 2. an engineer's office shall be provided.2-5.1-5.6.1.2 2. a separate area or room shall be provided specifically for storage.2-5.2 2.6.7.6.2 The amount of space and type of utilities provided shall will vary with accommodate the type of equipment used in the hospital and the types of outside contracts used for equipment maintenance. and specimens AF 2. 2.1 Common Elements for Hospitals (2) These storage areas shall be located to permit direct movement of the equipment to the exterior of the facility. equipment.7.7 Morgue Services 2.4 General Maintenance Shop(s) If required by the functional program. 2.2 This office shall have file space and provisions for protected storage of facility drawings. This shall contain the following: (1) A work counter with a hand-washing station (2) A storage space for supplies. *2.6.1-5.6.2 2.7 2.5 Medical Equipment Shop 2.2.1-5.1 Location. as specified in the functional program.1 Refrigerated facilities for body holding.1-5.6 Engineer’s Office DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 33 .2-5.2. a general maintenance shop(s) shall be provided to accommodate repair and maintenance requirements.1-5.

2 2.1-6.2.5 Provision for drinking water 2.1-6. 2.3 2. 2.1.4 Gift Shop R 2.1-6. 2.1.2.1-6.1-6.2 Reception Area or Lobby This shall include the following: 2.1-6.2.1-6.1 General 2.2 Public and administrative areas in all hospital types shall include the areas in Section 2.1.1.7.1-6.1-6.1 A counter or desk for reception and information Access to information 2.1. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 34 .1 2.1.2 Public waiting area(s) 2.1.2.1-6.3 Public toilet room(s) facilities 2.1-6.3 Public Waiting Rooms or Areas All other public waiting rooms or areas serving more than 15 people shall include a toilet room immediately accessible to the waiting room or area.4 2. For other requirements.2.1.2.2.4 Access to make local phone calls 2. and accessible to the disabled.3 2.1.2.1-6.1.1-6.2.2.2.1. D 2.1-6.1-6.3 2.2 2.3 Environmental services facilities.1 2.2-5. 2.1-6 Public and Administrative Areas *2.2.1-6. 2.2.2.1-6.1-6.1-5.2-5.2.1.2 Shared lobbies shall be permitted in multi-occupancy buildings.2.3 Body-Holding Room If autopsies are performed outside the facility.2. illuminated drop-off or entrance shall be reachable from grade level.1-6.1-6.1-6. AF 2.1-6.1.1 All hospital types shall provide for the reception and accommodation of the visiting public and for the administrative functions of the facility.2.2. a well-ventilated.2 2.7.2.1-6.1-6.1 Vehicular Drop-Off and Pedestrian Entrance This shall be at grade level.7. see specific facility chapters.1-5. sheltered from inclement weather.7.2.1. 2. A housekeeping service sink or receptor shall be provided for cleanup and housekeeping.1-6.2 Location Public areas shall be clearly identified and located to accommodate persons with disabilities. temperature-controlled body-holding room shall be provided.1 A minimum of one well-marked.1 Common Elements for Hospitals 2.2. *2.1.5 2.2.1-6.1 Public Areas The following shall be provided.2.1 Application 2.

1-6. related to social service.1 Admissions Area 2.4 2. the medical records area shall either be restricted to staff movement or located so it is remote from treatment and public areas.1 Reserved If required by the functional program for initial admission of inpatients. medical and financial records. credit.3. see specific facility chapters.2 Space requirements 2. 2.5. the area an admissions area shall be provided and shall include: 2.1-6.1 A separate waiting area for patients and accompanying persons 2. 2.2.5 Reserved 2. *(2) Storage area(s) shall be provided as required by the functional program for forms/documents.3.5 Medical Records Area *2.3 2. Shared use of an office or consultation room for this purpose shall be permitted. (2) Records shall be protected from loss or damage as required by the functional program.1-6.1-6.1-6.1-6.1-6.1-6.4 Multipurpose Room(s) For requirements.2.3.1-6.4.3 General or Individual Office Office(s) space shall be provided for general and individual offices for business transactions. (1) Space shall be provided as required by the functional program. electronic media. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 35 . D 2.1 Location.2. 2.3 Security R 2. *2. and admissions.3.3.2 Several services or departments shall be permitted to share one multipurpose room.2.3.1-6.1-6.1 At least one private multipurpose or consultation room shall be provided. a gift shop with toiletries and other items available for purchase shall be provided.1-6. (1) Provisions shall be made for securing medical records of all media types used by the facility.1-6.2 Interview Space Space(s) shall be provided for private interviews shall be provided separate from public and patient areas.3 2.1-6.5.1.2 Administrative Areas The following shall be provided if required by the functional program: *2.1 Common Elements for Hospitals If required by the functional program.1-6.2 2. and administrative and professional staff. To maintain confidentiality of records.4.1-6.1-6. AF *2. or electronic storage devices used to create medical records.1-6.4.3.3.3.1-6.3 Shared use of an office or interview room for this purpose shall be permitted.1.3. 2.2 A work counter or desk for staff *2.3.1-6.3.2.2.5.3.

shops.1-7.1 Common Elements for Hospitals 2. Separate freestanding buildings for nonpatient contact areas (e. and other fire prevention and fire protection measures. 2.2 2. Compartmentation.2 Fire prevention/protection measures.1-7. in accordance with accepted engineering practices and standards as prescribed by local jurisdiction or the International Building Code.1.1-1.1-7. 2. These shall be in addition to. automatic extinguishing systems.1.2. the International Building Code or NFPA 5000 shall be used.1-7. the boiler plant.1 Building Codes and Standards 2. shall comply with NFPA 101.1 2.1.1-5 (Building Codes and Standards) for exceptions. with the following stipulation. see 1.4 Insulation materials. exits.1.1-7. the requirements contained herein.1.6 2. For requirements.3.1-7.2 through 1.1. including those within existing facilities. shall have a flame-spread rating of 25 or less and a smokedeveloped rating of 150 or less when tested in accordance with NFPA 255.) See 1. and toilets shall be provided for employees and volunteers as required by the functional program..2. and separate from.1-6.1.1 Every building and portion thereof shall be designed and constructed to sustain all live and dead loads.2. If there are no applicable local codes.2. 2. 2.1-1.6 Equipment and Supply Storage Storage shall be provided for office equipment and supplies as required by the functional program. including seismic and other environmental forces. Construction shall comply with the applicable requirements of NFPA 101.1-5 (Building Codes and Standards). in new construction and renovation.1 General. (For more information. For requirements.2.2. *2.1-7. This requirement does not apply to minor quantities of wood or other trim (see NFPA 101) or to wall coverings less than 4 millimeters thick applied over a noncombustible base. lounges.1.5. (The FSES is intended as an evaluation tool for fire safety only. Interior finish materials shall comply with the flame-spread limitations and smoke-production limitations in NFPA 101.1.1.4. and general storage) shall be built in accordance with applicable building codes for such occupancies. see specific facility chapters.1-7.1-7 Design and Construction Requirements 2. AF 2.2. 2. fire alarms. see specific facility chapters.1-6. unless sealed on all sides and edges with noncombustible material.3 Provisions for Disasters For further requirements.3. for more information.1-6.1. and the requirements of authorities having jurisdiction.1-7. those required for the public.2-6.1.g.1-7. Use of the Fire-Safety Evaluation System (FSES) is permitted. Building insulation materials.3 Support Areas for Staff and Volunteers Lockers. subject to AHJ approval.3 Interior finishes.4 2. see 1.1 Building Codes—Reserved 2.2 Freestanding buildings.1-7.1.2 Construction Requirements D R 2.1-7. *2.) DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 36 .3. laundry. see 1.2.1-6.

For corridor width requirements.1-7.1-7. surfaces.3. and Furnishings) of the Guidelines in the area of work. at a minimum.) *2.1-7.1. (2) Where facilities may be subject to wind or water hazards.2.2 Ceiling height. An emergency-radio communication system shall be provided in each facility. provision shall be made to ensure continuous operation.2. and furnishings herein.2 Architectural Details D R *2.1. (1) This system shall operate independently of the building’s service and emergency power systems during emergencies.2. Architectural details. with the following exceptions: *(1) The minimum ceiling height in cCorridors . to comply with applicable requirements of the Existing Health Care Occupancies section of NFPA 101. 2. and Furnishings 2.1 General.1. Surfaces.1 Common Elements for Hospitals 2. shall comply with the requirements for architectural details.1-7. Where renovation work is undertaken. including additions and alterations.2 Renovation. The minimum ceiling height shall be 7 feet 10 inches (2. *2.1 General 2. storage rooms. retained portions of existing facilities that are not required to be totally modernized shall be permitted.1-7. and portable equipment shall not restrict corridor traffic or reduce the corridor width below the minimum standard. (See Section 1. every effort shall be made to meet the standards in Section 2. 2.2. (3) Additional communication capabilities are required of facilities containing a formal community emergency-trauma service or other specialty services (such as regional pediatric critical care units) that utilize staffed patient transport units.2 Emergency communication system. surfaces. Surfaces. reduction of corridor width to 5 feet (1. (2) Location of items such as drinking fountains. toilet rooms. (1) Unless specifically approved. 2.1-7.2.2 Architectural Details.2.3. hospitals shall not be built in areas subject to damage or inaccessibility due to natural floods.1. etc.2.1-7.2 (Architectural Details.1-7. (2) The system shall have frequency capabilities to communicate with state emergency communication networks. If it is not possible to meet the standards. and furnishings in new construction projects.39 meters). Ceilings in these and AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 37 .1-3 concerning existing facilities where total compliance is structurally impractical. vending machines.52 meters) shall be permitted.2. (1) In outpatient suites and in areas not commonly used for patient bed or stretcher transportation. the authority having jurisdiction (AHJ) shall be permitted to grant approval to deviate from a requirement. see applicable building codes.1 Corridor width.1-7. If approved by authorities having jurisdiction.1-7.1 New construction.2. telephone booths.

1-7. (2) Rooms with ceiling-mounted equipment/light fixtures.2. rails. they shall be permitted to restrict the minimum corridor width required by applicable building codes. and other rooms containing ceilingmounted equipment or ceiling-mounted surgical light fixtures.03 meters) shall be permitted. shall be not less than 7 feet 6 inches (2. In areas other than those designated in Section 2.74 meters).2. the The door opening to patient rooms inpatient bedrooms shall have a minimum clear width of 3 feet 8 inches (1.1-7. and delivery rooms.36 AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 38 . Ceilings The minimum ceiling height in radiographic. of each door opening. (ii) When sliding doors with breakaway features are used for clinical access in the full open position. normally unoccupied spaces may be reduced. *(2) Door openings. and wheeled beds (i) Door openings to other rooms used for stretchers (including hospital wheeled-bed stretchers) and/or wheelchairs shall have a minimum clear width of 2 feet 10 inches (86.12 meters) with a frame that is and a minimum clear height of 7 feet (2. Door opening dimensions shall permit the use of a standard-size door leaf where only one door is required.2. procedure. rooms. 2. (b) In renovation projects. To provide clearance for movement of beds and other equipment.34 2. The clear width needed to accommodate access by patients and patient equipment has been taken into consideration in calculating the door opening dimensions given. *(b) Access for stretchers.29 meters) in height.1-7.2. operating.13 2. every effort shall be made to have ceiling heights or clearances meet the above minimum standards.3 Doors and door hardware D R (1) Door type (a) All doors between corridors. In these Guidelines. (4) Clearances (a) The minimum height above the floor of sSuspended tracks. Existing door openings with a minimum clear width of 2 feet 10 inches (86. If it is not possible to meet the above minimum standards.2.14 meters) when the equipment or fixtures are in the stowed position.29 meters) above the floor. the The door openings given opening sizes given are the nominal minimum clear dimensions. (3) Seclusion treatment rooms shall have a minimum ceiling height of 9 feet (2.14 meters) high. (ii) Renovation. clearances of 6 feet 8 inches (2. which shall be no less than 7 feet (2.3 (1)(b) below. *(b) Sliding doors (i) Use of mManual or automatic sliding doors with tracks and hardware that can easily be cleaned shall be permitted where fire and other emergency exiting requirements are not compromised and where cleanliness of surfaces can be maintained. Ceiling heights in small. (a) Inpatient bedrooms Patient rooms (i) New construction.2 (4)(a).2. or spaces subject to occupancy shall be of the swing type or shall be sliding doors as noted in Section 2.2. and pipes located in the traffic path for patients in beds and/or on stretchers. including those in inpatient service areas.1 Common Elements for Hospitals normally unoccupied spaces shall be not less than 7 feet 6 8 inches (2. shall be of sufficient height to accommodate the equipment or fixtures and their normal movement equipment mount height. the AHJ shall be permitted to grant approval to deviate from these requirements. /wheelchairs. *(iii) Sliding doors shall not have floor tracks.36 centimeters) may be considered for acceptance where patient safety or access to the area is not adversely affected.

12 meters) and a minimum clear height of 7 feet (2.2. *(b) Where the room opens onto a public area or corridor.2. (1) Thresholds. showers. (c) If required by the functional program. design of door hardware on patient toilet rooms in psychiatric nursing units shall be permitted to allow staff to control access.1-7. or (iii) A door equipped with emergency rescue hardware.4 Thresholds and expansion joints. shall not be permitted to swing into corridors as permitted by applicable building codes. state. except those in behavioral health units and to spaces such as small closets not subject to occupancy. every effort shall be made to meet the above minimum AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 39 . (c) Door protection shall be used provided as required by the functional program. Door and hardware finishes shall be selected to withstand cleaning and impact damage. and federal requirements the Americans with Disabilities Act Guidelines. and federal requirements. (3) Door swing. state.14 meters). (2) Expansion and seismic joints shall be constructed to restrict the passage of smoke.16-centimeter) diameter sphere.1 Common Elements for Hospitals centimeters) and a minimum clear height of 7 feet (2.2.14 meters). (b) Lever hardware shall be selected for ease of use.2. *2. *(2) (1) Operable windows are not required in patient rooms. the minimum net glazed area shall be no less than 8 percent of the floor area of the room served. (4) Where renovation work is undertaken.) (4) Door hardware (a) Door hardware shall comply with all local. state. (Large walk-in-type closets are considered inhabitable spaces. (ii) Door openings to other rooms used for wheeled beds shall have a minimum clear width of 3 feet 8 inches (1. sitz baths. operation of such windows shall be restricted to inhibit possible escape or suicide. the windows shall be provided with either stop limit/restrictor hardware or an open guard/screen that does not permit passage of a 4-inch (10. *(5) Door and door hardware finishes. and expansion/seismic joints and covers shall be flush with the floor surface to facilitate the use of wheelchairs and carts meet all local. visual privacy shall be maintained when emergency rescue hardware is used.2. *(1) Each patient room shall be provided with natural light by means of a window to the outside. in a manner that might obstruct traffic flow or reduce the required corridor width. (3) (2) When a window is required. D 2.5 Windows R (6) Doors for patient bathing/toilet facilities (a) Rooms that contain bathtubs. or (iv) A sliding door where permitted by the AHJ. and/or water closets for patient use shall either have one of the following: (i) Two separate doors separated by a horizontal distance equal to one-half the length of the maximum overall diagonal dimension of the room. (c) All other door openings shall comply with all local. and federal requirements. (ii) A door that swings outward. Doors. If operable windows are provided in patient rooms or suites.1-7.

and federal requirements. NFPA 101 contains additional requirements for glazing in exit corridors.52 meters] above the finished floor) (b) Wall wall openings in active areas such as recreation and exercise rooms. (2) Sinks. only glazing within 1 foot 6 inches (45.48 centimeters) of a door jamb (with a bottom-frame height of less than 5 feet [1. wired glass. (3) Anchoring. 2.2. More information about the number and placement of hand-washing stations and hand sanitation dispensers can be found in Section 1.1 Common Elements for Hospitals standards.1-7. D R *2. state. unless otherwise required for fire safety and interior windows and doors.2 (ICRA Considerations—Design elements). (b) Interior windows and doors. break-resistant material.2. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 40 .1-7. and 4 of these Guidelines.3. and in facility type chapters in Part 5. (c) Hand-washing stations in patient care areas shall be located in clearly visible. state. In renovation projects.7 Glazing materials.2. unobstructed areas (not hidden behind cubicle curtains. or doors or located in areas used for equipment/material storage). lights.6 Insect screens. or plastic.2. including those in pediatric and psychiatric unit corridors. Lavatories and hand-washing stations shall be securely anchored to withstand an applied vertical load of not less than 250 pounds (113.1-8. (3) (2) Safety glass–tempered or plastic glazing materials shall be used for the following: (a) Shower doors and bath enclosures.2 (Hand-washing station sinks). including those in pediatric and psychiatric unit corridors (4) (3) Flame-spread ratings. especially in buildings without sprinkler systems. 2.1. see Section 2. sidelights. *(b) The number and placement of both hand-washing stations and hand sanitation dispensers shall be determined by the ICRA. (2) (1) Fixed glazing with polycarbonate or laminate on the inside face or any glazing that meets or exceeds the requirements for Class 1. (1) General (a) Hand sanitation dispensers shall be provided in addition to hand-washing stations. Plastic and similar materials used for glazing shall comply with the flamespread ratings of NFPA 101 all local.2. (1) Glazing materials shall meet all local.4 per ASTM F1233-08: Standard Test Method for Security Glazing Material and Systems Safety glass.8 Hand-washing stations (5) (4) Renovation. or federal requirements. 3. break-resistant material that creates no dangerous cutting edges when broken shall be used in the following: (a) Glass doors.2-3. or plastic. and windows located within 12 inches (30..2. columns.2.1-7. If it is not possible to meet the above minimum standards. the AHJ shall be permitted to grant approval to deviate from this requirement. etc. Windows and outer doors that frequently may be left open shall be equipped with insect screens. borrowed lights. wire glass.4 kilograms) on the fixture front.4.72 centimeters) of the floor must be changed to safety glass.2. Provisions of this section concern safety from hazards of breakage. For these requirements. in the common elements chapters in Parts 2.

See Section 1. (a) Hand-washing stations shall include a hand-drying device that does not require hands to contact the dispenser.2. patients. (i) Single-lever or wrist blade devices shall be permitted. or solid-surface materials. (b) These provisions shall be paper or cloth units enclosed to protect against dust or soil and to ensure single-unit dispensing. bathtubs.81 centimeters).88 453. and food handlers shall be trimmed with valves that can be operated without using hands. shall be sufficiently anchored to sustain a concentrated load of 250 pounds (113. *(2) Grab bars shall be provided in all patient toilets. Hot air dryers shall be permitted.1-7.40 kilograms). or other areas where asepsis control would be lessened by hair combing.1-7. (5) (4) Fittings (a) General h Hand-washing stations used by medical and nursing staff. D *2.1 (Design Standards for the Disabled).10 Handrails R *2. at minimum the substrate shall be marine-grade plywood (or an equivalent material) with an impervious seal.9 Grab bars (8) (7) Mirror. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 41 . nurseries. showers. (3) Grab bars installed in areas intended for use by bariatric patients (as described in the functional program) shall be designed and installed to sustain a minimum concentrated load of 800 1. provided that installation precludes possible contamination by recirculation of air. (c) If provided. the Americans with Disabilities Act Guidelines. (7) (6) Cleansing agent.2. *(b) If hand-washing station sinks basins are set into plastic laminate countertops. clean and sterile supply areas. and sitz baths at a wall clearance of 1. (6) (5) Provisions for drying hands.1-7. Provisions for hand drying shall be required at all hand-washing stations except scrub sinks.59 kilograms). (ii) Blade handles used for this purpose shall be at least 4 inches (10.2. state.2. Hand-washing stations shall include liquid or foam soap dispensers. (b) Sensor-regulated water fixtures shall meet user need for temperature and length of time the water flows.2.4. Electronic faucets shall be capable of functioning during loss of normal power.1-4. and federal requirements. (2) (3) Grab bars. stainless steel. scrub sinks. (iii) Care shall be taken in The location and arrangement of fittings to shall provide the clearance required for operation of blade-type handles. (c) Sensor-regulated faucets with manual temperature control shall be permitted. (1) Grab bars in all areas required to comply with the Americans with Disabilities Act shall comply with all local. Mirrors shall not be installed at hand-washing stations in food preparation areas.000 pounds (362.5 inches (3. the public.2 (4) Hand-washing station basins/countertops (a) Hand-washing station basins/countertops shall be made of porcelain. hand towels shall be directly accessible to sinks.2 centimeters) in length.2.1 Common Elements for Hospitals (4) 2. including those that are part of such fixtures as soap dishes.

exercise rooms.1-4. and similar spaces where impact noises may be generated shall not be located directly over patient bed areas or delivery and operating suites.2. unsealed (open) water features shall not be permitted. shall comply with the Americans with Disabilities Act (ADA) Guidelines. shall be insulated to prevent the floor surface above and below and /or the adjacent walls of occupied areas from exceeding a temperature of 10oF (6oC) above ambient room temperature. Testing is to be coordinated with local authorities to prevent duplication of test observations or construction inspections. (4) (3) Handrails or lean rails and fasteners shall be completely smooth and free of rough edges. (2) Provision shall be made for testing completed installations before use.2. floors.2. See Section 1.5 for information on recommendations and code requirements for surface selection.13 Protection from heat-producing equipment. (3) (2) As determined by the functional program.1-7.2. D 2. state. unless special provisions are made to minimize such noise.1-7. (1) See A1. 2.1-7. Rail ends shall return to the wall. and ceiling construction in patient areas.3. 147.3 Surfaces R (2) The noise reduction criteria shown in Table 1. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 42 . Installation of indoor. and 151 and all local. *2.2. Maintenance and performance shall be considered when selecting surface and furnishing materials and products for use in hospitals. handrails shall be provided to assist mobility-impaired persons.1.1-7. 2. Rooms containing heat-producing equipment.2. (6) Handrails shall be made of a non-porous material.1 Common Elements for Hospitals (1) Handrails shall be installed on both sides of the patient use corridor. and federal requirements. AF *2.1-7.2. 2. state.2. (1) Radiation protection requirements for x-ray and gamma-ray installations shall conform with National Council on Radiation Protection & Measurements (NCRP) reports 102. applicable local requirements. and federal codes and standards. such as boiler or heater rooms or laundries.14 Decorative water features.12 Noise control (1) Recreation rooms.1 Surface selection c Characteristics and criteria for selection of surface materials.2. (2) Handrails shall be located in accordance with all local. (5) (4) Handrails or lean rails shall have eased edges and corners if a mitered corner condition exists.2-3 (Design Criteria for Minimum Sound Isolation Performance Between Enclosed Rooms) shall apply to partitions. All defects shall be corrected before approval.2.11 Radiation protection.1 (Design Standards for the Disabled).2.1-7. equipment rooms.2-3.2.

environmental services rooms with mop sinks. shower and bath areas). *(2) (4) Flooring surfaces shall provide sSmooth transitions shall be provided between different flooring materials. including tile joints. or residents utilizing orthotic devices. The slip-resistance coefficiency ratings of flooring surfaces shall be appropriate for the area of use—for dry or wet conditions and for use on ramps. *(3) (5) Flooring surfaces. that are to be slip-resistant shall be in accordance with ASTM C1028: Standard Test Method for Determining the Static Coefficient of Friction of Ceramic Tile and Other Like Surfaces by the Horizontal Dynamometer Pull-Meter Method. (b) The floors of soiled workrooms. readily cleanable. (3) All flooring surfaces shall allow easy movement of all wheeled equipment required by the functional program. walkers. and in other areas as required by the functional program. in areas that include water for patient services. kitchens. firm. (5) (7) Food preparation areas (a) Floors in areas used for food preparation and assembly shall be water-resistant. on ramps.g. wheeled carts. shall be resistant to food acids. that might create hazards or interfere with the operation of lifts. and appropriately wearresistant for the location. (7) (11) Joints for floor openings for pipes. (6) Slip-resistant flooring products shall be used in wet areas (e.2. Joints of structural elements shall be similarly sealed. including those on stairways. ducts. (b) Floor surfaces. shall be stable. (c) Floor construction in dietary and food preparation areas shall be free of spaces that can harbor pests. in entries from exterior to interior space.2.1-7. public bathrooms. Carpet tiles shall be affixed to the floor per the manufacturer’s recommendations. and conduits shall be tightly sealed.1-1 for a list of surfaces and furnishings categories in typical hospital nursing units. D R *(6) (10) Carpet and sheet carpet with padding in patient areas shall be glued down or stretched taut and free of loose edges or wrinkles. *2.. flooring materials shall not be physically affected by germicidal or other types of cleaning solutions. *(9) Highly polished flooring or flooring finishes that create glare shall be avoided. tThe floors and wall bases of all operating AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 43 .3. wheelchairs. *(2) Flooring surfaces shall allow for ease of ambulation and self-propulsion.1 Common Elements for Hospitals (2) See Table 2. in stairways. (4) (8) In all a Areas subject to frequent wet-cleaning methods (a) In all such areas. (8) (12) In new construction or major renovation work.2 Flooring *(1) Selected flooring surfaces shall be easily maintained. and slip-resistant and comply with Americans with Disability Act (ADA) standards. and other areas subject to frequent wet cleaning shall be monolithic and the flooring material shall be carried up the walls to provide an integral coved wall base tightly sealed to the wall and constructed without voids.

tightly sealed to the wall.and rodent-harboring spaces. nonperforated.3 Walls.g. and trim. airborne infection isolation rooms. public bathrooms) shall be monolithic and coved with the floor. wall finishes shall be smooth. and other areas subject to frequent wet cleaning shall also be homogenous. kitchens. capable of withstanding cleaning with chemicals.1-7.1-7. and minor surgical procedure rooms) shall be smooth. soiled utility/holding. kitchens. IV and chemotherapy preparation rooms. finish. In the vicinity of plumbing fixtures. open joints. cesarean delivery rooms.3.g. cardiac cath labs. shall be free of insect.g. AF (1) Wall finishes (a) Wall finishes shall be washable. shall not create ledges or crevices. soiled and clean utility rooms. cesarean delivery rooms. and minor surgical procedure rooms shall be able to withstand chemical cleaning. (b) Wall bases in areas that require frequent wet cleaning (e. dietary facilities. including the joints between the walls and the floors. or crevices that may retain or permit passage of dirt particles. specialized radiographic rooms. In these areas. but may have tightly sealed joints. isolation rooms.. environmental services closets) shall be monolithic and all seams shall be covered and/or sealed.2. (1) Ceilings shall be provided in areas occupied by patients and in rooms/areas used for clean utility/supply/linen.1 Common Elements for Hospitals rooms. (b) Wall finishes in operating rooms. cath and EP labs. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 44 (15) Floors in areas and rooms in which flammable anesthetic agents are stored or administered shall comply with NFPA 99. interventional radiology. where used. and laboratories and shall be cleanable with routine housekeeping equipment. wall construction. and constructed without voids. nonabsorptive. protruding corners shall be avoided.2. D R 2. (5) (d) Wall protection devices and corner guards shall be durable and scrubbable. interventional imaging rooms. environmental services rooms with mop sinks. central services. clean corridors. protective environment rooms. IV and chemotherapy preparation room. central sterile supply spaces. (14) The floors and wall bases of kitchens. 2. urological.. scrubbable. (9) (13) Airborne infection isolation and protective environment rooms. .3. (2) Semirestricted areas (a) Ceiling finishes in semirestricted areas (e. pharmacy. such as angiography. endoscopy procedure rooms. and have an integral base.4 Ceilings (4) (c) Sharp. nourishment. IV and chemotherapy preparation rooms. (3) Wet areas and areas that require frequent wet cleaning (a) Wall surfaces in wet areas (e. and sterile processing rooms shall be free of fissures. Acoustic and lay-in ceiling. wall bases. be monolithic and joint free. These rooms and anterooms (where provided) shall have seamless flooring with integral coved base. and without crevices that can harbor mold and bacterial growth.. and water-resistant. and cystoscopy.2. and wall protection (2) Dietary and food preparation areas. scrubbable. soiled workrooms.

lighting fixtures. See Section 1. Perforated. To minimize entry of rodents and insects.1 (Design Standards for the Disabled) Americans with Disabilities Act (ADA) Guidelines. (2) A work space. and other appurtenances shall be of a tamper-resistant type.1-7. (2) Hand-washing basins/countertops (a) Hand-washing basins/countertops shall be made of porcelain. or highly textured tiles are not acceptable. and federal requirements.1-7.1 Casework.1-4. 2.1 for characteristics and criteria that apply to selection of both surfaces and furnishings to be used in hospitals. work counter. millwork. state.1-7. In psychiatric patient rooms. and conduits shall be tightly sealed.4. work area. 2. scrubbable. 2. nonperforated. *(3) Restricted areas (a) Ceilings in restricted areas (e.4.g. (b) Ceiling finishes shall be scrubbable and capable of withstanding cleaning and/or disinfecting chemicals. or work surface. the ceiling and air distribution devices.2. it shall be gasketed or each ceiling tile shall weigh at least one pound per square foot to prevent the passage of particles from the cavity above the ceiling plane into the semirestricted environment. toilets. and seclusion rooms. D R 2.2. millwork. (4) Dietary and laundry areas (a) Either a sealed monolithic and scrubbable gypsum board ceiling or a lay-in ceiling shall be provided. (b) If a lay-in ceiling is provided.2.6 Psychiatric patient locations. Omission of suspended ceilings in mechanical and electrical rooms or spaces shall be permitted unless required for fire safety purposes.4.2. wherever required in Part 2. stainless steel. it shall include the following: (i) A rust-free.2. and built-ins (1) Cabinetry Casework.2. tegular. serrated cut.3. *(b) If hand-washing basins are set into plastic laminate countertops.4 Furnishings 2. and capable of withstanding cleaning with chemicals (5) Mechanical and electrical rooms.1-7. (c) All access openings in these ceilings shall be gasketed.1 Common Elements for Hospitals (b) If a lay-in ceiling is provided.2. sprinkler heads.2.1-7. ducts.3. shall provide a minimum of 4 square feet (xx square meters) of contiguous clear surface for each person AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 45 . at minimum the substrate shall be marine-grade plywood (or an equivalent material) with an impervious seal.1 Characteristics and criteria for selection of furnishing materials.3.5 Penetrations. joints where floors and walls are penetrated by pipes. and built-ins and cabinetry door hardware shall comply with all local. Cracks or perforations in these ceilings shall not be permitted.1-7. See A2. non-corrosive grid (ii) Ceiling tiles that weigh at least one pound per square foot and are smooth.1-7.. operating rooms) shall be of monolithic construction. Joints of structural elements shall be similarly sealed. or solid-surface materials.2 2. nonabsorptive.

2. wipeable.1 Reserved *2. Smooth-surfaced.4.4. D R 2. and staff to operate.4 2. 2. Details for cost-effective implementation of design features are interrelated and too numerous (as well as too basic) to list individually.2.1 Common Elements for Hospitals programmed to work in the space at the same time.1-7. kitchen equipment and similar types of furnishings shall be installed so they can be routinely moved for cleaning. visitors.2.1-8.2. and where sufficient access is not provided to permit cleaning under and behind the unit.1-7. *(1) (2) Furniture and equipment in clinical areas that is not easily moved by environmental services personnel.2 Furniture and equipment (1) Furniture shall be upholstered with impervious materials according to the functional program and an ICRA. The mechanical system shall be designed for overall efficiency and appropriate lifecycle cost.1-7. *2.1-7. (3) Window treatments shall be selected for ease of cleaning.1. *(1) Efficiency. medicine and clean supply dispensing units. This section of the Guidelines includes additional requirements.1-8 Building Systems 2.1 General Basic HVAC system requirements are defined in Part 6 (ANSI/ASHRAE/ASHE Standard 170-2013 2008: Ventilation of Health Care Facilities). Ventilation.2.3 2.4.2.1-8.1 Mechanical system design *(5) Use of fabric privacy curtains shall be permitted if they are washable at a temperature of 140–160ºF (60–71ºC).2 Heating. shall be sealed against floors and adjoining walls. (4) Fabric drapes and curtains shall not be used for window treatments. sheers. nonpleated window treatments shall be used.3 Window treatments and privacy curtains in patient rooms and other patient care areas DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 46 . and Air-Conditioning (HVAC) Systems *2.2.4. (2) Window treatments shall not compromise patient safety and shall be easy for patients. (3) Equipment such as refrigerators. or other patient-controlled window treatments shall be provided within patient rooms to control light levels and glare. (3) Built-in seating shall be upholstered with impervious materials according to the functional program and an ICRA.1-8. AF *2. (1) Blinds.1-8.

programmed controls for unoccupied periods (nights and weekends. All rooms and areas used for patient care shall have provisions for ventilation. Different geographic areas may have climatic and use conditions that favor one system over another in terms of overall cost and efficiency.1-8.2 Ventilation and space-conditioning requirements. building mass.2 HVAC Requirements for Specific Locations The requirements in this section apply when a specific hospital facility includes these patient care areas. If system modifications affect greater than 10 percent of the system capacity. heating.1 Common Elements for Hospitals (2) Air-handling systems with unitary equipment that serves only one room. (3) Vibration isolators. The energy-saving potential of variable-air-volume systems is recognized. load shedding. as noted in 2. and piping shall be mounted on vibration isolators as required to prevent unacceptable structure-borne vibration. (d) Facility design considerations shall include site.5.). Any system used for occupied areas shall include provisions to avoid air stagnation in interior spaces where thermostat demands are met by temperatures of surrounding areas. *2. (6) Acoustic considerations *(a) Outdoor mechanical equipment shall not produce sound that exceeds 65 dBA at the hospital façade.1 (Filter efficiencies).1 Airborne infection isolation (AII) rooms. Mechanical equipment. . Table 7-1. etc.) (f) VAV systems.1-8. (Use of mechanically circulated outside air does not reduce the need for filtration.1.1-8. D R 2. See Part 6 (ASHRAE 170) for further requirements. Supply and return mains and risers for cooling.2.1-8. ductwork. designers shall utilize pre-renovation water/air flow rate measurements in the affected zones to verify that sufficient capacity is available and that renovations have not adversely affected flow rates in nonrenovated areas. (1) Although natural ventilation for nonsensitive areas and patient rooms (via operable windows) shall be permitted. 2. and steam systems shall be equipped with valves to isolate the various sections of each system. configuration.2.2. Each piece of equipment shall have valves at the supply and return ends. *(b) Outdoor mechanical equipment shall not produce sound that exceeds daytime and nighttime noise limits at neighboring properties as required by local ordinance. orientation. and natural ventilation shall be considered.2.2.2. (4) System valves. These units shall be permitted for use as recirculating units only. (b) In no case shall patient care or safety be sacrificed for energy conservation. *(e) Air-handling systems shall be designed with an economizer cycle where appropriate to use outside air. fenestration. and other features relative to passive and active energy systems. All outdoor air shall be provided by a separate central air-handling system with proper filtration. A well-designed system can generally achieve energy efficiency at minimal additional cost and simultaneously provide improved patient comfort. (5) Renovation. site and climatic conditions permitting. unless special consideration is given to façade sound isolation design in impinged areas. and the requirements herein are intended to maximize appropriate use of those systems. The AII room is used for isolating the airborne AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 47 (a) Recognized engineering procedures shall be followed for the most economical and effective results. (c) Use of recognized energy-saving mechanisms such as variable-air-volume (VAV) systems. mechanical ventilation shall be provided for all rooms and areas in the facility in accordance with Part 6.

.1-8. air supply for cesarean delivery rooms shall be in accordance with Section 7.2.2. justify special designs. (3) Standards for special procedures. (2) HVAC equipment shall be of a type that minimizes the need for maintenance within the room.2.5 Operating and delivery rooms D R 2.1 Common Elements for Hospitals spread of infectious diseases (e.2. ventilation outlets. Special consideration shall be given to the type of heating and cooling units. Where extraordinary procedures.2.1-8. 2. airflow shall be from the corridor into the anteroom and from the anteroom into the patient room. (b) During unoccupied hours. (b) In addition to the required low return (or exhaust) air grilles. and appurtenances installed in patient-occupied areas of psychiatric units and psychiatric hospitals.6 Bronchoscopy procedure rooms (1) Air supply (a) In new construction and major renovation work. operating and delivery room air change rates may be reduced. (4) See Part 6 (ASHRAE 170) for additional ventilation requirements. (1) Use of AII rooms for routine patient care during periods not requiring isolation precautions shall be permitted.4 Psychiatric patient areas.2. 2.1 (Class B and C Operating Rooms) of Part 6 (ASHRAE 170). (2) Each AII room shall have a permanently installed visual mechanism to constantly monitor the pressure status of the room when occupied by a patient patients with an airborne infectious disease. varicella. measles.2. . such as organ transplants. (4) See Part 6 (ASHRAE 170) for additional ventilation requirements.g. Differential pressure requirements shall remain unchanged when the AII room is used for routine non-infectious patient care.4.2. The mechanism shall monitor the pressure differential between the AII room and the corridor.2.1-8. whether or not there is an anteroom between the corridor and the AII room.1-8. such grilles placed high on the walls shall be permitted.1-8. except during maintenance and conditions requiring shutdown by the building’s fire alarm system. (2) Ventilation rates *(a) Operating and delivery room ventilation systems shall operate at all times. installation shall properly meet performance needs as determined by applicable standards.2.3 Reserved 2.2. provided the positive room pressure is maintained as required in Part 6. The following shall apply: (1) All convector or HVAC enclosures exposed in the room shall be constructed with rounded corners and shall have enclosures fastened with tamper-resistant screws. These special designs should be reviewed on a case-by-case basis. tuberculosis). AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 48 (3) When an anteroom is provided.2 Reserved 2.

and the space above the sterilizer door.1-8. When these areas are not enclosed. The ventilation system for inhalation anesthesia storage rooms shall conform to the requirements for medical gas storage or transfilling as described in NFPA 99.62 meters) away from any air intake.1 Common Elements for Hospitals (1) Differential pressure shall be a minimum of 0.2. (Refer to 29 CFR 1910.1-8.2. as well as the aerator. The ventilation system for the space that houses ethylene oxide (ETO) sterilizers shall be designed as follows: (1) A dedicated exhaust system (i.2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 49 . an exhaust drain cap shall be provided (coordinate with local codes). (1) Exhaust hoods handling grease-laden vapors in food preparation centers shall comply with NFPA 96. 2.2. 2. (b) The relief valve shall be terminated in a well-ventilated. fire-extinguishing systems.1-8. 2. D R 2.10 Food preparation centers (4) An audible and visual alarm shall activate in the sterilizer work area.01” water gauge (2. 2. (4) Food preparation centers shall have ventilation systems whose air supply mechanisms are interfaced appropriately with exhaust hood controls or relief vents so that exfiltration or infiltration to or from exit corridors does not compromise the exit corridor restrictions of NFPA 90A or the pressure requirements of NFPA 96.2.9 ETO sterilizer space. unoccupied equipment space. an exhaust system not connected to a return air or another exhaust system) shall be provided.e. (2) Local exhaust shall be provided. upon loss of airflow in the exhaust system.2. (a) If the ETO cylinders are not located in a well-ventilated. an exhaust hood shall be provided over the cylinders. including the sterilizer equipment room. AF (2) All source areas shall be exhausted.1-8.1047: Ethylene Oxide (EtO) Standard.2.11 Fuel-fired equipment rooms.7 Emergency and radiology waiting areas. service/aeration areas. (3) Cleanout openings shall be provided every 20 feet (6.10 meters) and at changes in direction in the horizontal exhaust duct systems serving these hoods.5 Pa). unoccupied equipment space. and heat-actuated fan controls.) The exhaust outlet to the outside shall be at least 25 feet (7. (2) All hoods over cooking ranges shall be equipped with grease filters.2. unoccupied equipment space or outside the building. Horizontal runs of ducts serving range hoods shall be kept to a minimum.2. the exhaust air change rate shall be based on the general volume of the space.2.8 Anesthesia storage rooms.1-8. and in a 24-hour staffed location. Rooms with fuel-fired equipment shall be provided with sufficient outdoor air to maintain equipment combustion rates and to limit workstation temperatures.2. (c) If the floor drain to which the sterilizer(s) discharges is not located in a well-ventilated. (3) General airflow shall be away from the sterilizer operator(s)..

1-8. and equipment. If existing lined ductwork is reworked in a renovation project. *(2) Duct humidifiers (a) If duct humidifiers are located upstream of the final filters.1 Return air systems.2. they shall be at least twice the rated distance for full moisture absorption upstream of the final filters. (b) Ductwork with duct-mounted humidifiers shall have a means of water removal.1-8.2. nurseries.1-8.1-8. Insulation. repaired. ventilating. (Material that will not absorb or transmit moisture will not require a separate vapor barrier. and reduce noise. (2) Duct lining shall not be installed within 15 feet (4. (c) Humidifiers shall be connected to airflow proving switches that prevent humidification unless the required volume of airflow is present or high-limit humidistats are provided.1 Common Elements for Hospitals 2. including finishes and adhesives on the exterior surfaces of ducts. piping. protective environment rooms. (d) All duct takeoffs shall be sufficiently downstream of the humidifier to ensure complete moisture absorption. and/or replaced. 2.4. heating. as appropriate.1 General.2. (3) Renovation. When smoke partitions are required.2 Duct linings (1) Duct linings exposed to air movement shall not be used in ducts serving patient care areas operating rooms. (e) Steam humidifiers shall be used.4 HVAC Air Distribution D R 2. return air shall be via ducted systems. located. LDR rooms.2. Insulation on cold surfaces shall include an exterior vapor barrier. shall have a flame-spread rating of 25 or less and a smoke-developed rating of 50 or less as determined by an independent testing laboratory in accordance with NFPA 255. and installed in accordance with the AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 50 . Insulation shall be provided within the building to conserve energy.4. Existing accessible insulation within areas of facilities to be modernized shall be inspected. prevent vapor condensation.1-8. (1) Vapor barrier. This requirement shall not apply to mixing boxes and sound attenuators that have special coverings over such lining. and critical care units.2 HVAC ductwork 2.3. 2. Reservoir-type water spray or evaporative pan humidifiers shall not be used.57 meters) downstream of humidifiers.1-8. protect personnel.2.2.2.3 Thermal Insulation and Acoustical Provisions 2. the liner seams and punctures shall be resealed. (3) Fire and smoke dampers (a) Fire and smoke dampers shall be constructed. (3) Renovation.) (2) Flame-spread rating.3. For patient care areas. delivery rooms. (1) General. and air conditioning zones shall be coordinated with compartmentation insofar as practical to minimize the need to penetrate fire and smoke partitions.

(d) Gases from the scavenging system shall be exhausted directly to the outside.1-8.2. see Part 6 (ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities). (b) Local exhaust systems shall be used whenever possible in place of dilution ventilation to reduce exposure to hazardous gases. (e) Dampers shall be activated in accordance with NFPA 90A. R *2. fumes. (d) Airborne infection isolation rooms shall not be served by exhaust systems incorporating a heat wheel. (c) Fans serving exhaust systems shall be located at the discharge end and shall be readily serviceable. For exhaust system requirements. air supply shall be at or near the ceiling. (b) If air change standards in Part 6 (ASHRAE 170) do not provide sufficient air for proper operation of exhaust hoods and safety cabinets (when in use). or other radiation shall not impair the effectiveness of the protection.2.4. (c) Makeup systems for hoods shall be arranged to minimize “short circuiting” of air and to avoid AF (1) General. or mists. (b) When anesthesia scavenging systems are required. Ducts that penetrate construction intended to protect against x-ray. 2. RFI. combined exhaust systems shall be permitted. (c) Maintenance access shall be provided at all dampers. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 51 . vapors. Installation of switching systems for restarting fans shall be permitted for fire department use in venting smoke after a fire has been controlled. The anesthesia evacuation system may be combined with the room exhaust system. (e) Scavenging systems are not required for areas where gases are used only occasionally. Use of makeup air will avoid dependence upon infiltration from outdoor and/or from contaminated areas. (4) Construction requirements. and detectors shall be interconnected so that damper activation will not damage ducts.2. the gas-collecting system shall be arranged so it does not disturb patients’ respiratory systems. and the specific damper’s listing requirements. Provisions to avoid possible damage to the system due to closed dampers shall be permitted. 90A. magnetic. dampers. supplementary makeup air (filtered and preheated) shall be provided around these units to maintain the required airflow direction and exhaust velocity. (d) All damper locations shall be shown on design drawings. Return or exhaust air inlets shall be near the floor level. etc.4 Ventilation hoods *(1) Exhaust hoods and safety cabinets (a) Hoods and safety cabinets may be used for normal exhaust of a space providing minimum air change rates are maintained and the performance of the hood is not impaired. (c) If a vacuum system is used. (b) Fans. offices for routine dental work. such as the emergency department. provided the part used for anesthesia gas scavenging exhausts directly to the outside and is not part of the recirculation system.1 Common Elements for Hospitals requirements of NFPA 101.3 Exhaust systems D *(2) Anesthesia scavenging systems (a) Each space routinely used for administering inhalation anesthesia and inhalation analgesia shall be served by a scavenging system to vent waste gases.1-8.4. (a) To enhance the efficiency of recovery devices required for energy conservation.

1 Filter efficiencies.1 Common Elements for Hospitals reduction in air velocity at the point of contaminant capture.56 meters per second) with suitable pressure-independent air-modulating devices and alarms to alert staff of fan shutdown or loss of airflow.1-8. (iii) Electrical equipment intended for installation within such ducts shall be designed and constructed to resist penetration by water. D R AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 52 . (iv) When perchloric acid or other strong oxidants are only transferred from one container to another. Lubricants and seals shall not contain organic materials.97 percent efficiency (based on the DOP test method) in the exhaust stream and be designed and equipped to permit the safe removal. (2) Laboratory fume hoods. each hood used to process infectious or radioactive materials shall meet the following requirements: (i) Each hood shall have a minimum face velocity of 90 to 110 feet per minute (0. Filters shall be located within 10 feet of the hood to minimize duct contamination. and other hazardous chemicals are handled shall meet the following requirements: (i) Local exhaust ventilation shall be provided for gross examination of surgical specimens.5. 2. (d) Anatomic pathology facilities where formaldehyde. Facilities for Handling Radioactive Materials. (ii) Each shall also have filters with a 99. Note: Radioactive isotopes used for injections. etc. Noncentral air-handling systems shall be equipped with permanent (cleanable) or replaceable filters with a minimum efficiency of MERV 6. disposal. (ii) These hoods and equipment shall be provided with a water wash and drain system to permit periodic flushing of duct and hood.2.45 to 0. and replacement of contaminated filters. (d) All specialty local exhaust ventilations systems shall be equipped with visual and audible alarms to warn the operator of insufficient airflow.38 meters per second) (ii) Connection to an exhaust system to the outside that is separate from the building exhaust system (iii) Location of an exhaust fan at the discharge end of the system (iv) Inclusion of an exhaust duct system of noncombustible corrosion-resistant material as needed to meet the planned usage of the hood (b) Special standards for use with strong oxidants (i) Fume hoods and their associated equipment in the air stream intended for use with perchloric acid and other strong oxidants shall be constructed of stainless steel or other material consistent with special exposures.1-8. (c) Special standards for use with infectious or radioactive materials.2. standard laboratory fume hoods and the associated equipment may be used in lieu of stainless steel construction. (ii) Surgical specimen storage shall be located in ventilated cabinets of capacity sufficient to contain vapors within the cabinet. without probability of airborne particulates or gases may be processed in a clean-workbench-type hood where acceptable to the Nuclear Regulatory Commission.2.5 HVAC Filters See Part 6 (ASHRAE 170) for further filter requirements. In new construction and major renovation work. xylene. (iii) Fume hoods intended for use with radioactive isotopes shall be constructed of stainless steel or other material suitable for the particular exposure and shall comply with NFPA 801. 2. Laboratory fume hoods shall meet the following standards: (a) General standards (i) An average face velocity of at least 75 feet per minute (0..

For requirements. shall be ventilated to prevent the floor surface above and/or the adjacent walls of occupied areas from exceeding a temperature of 10oF (6oC) above ambient room temperature.6 Heating Systems and Equipment 2. In addition.3 Acoustics considerations.3 Electrical Systems (1) All electrical material and equipment. (2) Fuel sufficient to meet demand loads for the same length of time required for emergency generators shall be provided on site. For requirements.6.2. such as boiler or heater rooms or laundries. shall be provided with redundancy that makes it possible to meet the heating capacity of the plant required in Section 2. Electrical installations.1 General 2. controls.5.1. Electro-acoustic systems can affect the acoustical environment of health care facilities. see Section 6.2 Boiler plant accessories.1-8.1 Common Elements for Hospitals 2. and patient/resident use shall be included in the reserve capacity to be served by the remaining sources.1-8. including alarm. including conductors.3. *2. including feedwater pumps.1 of Part 6 (ASHRAE 170). A written record of performance tests on special electrical systems and equipment shall show compliance with applicable codes and standards. (2) Heating units shall have a maximum surface temperature of 125°F (52oC) or shall be protected from occupant contact.3. dietary.1 (Boilers—Capacity) when any one of these components is out of service due to failure or routine maintenance.6.1. Filter frames shall be durable and proportioned to provide an airtight fit with the enclosing ductwork.1-8. shall be installed in compliance with applicable sections of NFPA 70 and NFPA 99. All joints between filter segments and enclosing ductwork shall have gaskets or seals to provide a positive seal against air leakage. nurse call.3 Temperature control (1) Rooms containing heat-producing equipment.6.2. see Section 6. and condensate transfer pumps. 2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 53 . fuel pumps.1-8.1-8.1 Applicable standards 2.1-8. and the acoustical environment can affect the perception of these systems. and signaling devices. Patient safety and comfort as well as staff comfort and productivity are considerations in the configuration of these systems: AF 2.2 Testing and documentation.1.1.2. Major supporting components of the heating plant.3.2.1-8.1-8. 2.2.3.2.1 in Part 6 (ASHRAE 170). staff emergency signal.1-8.2.1. D R 2.1-8.2.2.6.1-8. (2) All electrical material and equipment shall be listed as complying with available standards of listing agencies or other similar established standards where such standards are required.1 Boilers (1) Capacity. 2. and communications systems shall be tested to demonstrate that equipment installation and operation is appropriate and functional.2 Filter frames. domestic hot water for clinical.

or any flammable material. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 54 .4 dB at the 2000 Hz octave band throughout corridors.2 dBA.2 Panelboards 2.3.2 Electrical Distribution and Transmission 2. and (b) Switchboards shall be accessible to authorized persons only.3. (2) When GFCIs are used in critical care areas. readily accessible for maintenance.2-4 (Design Criteria for Speech Privacy for Enclosed Rooms and Open-Plan Spaces). (b) Loudspeaker coverage shall provide for uniformity of +/. *(c) Masking system spectra shall be designed to comply with Table 1. 2.50 or a Common Intelligibility Scale (CIS) rating of 0. (c) (b) Switchboards shall be located where they can easily be accessed. gases. (2) (3) New panelboards shall not be located in public corridors. (1) (2) Panelboards serving critical branch emergency branch circuits shall be permitted to also serve the floors on which they are located and the floor immediately above and/or below the level where the panel is located. (d) (c) Switchboards shall be located in a dry. other liquids. (1) Panelboards serving life safety branch circuits shall be permitted to also serve floors above and/or below.1-8. (1) Ground-fault circuit interrupters (GFCIs) shall comply with NFPA 70: National Electrical Code.3. provisions shall be made to ensure that other essential equipment is not affected by activation of one interrupter.1-8.2.2. convenient for use.2.1-8. D R 2. or steam and that is not directly related to the support of the room.2. exit enclosures. or exit passageways the required means of egress.1-8. (b) Performance of the system shall achieve the following: (i) 70 dBA minimum sound level or 10 dBA above background noise levels (whichever is higher) (ii) Coverage within +/.70 at representative points within the area of coverage to provide acceptable intelligibility from the system. ventilated space free of corrosive or explosive fumes.3.1 Common Elements for Hospitals *(1) Paging and call systems *(a) Voice paging and call systems shall be designed to achieve a minimum Speech Transmission Index (STI) of 0. and away from traffic lanes.1 Switchboards (1) Location (a) Main s Switchboards shall be located in an area that is separate from plumbing and mechanical piping and equipment that contains water.3 Ground-fault circuit interrupters (2) Overload protective devices shall operate properly in ambient room temperatures. open treatment areas and public spaces (2) Masking systems (a) Masking systems shall be designed for levels that do not exceed 48 dBA.

NFPA 101.3 Power Generating and Storing Equipment 2.3.1-8.4. showers) shall have smooth.2.1 As required by the functional program.4. shall be mechanically controlled to prevent the lamp from contacting the bed linen.1 Emergency electrical service (1) Emergency power shall be provided for in accordance with NFPA 99. (ii) The night-light shall be mounted on the wall near the floor (to avoid disturbing the patient).3. This requirement does not apply to intensive care patient rooms where view panels are provided to the corridor. the light source shall be covered by a diffuser or lens. (ii) An engine exhaust muffler shall be provided for the emergency generator.3. *2.2-3 (Design Criteria for Minimum Sound Isolation Performance Between Enclosed Rooms). Central control of night-lights such as a common switch at the nurse station or time clock shall be prohibited.3. (a) A reading light shall be provided for each patient. cleanable. (ii) Incandescent and halogen light sources that produce heat shall be avoided to prevent burns to the patient and/or bed linen.4. shatter-resistant lenses and no exposed lamps.3.3 Lighting for specific locations in the hospital (1) Patient rooms. D R AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 55 . if used. *(ii) (iii) The night-light shall be located for staff and patient use to illuminate both the path from the room entrance to the bedside and the path (between the bed and the toilet room).1-8. Light fixtures in wet areas (e.g..1 Common Elements for Hospitals 2. (iii) Unless the light source is specifically designed to protect the space below. (b) Interior noise levels shall meet those specified in Tables 1.1-8.1-8. kitchens. Patient rooms shall have general lighting and night lighting. special needs of the elderly shall be incorporated into the lighting design. *(i) Interior and exterior generators shall be designed to limit sound levels at nearest hospital building facades to a level not exceeding 70 dBA and not to exceed the applicable community noise code for the period of day when maintenance operations occur. 2.3. *(2) Where stored fuel is required. (i) Reading light controls shall be accessible to the patient(s) without the patient having to get out of bed. *(b) At least one night-light fixture shall be located in each patient room. storage capacity shall permit continuous operation for at least 24 hours. (3) Acoustic considerations for emergency generators (a) Generators shall meet the following criteria and be placed in a sound reduction enclosure if necessary to meet the criteria.1-8.1-8. (4) For hospitals built in FEMA Flood Zones A or V.3. (iv) Flexible light arms. *2.4 Lighting *2. and NFPA 110.2-2 (Minimum–Maximum Design Criteria for Noise in Interior Spaces) and 1. *(i) The night-light shall be controlled at the room entrance.2 Light fixtures. emergency generators and accessories and other components of the electrical system necessary to maintain continuity of the emergency power system shall be located on levels of the hospital above the floodplain.

1-8.3. (3) Exam/treatment/trauma rooms.3.3. 2.1 Common Elements for Hospitals *(iv) The night-light shall illuminate the path of travel from bed to corridor door and toilet without glare.1-8. if used.6. (2) Nursing unit corridors.5. (2) Receptacles in pediatric and psychiatric unit corridors shall be of the tamper-resistant type.1-8.3. it shall be connected to the essential electrical system.1-8.1 Special electrical equipment. *2. . If color is used for identification purposes.62 meters) of corridor ends.1-8. one on every other wall.3 Emergency system receptacles.1-8.5. General lighting and special lighting shall be on separate circuits. An information technology (IT) system that is connected to the emergency power supply system whose failure would compromise patient care during the transfer from normal power to the emergency power supply system shall be provided with an uninterruptible power supply. and surgical suites is dependent on the building electrical service. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 56 (4) Operating and delivery rooms.6. (1) Receptacles shall be provided according to Table 2.2 Hand-washing stations and scrub sinks.3. A portable or fixed examination light shall be provided for examination. 2. see facility chapters in Part 2.6 Receptacles D R 2. the same color shall be used throughout the facility. For requirements. (2) Patient rooms. (c) Lighting for coronary and intensive care bed areas shall permit staff observation of the patient while minimizing glare.1 Receptacles in corridors (1) Duplex-grounded receptacles for general use shall be installed approximately 50 feet (15.5. If operation of any required hand-washing station or a scrub sink or a hand-washing station in critical care areas.3 Electronic health record system. one for television. treatment.1-8. AF 2. Electrical receptacle cover plates or electrical receptacles supplied from the emergency systems shall be distinctively colored or marked for identification. (a) There shall be one at each side of the head of each bed. (b) Omission of receptacles from exterior walls shall be permitted where construction or room configuration makes installation impractical.3.5 Electrical Equipment *2. Each patient room shall have duplex grounded receptacles. and trauma rooms. emergency departments.1-8.3. Operating and delivery rooms shall have general lighting in addition to special lighting units provided at surgical and obstetrical tables. 2. labor and delivery.3.1-3 (Electrical Convenience Receptacle Requirements for Clinical Areas). Corridors in nursing units shall have general illumination with provisions for reducing light levels at night. *2.2.2 Receptacles in patient care areas.6. and one for each motorized bed.24 meters) apart in all corridors and within 25 feet (7.

2.1 Common Elements for Hospitals

2.1-8.3.7 Call Systems Hospital signaling and nurse call equipment includes four types of call stations: patient stations, bath stations, staff emergency stations, and code call stations. 2.1-8.3.7.1 General (1) Call station Nurse call system locations shall be provided as required in Table 2.1-4 (Location of Nurse and Staff Call Devices). (2) Call stations Nurse call systems shall report to an attended location with electronically supervised visual and audible annunciation as described in the functional program and in Table 2.1-4. (3) Where provided, nurse master stations shall provide audible/visual prompting and display all pending calls. If display capabilities are limited, the system shall display the highest priority calls as described in the functional program. (4) The call system shall include a priority hierarchy to account for the needs of specific patient (e.g., non-verbalizing patients or patients with a high risk of falling).

*(5) Use of alternate technologies that meet the requirements of UL 1069: Standard for Hospital Signaling and Nurse Call Equipment, including radiofrequency systems, shall be permitted for call systems. (6) In addition to these guidelines, call systems shall meet the requirements of UL 1069: Standard for Hospital Signaling and Nurse Call Equipment and state and local requirements. 2.1-8.3.7.2 Patient call stations. A patient call station shall be provided to allow each patient to summon assistance from the nursing staff. (1) Each patient sleeping bed, except nursery beds, shall be provided with a patient call station equipped for two-way voice communication. Use of a dual call station shall be permitted when beds are located adjacent to each other.

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(2) The patient call station shall be equipped with the following: (a) A visible signal once it has been activated. An indicator light or call assurance lamp that remains lighted as long as the voice circuit is operating shall be provided. In rooms containing two or more patient stations, call assurance lamps shall be provided at each station. (b) A reset switch for canceling a call (3) The patient call station shall activate signals as follows: (a) A visible signal in the corridor at the patient’s door. In multi-corridor nursing units or patient care areas, additional visible signals shall be installed at corridor intersections. (b) A visible and audible signal at nurse call duty stations in the locations listed below. The audible signal may be temporarily silenced provided subsequent calls automatically reactivate the audible signal. (i) Clean workroom (ii) Soiled workroom (iii) Medication preparation room (iv) Documentation area or other charting facilities (v) Nourishment area (vi) Nurse master station of the nursing unit or patient care area

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2.1 Common Elements for Hospitals

(4) Diagnostic and treatment areas. A nurse call system shall be provided in each diagnostic and treatment area (including labor rooms, LDR rooms, emergency examination/treatment rooms or cubicles, and preoperative rooms or cubicles) as required by other sections of the Guidelines or the functional program. 2.1-8.3.7.3 Bath stations. A bath station that can be activated by a patient lying on the floor shall be provided at each room containing a patient toilet water closet, bathtub, sitz bath, or shower stall. (1) An alarm in these areas shall be able to be turned off only at the bath station where it was initiated.

(4) A bath station shall be permitted to serve both a toilet and a shower or other fixture if it is accessible to both. 2.1-8.3.7.4 Staff emergency stations. Staff emergency stations for summoning additional local staff assistance for non-life-threatening situations shall be provided in each patient care location. *2.1-8.3.7.5 Code call stations. Commonly referred to as a “Code Blue,” code call stations are meant for use during a life-threatening situation to summon assistance from outside the unit or department. (1) Code call stations shall be provided per the functional program.

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2.1-8.4 Plumbing Systems 2.1-8.4.2.1 General piping and valves

(2) The code call station shall be equipped with a continuous audible or visual confirmation to the person who initiated the code call.

2.1-8.3.7.6 Alarm in psychiatric nursing units. A nurse call is not required in psychiatric units, but if one is included the following shall apply: (1) Provisions shall be made for easy removal or for covering of call button outlets. (2) All hardware shall have tamper-resistant fasteners.

2.1-8.4.1 General In the absence of local and state plumbing codes, all plumbing systems shall be designed and installed in accordance with the International Plumbing Code. 2.1-8.4.2 Plumbing and Other Piping Systems

(1) All piping, except control-line tubing, shall be identified.

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(3) Bath stations shall be located to the side of toilets, within 12 inches (30.48 centimeters) of the front of the toilet bowl and 3 to 4 feet (.91 meter to 1.22 meters) above the floor. A bath station shall be permitted to serve both a toilet and a shower or other fixture if it is accessible to both.

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(2) Bath stations in shower stalls and tubs shall be located 5 to 6 feet (1.52 to 1.83 meters) above the floor, within normal view of the user and within reach of staff without the need to step into the shower stall or tub.

2.1 Common Elements for Hospitals

(2) All valves shall be tagged, and a valve schedule shall be provided to the facility owner for permanent record and reference. (3) No plumbing piping shall be exposed overhead or on walls where possible accumulation of dust or soil may create a cleaning problem or where leaks would create a potential for food contamination. *2.1-8.4.2.2 Hemodialysis/hemoperfusion piping (1) In new construction and renovation in any hospital where hemodialysis or hemoperfusion is routinely performed, a separate water supply and a drainage facility that does not interfere with hand-washing shall be provided.

(3) All reverse osmosis water and dialysis solution piping shall be accessible. 2.1-8.4.2.3 Potable water supply systems

(1) Capacity. Systems shall be designed to supply water at sufficient pressure to operate all fixtures and equipment during maximum demand. Supply capacity for hot- and cold-water piping shall be determined on the basis of fixture units, using recognized engineering standards. When the ratio of plumbing fixtures to occupants is proportionally more than required by the building occupancy and is in excess of 1,000 plumbing fixture units, a diversity factor shall be permitted. (2) Valves. Each water service main, branch main, riser, and branch to a group of fixtures shall have valves. (a) Stop valves shall be provided for each fixture. (b) Appropriate panels for access shall be provided at all valves where required. (3) Backflow prevention (a) Systems shall be protected against cross-connection in accordance with American Water Works Association (AWWA) Recommended Practice for Backflow Prevention and Cross-Connection Control. (b) Vacuum breakers or backflow prevention devices shall be installed on hose bibs and supply nozzles used for connection of hoses or tubing in laboratories, housekeeping sinks, bedpanflushing attachments, autopsy tables, etc.

D

R

(4) Bedpan-flushing devices. Bedpan-flushing devices (may be cold water) shall be provided in each inpatient toilet room; however, installation is optional in psychiatric and alcohol-abuse units where patients are ambulatory. (5) Potable water storage. Potable water storage vessels (hot and cold) not intended for constant use shall not be installed, except as required for disaster preparedness or similar emergency supply use. (6) Emergency eyewash and showers shall comply with ANSI Z358.1.

AF

(2) When the functional program includes hemodialysis, continuously circulated filtered cold water shall be provided. (a) Piping shall be in accordance with AAMI RD62. (b) If the dialysis equipment includes sufficient water treatment provisions, use of domestic cold water without special piping requirements shall be permitted.

DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities

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59

62 meters) in length. oversized drip pans) to protect the space below from leakage. (c) Any equipment required to provide potable water in the event of a utility failure or disaster shall be served by emergency power.” *2.g.1 Common Elements for Hospitals (7) Provisions shall be made to provide potable water to the facility in the event of a utility failure or disaster.2.2. water shall be permitted to be supplied at a constant temperature between 70°F and 85°F using a single-pipe supply instead of following the requirements in 2. (1) Piping. *(5) For hand-washing stations. (b) Services provided in this scenario shall be as defined by the owner’s facility operation plan (e. (3) Elimination of dead-end piping (a) Installation of dead-end piping (risers with no flow. it shall contain a nonsplash.4. *2. (b) Provisions shall be included in the domestic hot water system to limit the amount of Legionella bacteria and opportunistic waterborne pathogens. (c) Dietary area floor drains and/or floor sinks AF (1) General (a) The standards in this section shall apply to potable hot water systems.. Any non-potable water system piping shall be clearly marked “non-potable. Where drainage piping is installed above the ceiling of. horizontal-flow flushing bowl beneath the drain plate. Note: Methods for hot water piping system design are provided in the appendix.1-8. food storage areas. Storage of water at higher temperatures shall be permitted. double wall containment piping. (c) Installation of empty risers. or exposed in. Non-recirculated fixture branch piping shall not exceed 25 feet (7. dead-end piping shall be removed.2.6 Drainage systems *(4) (1) The water-heating system shall have sufficient supply capacity at the temperatures and amounts indicated in the applicable table Table 2. electronic data processing areas. minimal clinical uses). or dust particles. food-serving facilities. storage tank. and branches installed for future use shall be permitted. (a) A well. central services.2. or electric closets. mains..g. branches with no fixture) shall not be permitted in new construction. food preparation centers. or building system piping connection shall be permitted to serve this purpose.4.2. the piping shall have special provisions (e.18. nurseries. (2) Floor drains (a) Floor drains shall not be installed in operating and delivery rooms.1-8.5 (3)(a). D R 2.4. and condensation. (b) In renovation projects.5 Hot Heated potable water distribution systems (2) Hot Heated potable water distribution systems serving patient care areas shall be under constant recirculation to provide continuous hot water at each hot water outlet. *(b) If a floor drain is installed in cystoscopy.4 Non-potable water supply systems. operating and delivery rooms. cooling tower or boiler make-up water.1-8.1-5 (Hot Water Use—General Hospital). DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 60 .4.

Where plaster traps are used. the facility shall treat its sewage in accordance with local and state regulations.4.3.1-8.1 Common Elements for Hospitals (i) Type.3. Removable stainless steel mesh shall be provided in addition to grilled drain covers to prevent entry of large particles of waste that might cause stoppages. Water spouts used in lavatories and sinks shall have clearances adequate to avoid contaminating utensils and the contents of carafes. (2) An air gap shall be provided where condensate drains empty into building drains.8 and 2.2. 2.4.1 General R 2.2. see 1.2. Location of floor drains and floor sinks shall be coordinated to avoid conditions where locations of equipment make removal of covers for cleaning difficult. Drain systems for autopsy tables shall be designed to positively avoid splatter or overflow onto floors or back siphonage and for easy cleaning and trap flushing. (b) Grease traps shall be located and arranged to permit easy access without the need to enter food preparation or storage areas. For further requirements regarding hand-washing stations.1-8.1. The material used for plumbing fixtures shall be nonabsorptive and acid-resistant.4.1-8. (ii) Location.1-8. (2) Clearances.3. (1) Materials. Where such a system is not available. (c) Grease traps shall be accessible from outside the building without need to interrupt any services.5.2 (ICRA considerations—Design elements). 2. Building sewers shall discharge into community sewerage.2-3. Floor drains or floor sinks shall be provided at all “wet” equipment (as ice machines) and as required for wet cleaning of floors.1-8.2. (3) Heater elements shall be provided for condensate lines in freezers or other areas where freezing may be a problem. . (3) Sewers.2 (Hand-washing stations and scrub sinks).3 Plumbing Fixtures *2.1-7. Drainage from emergency face and eyewash equipment shall be connected directly to the sanitary sewer or located over a sink large enough to capture all effluent. (7) (6) Autopsy table drain systems. etc.2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 61 (4) Kitchen grease traps (a) Grease traps shall be of capacity required.4. AF (5) Plaster traps.7 Condensate drains D 2. (6) Emergency face and eyewash.2 Hand-washing station sinks (1) Condensate drains for cooling coils shall be a type that may be cleaned as needed without disassembly. (1) General. provisions shall be made for appropriate access and cleaning. These shall be of a type that can be easily cleaned by removing the cover.

the substrate is marine-grade plywood (or equivalent) with an impervious seal. 2.03 square centimeters). Handles on clinical sinks shall be at least 6 inches (15. (7) (g) Design of sinks shall not permit storage beneath the sink basin (in casework) and in areas below the sink open to the floor.3. AF DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 62 . at a minimum.5 Clinical sinks (2) If provided.4 centimeters) above the bottom of the basin.1 Common Elements for Hospitals (2) Sinks *(1) (a) Sinks in hand-washing stations shall be designed with deep basins to that prevent splashing to areas where direct patient care is provided. (4) (d) Sinks shall have well-fitted and sealed basins to prevent water leaks onto or into cabinetry and wall spaces. (3) (c) Hand-washing basins/countertops shall be made of porcelain.4. Single-lever or wrist blade devices shall be permitted. stainless steel.24 centimeters) long.1-8.86-centimeters) in width or length. 2.2.1-7.3.4 Ice machines. Quick-drench emergency deluge shower and face/eyewash devices shall be provided per OSHA 29 CFR 1910. knee.4.4. OSHA 29 CFR 1910. (1) Clinical sinks shall be trimmed with valves that can be operated without hands. (6) (f) The water pressure at the fixture shall be regulated.1-8.4.1-8. with a minimum dimension of 9 inches (22. soap dishes shall be recessed. and ANSI/ISEA Z358. single-lever wrist blades are not permitted except for the temperature pre-set valve.3. (2) Clinical sinks shall have an integral trap wherein the upper portion of the water trap provides a visible seal.2 (2) if. Basins shall be permitted to be set into plastic laminate countertops in accordance with Section 2. OSHA 29 CFR 1910.1048 (Formaldehyde). Freestanding scrub sinks and lavatories used for scrubbing in procedure rooms shall be trimmed with foot.1-8. (2) (b) The open area of the basin shall not be less than 144 square inches (929. D R 2. 2. (5) (e) The discharge point of hand-washing sinks shall be at least 10 inches (25. Copper tubing shall be provided for supply connections to ice machines.6 Scrub sinks.1: Emergency Eyewash and Shower Equipment.4.3 Showers and tubs (1) Showers and tubs shall have nonslip walking surfaces.2.1030 (Bloodborne Pathogens). particularly those surfaces where sterile procedures are performed and medications are prepared. 2. or solid-surface materials.7 Emergency first-aid equipment.4.1-8.3. or electronic sensor ultrasonic controls.151 (Medical Services and First Aid).3.

1-6 for station outlet requirements.1 General The space.5.62 meters) from all outside air intakes. *2.2 Vacuum systems (1) Clinical vacuum system installations shall be in accordance with NFPA 99. 365-day-per-year basis. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 63 .5 Communications Systems *2.1 Medical gas systems.2 Size.4. and next to the electrical service room to reduce the length of bonding conductor to the electrical grounding system.4 Medical Gas and Vacuum Systems Station outlets shall be provided consistent with need established by the functional program.66 meters by 4. AF 2.1-8.1.1-8. (2) The vacuum discharge shall be located at least 25 feet (7.1-8. The TSER shall have minimum dimensions of 12 feet by 14 feet (3.1-8. The installation.4.1-8.3 Location and access requirements (1) The TSER shall be located in a dry area not subject to flooding.4. environmental. pathway.2. (2) Temperature and humidity in the TSER shall be controlled to the operating range of 64 to 75 degrees F (18 to 24 degrees C) with 30 to 55 percent relative humidity.4 Building system requirements 2.1-8. *2. pass through. (See Table 2.1-8. and operable windows.) 2. doors. Reliable cooling and heating shall be provided on a 24-hour-per-day. as close as practicable to the building entrance point.4.5.27 meters).5. (1) Mechanical and electrical equipment and fixtures that are not directly related to the support of the TSER shall not be installed in. (2) Access to the TSER shall be restricted and controlled by an access control system with an audit trail. and certification of nonflammable medical gas and air systems shall comply with the requirements of NFPA 99.5.5. 2. D R *2.1.1 Common Elements for Hospitals 2.5.1 Telecommunications Service Entrance Room The telecommunications service entrance room (TSER) houses the point at which outside carrier data and voice circuits and services enter the facility and outdoor cabling interfaces with the building’s internal cabling infrastructure. testing. *(3) Combination of the TSER and the technology equipment center shall be permitted.1-8. 2.4. and reliability requirements in this section shall be the minimum provided for the technology and medical communication systems of an acute care hospital.1 Number.1-8.1-8.1. Each hospital shall have at least one TSER that is dedicated to the telecommunications function and related support facilities and meets all of the requirements of this section.1. or enter the TSER.

3 Location and access requirements (1) The TEC shall be located above any floodplains and below the top level of the facility to deter water damage to the equipment from outside sources (e. D R 2.1 Common Elements for Hospitals (3) HVAC systems serving the TSER shall be connected to the hospital’s emergency power systems. induction heaters.2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 64 . (3) All circuits serving the TEC and the equipment within it shall be dedicated to serving the TEC. leaks from the roof or flood damage). Cooling systems serving the TEC shall be supplied by the emergency power system. (4) Combination of the TEC and the telecommunications service entrance room shall be permitted. radio and radar systems.2 Technology Equipment Center The technology equipment center (TEC) houses the main networking equipment and the application servers and data storage devices that serve the building. the TEC shall be located away from exterior curtain walls to prevent wind and water damage. SAN.g. networking. and storage.5. (4) Reliable cooling and heating shall be provided on a 24-hour-per-day. (3) A growth factor appropriate to the needs of the facility and as recommended by industry organizations such as BICSI or the Telecommunications Industry Association (TIA) shall be factored into the size of the TEC.2. or other sources of electromagnetic interference. 2.2 Size (1) The TEC shall be a size adequate to provide proper space to meet service requirements for the equipment that will be housed there.2. *2. Each hospital shall have at least one TEC space that is not used for any purposes other than data storage. pass through.1 Number. (3) Access to the TEC shall be restricted and controlled by an access control system. and networking and that meets the minimum requirements of this section.5..2. (1) Mechanical and electrical equipment or fixtures that are not directly related to the support of the TEC shall not be installed in. x-ray.1-8. In areas prone to hurricanes or tornados.1-8.1-8. (2) All computer and networking equipment within the TEC shall be served by UPS power. arc welders. processing.66 meters) from any transformer. *2. 365-day-per-year basis. AF (2) The TEC shall be sized based on the number of racks needed for anticipated servers. or enter the TEC.1-8. motors. *2.5.4 Facility requirements (2) The TEC shall be located a minimum of 12 feet (3.5.1-8.2.5.

(2) Access to the TDR shall be directly off a corridor and not through another space.1-8.1 Number . TDRs house a variety of technology systems and system components.2. All TDRs shall have minimum inside dimensions of 12 feet by 14 feet (3. 2.5. and electrical protection shall meet the requirements of the latest version of NEC and J-STD-607-A. (3) Access to a TDR shall be restricted and controlled by an access control system.3. *2. nurse call systems. or enter the TDR.1-8.4.1-8. flexible.3 Location and access requirements (1) The TDR shall be located in an accessible. non-sterile area on each floor. D R 2.2 Size.5.5. (4) Reliable cooling and heating shall be provided on a 24-hour-per-day. (1) There shall be a minimum of one TDR on each floor of the facility. network electronics. *2. (3) All circuits serving the TDR and the equipment within it shall be dedicated to serving the TDR.66 meters by 4.3.1 Common Elements for Hospitals (5) Temperature and humidity in the TEC shall be in accordance with ASHRAE’s Thermal Guidelines for Data Processing Environments controlled to an operating range of 64 to 75 degrees F (18 to 24 degrees C) with 30 to 55 percent relative humidity. and other technology and communications equipment throughout the building.1-8. bonding. pass through. 365-day-per-year basis.1-8.1 Grounding.5. *2.3.5. such as an electrical room or mechanical room.1-8.4 Facility requirements (1) Mechanical and electrical equipment or fixtures not directly related to the support of the TDR shall not be installed in. AF (2) TDRs shall be provided throughout the facility as necessary to meet the 292-foot (90-meter) maximum cable distance required for Ethernet cables from the termination point in the TDR to each wall outlet.5.27 meters).4 Grounding for Telecommunication Spaces 2.1-8. (5) Temperature and humidity in the TDR shall be controlled to an operating range of 64 to 75 degrees F (18 to 24 degrees C) with 30 to 55 percent relative humidity. (2) Each TDR shall be connected to the technology equipment center to provide a building-wide network and communications system.3.5. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 65 2.3 Technology Distribution Room Technology distribution rooms (TDRs) provide a secure. and easily managed location for the structured cabling wiring systems. clinical systems.

5.2.5.1-8.1-8.1 Electronic surveillance systems are not required. (2) All racks. and metal components of the technology system that do not carry electrical current shall be grounded to this bus bar.3 TMGB bar. electronic surveillance systems shall receive power from the emergency electrical system in the event of a disruption of normal electrical power.1-8. patient location systems.2 TGB bar (1) The ground bar shall be drilled with holes according to NEMA standard to accommodate bolted compression fittings.1-8.5.4. (3) TGB bars shall be connected by a backbone of insulated.5.1-8.1 Common Elements for Hospitals 2.5.2 Electronic surveillance system monitoring devices shall be located so they are not readily observable by the general public or patients. door access/control systems.7 Special Systems R 2.6. #6 (minimum) to 3/0 AWG stranded copper cable between all technology rooms.1 Fire Alarm System All health care facilities shall be provided with a fire alarm system in accordance with NFPA 101 and NFPA 72: National Fire Alarm and Signaling Code. TGB bars shall be connected back to the telecommunications main grounding bus (TMGB) bar in the telecommunications service entrance room.5.1-8.3 If installed.1-8. cabinets. 2.1 Outside plant infrastructure consists of the conduits.6.2. 2. 2. (1) The TMGB shall not be bonded to anything other than the building’s main electrical service ground.5 Cabling Pathways and Raceway Requirements *2.6. The main grounding bar shall then be connected back to the building main electrical service ground.4.1-8.1-8. 2.6 Electronic Safety and Security Systems D 2.2 Pathways and raceways distributing cabling between telecommunications service entrance rooms and technology distribution rooms shall be installed in conduit and in a manner that provides physical security from damage.2.5. 2. and infant abduction prevention systems. 2.2 Electronic Surveillance Systems Electronic surveillance systems include but are not limited to patient elopement systems. sections of cable tray. video/audio monitoring systems.6. any devices in patient areas shall be mounted in a tamper-resistant enclosure that is unobtrusive.6.2.1-8. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 66 2. 2.1-8. . AF (2) Bonding conductor cabling shall be colored green or labeled appropriately.1-8. vaults. and other pathways and cabling used to connect buildings on a campus and to provide services from off-campus service providers. but if provided for the safety of the patients.

maintenance. delivery.2.1-8.3 Insulation.7. a parts lists. AF (2) Operating staff persons shall also be provided with written instructions for proper operation of systems and equipment. all special systems shall be tested and operated to demonstrate to the owner or his designated representative that the installation and performance of these systems conform to design intent.7. 2. dining rooms. recreation areas) or critical services (e..2 Documentation (1) Upon completion of the special systems equipment installation contract. In the absence of an engineered traffic study. (Reduction in elevator service shall be permitted for those floors providing only partial inpatient services.7.7.2. 2. protect personnel. All hospitals having Hospitals with patient facilities (e. the following guidelines for number of elevators shall apply to all facility types in this chapter except psychiatric hospitals: (1) At least two hospital-type elevators shall be installed where 1 to 59 patient beds are located on any floor other than the main entrance floor. 2. 2. (2) Test results shall be documented for maintenance files.1-8.. operating.3 Dimensions and clearances.1.2. the owner shall be furnished with a complete set of manufacturers’ operating. (Reduction in elevator service shall be permitted for those floors providing only partial inpatient services. and reduce noise.1-8.2 Number. and complete procurement information including equipment numbers and descriptions.7.g. bedrooms. 2.1 Common Elements for Hospitals 2. Insulation shall be provided surrounding special system equipment to conserve energy.7.1 General 2. therapeutic areas) located on floors other than the grade-level entrance floor shall have electric or hydraulic elevators.g. and preventive maintenance instructions.1.1-8.1 Testing (1) Prior to acceptance of the facility. diagnostic. or where the major inpatient services are located on a floor other than those containing patient beds.1-8.1-8.1 General. This section shall apply to all facility types in this chapter except psychiatric hospitals. or where the major inpatient services are located on a floor other than those containing patient beds.1-8. (2) At least two hospital-type elevators shall be installed where 60 to 200 patient beds are located on floors other than the main entrance floor.2.7.7. Required information shall include all safety or code ratings as needed.) D R (3) At least three hospital-type elevators shall be installed where 201 to 350 patient beds are located on floors other than the main entrance floor.) (4) For hospitals with more than 350 beds.1.1-8. the number of elevators shall be determined from a study of the hospital plan and the expected vertical transportation requirements.2 Elevators *2. DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 67 .

an increase in the size of existing elevators shall not be required if the elevators can accommodate patient beds used in the facility. .7.1-8. Field inspections and tests shall be made and the owner shall be furnished with written certification stating that the installation meets the requirements set forth in this section as well as all applicable safety regulations and codes. shall be equipped with an independent keyed switch for staff use for bypassing all landing button calls and responding to car button calls only.1-8.2.13 meters) high. 2.3 for existing facilities.2.35 millimeters).6 Installation and testing D R (1) Standards. *(2) Car Elevator car/cab doors shall have a clear an opening with a minimum clear width of not less than 4 feet 6 inches (1.2.1 Common Elements for Hospitals *(1) Hospital-type elevator cars shall have inside dimensions that accommodate a patient bed with attendants. Cars shall be at least Elevator cars/cabs shall have minimum inside clear dimensions of 5 feet 8 inches (1.) (2) Documentation. window shutters.7.37 meters) wide and a minimum clear height of 6 feet 11 inches (2. within restrictions set by standards for disabled access.1-8. (See ASCE/SEI 7: Minimum Design Loads for Buildings and Other Structures for seismic design and control system requirements for elevators.11 meters) 7 feet (2.7. Light beams. except those for material handling. those systems shall comply with requirements in Section 2.7.1-8. shall be used in combination with door-edge safety devices and shall be interconnected with a system of smoke detectors. AF 2.2.1 for new construction and ANSI/ASME A17.1-8..73 meters) wide by 9 feet (2.g.4 Leveling device. (3) In renovations.5 Elevator controls DRAFT 2014 Guidelines for Design and Construction of Health Care Facilities T 68 (4) Additional elevators installed for visitors and material handling shall be permitted to be smaller than noted above. if used for operating door reopening devices without touch. 2. *(2) Elevator call buttons and controls shall not be activated by heat or smoke.22 1. impact protection screens) due to hostile area weather conditions.74 meters) deep. Installation and testing of elevators shall comply with ANSI/ASME A17. Elevators shall be equipped with a two-way automatic level-maintaining device with an accuracy of ± 1/4 inch (± 6. *2. mechanized window protection.3 Building Envelope Protection Where hospitals employ building envelope protection (e.7. (1) Each elevator.1 (Special Systems—General).

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