As in effect on May 1, 2008
This rule is adopted pursuant to Title 26, Chapter 21.
The purpose of this rule is to establish construction and physical plant standards for the operation of a freestanding surgical facility that provides surgical services to patients not requiring hospitalization.
(1) Ambulatory Surgical Centers shall be constructed in accordance with the requirements of R432-4-1 through R432-4-23 and the requirements of the Guidelines for Design and Construction of Hospital and Health Care Facilities, Section 9.2., 9.5 and 9.9 including Appendix A, 2001 edition (Guidelines). Where a modification is cited, the modification supersedes conflicting requirements of R432-4 or the Guidelines.
(2) Ambulatory Surgical Centers shall consist of at least two Class C operating rooms, as outlined in the Guidelines section 9.5.F2, and support facilities.
(3) Ambulatory Surgical Centers shall be equipped to perform general anesthesia. Flammable anesthetics may not be used in Ambulatory Surgical Centers.
(4) Ambulatory Surgical Centers which are located within a building not constructed in accordance with NFPA 101, Life Safety Code, Chapter 20, shall be physically separated in accordance with requirements of the local building official having jurisdiction.
(a) The facility shall have at least two exits leading directly to the exterior of the building.
(b) Design shall preclude unrelated traffic through units or suites of the licensed facility.
(1) Adequate sterile supplies shall be maintained in the facility to meet the maximum demands of one day's case load.
(2) Operating rooms for cystoscopic procedures shall comply with Section 7.7.A4 of the Guidelines.
(3) A toilet room shall be readily accessible to recovery rooms and recovery lounge.
(4) Change areas shall comply with Guidelines subsection 9.5.F5.(i) and shall be arranged to accommodate a one way traffic pattern enabling personnel to change and directly enter the operating room corridor.
(5) Special or additional service areas such as radiology, if required by the functional program, shall comply with the requirements of the General Hospital Rules, R432-100.
(1) The administration and public areas which are not part of the Ambulatory Surgical Center exiting system, may be located outside of the institutional occupancy envelope when authorized by the local building official having jurisdiction.
(2) Cubicle curtains and draperies shall be affixed to permanently mounted tracks or rods. Portable curtains or visual barriers are not permitted.
(3) An elevator shall be provided when an ambulatory surgical center is located on a level other than at grade. The minimum inside dimensions of the cab shall be at least 5'8" wide by 8'5" deep with a minimum clear door width of 3'8".
(4) Yard equipment and supply storage areas shall be located so that equipment may be moved directly to the exterior without passing through building rooms or corridors.
(5) The facility shall provide for the sanitary storage and treatment or disposal of all categories of waste, including hazardous and infectious wastes, if applicable, using procedures established by the Utah Department of Environmental Quality and the local health department having jurisdiction.
(6) All rooms shall be mechanically ventilated.
(7) Access to medical gas supply and storage areas shall be arranged to preclude travel through clean or sterile areas. There shall be space for enough reserve gas cylinders to complete at least one routine day's procedures.
(8) An on-site emergency generator shall be provided and the following services shall be connected to the emergency generator:
(a) life safety branch as defined in 517-32 of the National Electric Code NFPA 70, 1999 edition;
(b) critical branch as defined in 517-33 of the National Electric Code NFPA 70, 1999 edition;
(c) equipment system as defined in 517-34 of the National Electric Code NFPA 70, 1999 edition.
(9) There shall be sufficient fuel storage capacity to permit at least four hours continuous operation shall be provided.
(10) Lighting shall comply with R432-4-23(21)(a).
(1) A facility that provides extended recovery services shall maintain a patient care area that is distinct and separate from the post-anesthesia recovery area. The patient care area shall provide the following:
(a) a room or area that ensures patient privacy, including visual privacy;
(b) a minimum of 80 square feet of space for each patient bed with at least three feet between patient beds and between the sides of patient beds and adjacent walls.
(c) a nurse call system at each patient's bed and at the toilet, shower and bathrooms, which shall transmit a visual and auditory signal to a centrally staffed location which identifies the location of the patient summoning help;
(d) a patient bathroom with a lavatory and toilet;
(e) oxygen and suction equipment;
(f) medical and personal care equipment necessary to meet patient needs.
(2) A separate food nutrition area which shall include a counter, sink, refrigerator, heating/warming oven or microwave, and sufficient storage for food items.
The following sections of the Guidelines do not apply to Freestanding Surgical Center construction:
(1) Parking, Section 9.5.C.
(2) Waste Processing Systems, Section 9.2.G3.
The Department may assess a civil money penalty of up to $5,000 and deny approval for patient utilization of new or remodeled areas if a health care provider does not submit architectural drawings to the Bureau of Licensing. The Department may assess a civil money penalty of up to $5,000 if the licensee fails to follow Department- approved architectural plans. The Department may assess a civil money penalty of up to $500 per day for each day a new or renovated area is occupied prior to Bureau of Licensing approval.
health facilities
March 13, 2003
January 28, 2005
26-21-5; 26-21-16
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