As in effect on June 1, 2008
This rule is adopted pursuant to Title 26, Chapter 21.
This rule provides construction and physical plant standards for birthing centers.
(1) Birthing centers shall be constructed in accordance with the requirements of R432-4-1 through R432-4-23 and the requirements of sections 9.2 and 9.7 of the Guidelines for Design and Construction of Hospital and Health Care Facilities, 2001 edition including Appendix A (Guidelines) and are adopted and incorporated by reference.
(2) Birthing Centers shall consist of at least two, but not more than five birthing rooms.
(3) Birthing rooms and ancillary service areas shall be organized in a contiguous physical arrangement.
(4) To qualify for licensure, regardless of size, a Birthing Center shall be constructed in accordance with NFPA 101, Life Safety Code, Chapter 20, New Ambulatory Health Care Occupancies.
(5) Birthing 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 established by the local building official having jurisdiction and shall have at least two exits leading directly to the exterior of the building.
(6) Administration and public areas that are not part of the Birthing Center exiting system may be located outside of the institutional occupancy envelope when authorized by the local building official having jurisdiction.
(7) A Birthing Center located contiguous with a general hospital may share radiology services, laboratory services, pharmacy services, engineering services, maintenance services, laundry services, housekeeping services, dietary services, and business functions. The owner shall retain in the Birthing Center a written agreement for the shared services.
(1) Requirements of sections 9.2 and 9.7 of the Guidelines shall be met except as modified in this section.
(2) When a modification is cited, the modification supersedes conflicting requirements of the Guidelines.
(3) When used in this rule, "room or office" describes a specific separate, enclosed space for the service. When "room or office" is not used, multiple services may be accommodated in one enclosed space.
(4) The facility shall be designed to allow access to service areas and common areas without compromising patient privacy.
(5) Patient rooms and service areas shall be grouped to form a physically defined service unit.
(6) Spaces shall be provided for each of the required services.
(7) Interior finishes, lighting, and furnishings reflect a residential rather than an institutional setting.
(8) Maximum room occupancy shall be one mother and her newborn infant or infants.
(9) Each birthing room shall have a window in accordance with R432-4-23(7). Windows with a sight line which permits observation from the exterior shall be arranged or draped to ensure patient privacy.
(10) Patient rooms shall provide each patient a wardrobe, closet, or locker, having minimum clear dimensions of 24 inches by 20 inches, suitable for hanging full-length garments. A clothes rod and adjustable shelf shall be provided.
(11) A toilet room with direct access from the birthing room shall be accessible to each birthing room.
(a) The toilet room shall contain a toilet, a lavatory, and a shower or tub.
(b) A toilet room may serve two patient rooms.
(c) All toilet room fixtures shall be handicapped accessible and shall have grab bars in compliance with ADAAG.
(d) Each birthing room shall be equipped with a lavatory for handwashing in addition to the lavatory in the toilet room. If the lavatory is equipped with wrist blades, it may be used for scrubbing.
(12) Newborn infant resuscitation facilities, remote from facilities serving the mother, including electrical outlets, oxygen, and suction shall be immediately available to each birthing room in addition to resuscitation equipment provided for the mother.
(13) A separate room for storage of maintenance materials and equipment shall be provided.
(a) The room may serve as a maintenance office with storage for maintenance files, facility drawings, and operation manuals.
(b) The storage room shall be in addition to the required janitors closet.
(14) Special surgical lighting is not required.
(15) An examination light shall be provided in each patient room. The light, if portable, shall be immediately accessible.
(16) An emergency electrical service is connected to an on-site emergency generator is required.
(a) Services shall be connected to the emergency generator to include:
(i) fire alarm system;
(ii) telephone;
(iii) nurse call;
(iv) one duplex convenience outlet in each patient room located to allow use of a portable examination light;
(v) one duplex convenience outlet at each nurse station;
(vi) heating system;
(vii) emergency lighting system.
(b) There shall be sufficient fuel storage capacity to permit at least four hours continuous operation.
The following sections of the Guidelines do not apply:
(1) Parking, Section 9.7A, subsection 9.7B.2., and subsection 9.7C.2.
(2) Radiology, Section 9.2.C.
(3) Laboratory, Section 9.2.D.
(4) General Purpose Examination Rooms, Subsection 9.2.B1.
(5) Special Purpose Examination Rooms, Subsection 9.2.B2.
(6) Treatment Rooms, Subsection 9.2.B3.
(7) Observation Rooms, Subsection 9.2.B4.
The Department may assess a civil money penalty of up to $5,000 and deny approval for patient utilization of new or remodeled areas denied 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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