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449.3 Additional Physical Plant Requirements for General, Rehabilitation, and Psychiatric Hospitals, Including Intensive Residential Treatment Facilities (IRTFs) for Children and Adolescents, and Unless Exempted by Chapter 395.0163, Florida Statutes , All Hospital Outpatient Facilities and Hospital Mobile and Transportable Units
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In addition to the codes and standards referenced in Section 449.2 of this code, the following minimum standards of construction and specified minimum essential facilities, shall apply to all new hospitals and all additions, alterations or renovations to an existing licensed hospital, as described in Section 449.1 of this code and listed in Section 449.3 of this code.
Reference The Guidelines for other requirements.
Sliding doors used for access to critical care rooms may be either manual or power operated and if located on an exit access corridor shall be smoke resistive and equipped with latching hardware.
Reference The Guidelines for other requirements.
General categories of neonatal services in the State of Florida are Level I, newborn nursery; Level II, intermediate care unit; and Level III, intensive care unit. Facilities which offer obstetrical services shall provide at a minimum a Level I newborn nursery or a holding nursery that shall meet the requirements of The Guidelines, and facilities that offer neonatal care for Level II and Level III neonatal services shall meet the requirements of The Guidelines for a newborn intensive care unit.
In addition to any other state of Florida required permits, mobile facilities shall be approved in advance by the Agency for Health Care Administration before they may be utilized for patient services.
The mobile facility shall comply with the applicable requirements of the Florida Building Code, Building, The Guidelines, Part 3 Outpatient Facilities, Chapter 3.13 Specific Requirements for Mobile, Transportable, and Relocatable Units, and with Section 449 of this code for the type of service to be provided.
Mobile or transportable units that are limited to providing noninvasive, diagnostic and treatment services without the use of anesthetics shall not be required to comply with other sections of The Guidelines as described in The Guidelines, Part 3 Outpatient Facilities, Chapters 3.13 - 8.2.1.2.
Electrical connection to the hospital electrical system shall be permitted only when the mobile facility complies with appropriate requirements of the Florida Building Code, Building.
When units provide critical care procedures, there shall be a "code blue" code call station in the unit connected to an attended location to summon assistance from the hospital emergency resuscitation response team.
Reference The Guidelines for other requirements.
Each patient sleeping room, except for newborn nurseries and neonatal intensive care units or rooms, shall have a window(s) with a view, visible from the patient's bed, to the exterior of the building or to an atrium that is visually open to the exterior of the building. The clear opening of the patient room window's width and height shall have a minimum of 20 feet (6.10 m) unobstructed vista to any permanent structure or equipment, and a minimum of 15 feet (4.57 m) unobstructed vista to any vehicular parking area or to the property line measured horizontally from the plane of the window.
Ceilings in rooms with ceiling-mounted surgical light fixtures and in kitchens shall be a minimum height of 9 feet (2.7 m).
A pair of doors opening to a room or closet that is located on an exit access corridor shall be equipped with automatic positive latching for both the active and inactive door leaf and shall be equipped with rabbets, bevels, or an astragal at the meeting edges of the doors. The inactive door leaf shall be equipped with either an automatic or semiautomatic flush bolt to provide positive latching. Where the doors are not required to be equipped with closers, a door coordinator is not required.
Toilet compartment partitions and urinal screens shall be constructed of products that do not rust, corrode or delaminate.
All fire walls, smoke barriers, horizontal exits and exit passageway partitions shall be constructed prior to the construction of all intervening walls. Where rated walls, barriers or partitions intersect, the continuity of the higher priority wall, barrier, or partition shall be maintained through the intersection.
Smoke barriers shall be constructed so as to provide a continuous smoke-tight membrane from exterior wall to exterior wall and from the floor to the underside of the floor or roof deck above. This includes interstitial space and the area above monolithic firerated ceiling membranes. Roof trusses shall be permitted to penetrate portions of the smoke barrier located above the fire-rated ceiling membrane where the annular space between the penetrating truss member and the smoke barrier is sealed to limit the transfer of smoke.
Where it is not possible to visually inspect a fire-rated partition, wall or barrier or a smoke barrier that extends through the attic or interstitial space to the roof or floor deck above because of the location of a monolithic ceiling membrane, ceiling access panel(s) shall be installed adjacent to each side of the partition, wall or barrier at intervals not exceeding 30 feet (9.00 m) and in such locations as necessary to view all surfaces of the partition, wall or barrier. Other ceiling access panels shall only be installed as required by other sections of the code. Partitions, walls and barriers requiring protected openings or penetrations shall be identified in accordance with Section 703 of this code.
Where electrical conduits, cable trays, ducts and utility pipes pass through the smoke barrier, the utilities shall be located so that access is maintained to adjacent wall surfaces and to all damper access panels. The details shall show the studs and reinforcing half studs so that proper support is provided for the wall surfacing material. There shall be a minimum clearance of 4 inches (102 mm) between all conduits, piping and duct work insulation that are located parallel or adjacent to a fire-rated wall or to a smoke barrier to facilitate the inspection of these walls.
The use of pocket sliding or folding doors to patient use toilet, baths, or shower rooms shall not be permitted. A sliding door equipped with sliding door hardware located on the patient room side of the wall and not equipped with a bottom door track shall be permitted.
(Reference The Guidelines for other requirements.)
All elevators shall be in compliance with the requirements of Chapter 30 of the Florida Building Code, Building and Chapter 69A-47, Florida Administrative Code, "Uniform Fire Safety Standards for Elevators."
Reference The Guidelines for other requirements.
Air-handling equipment shall be installed exterior of the building, to include the roof, in a designated equipment room(s), in an open space(s) of an attic(s) or interstitial space(s) located inside the conditioned envelope of the building, or in an enclosed space located in an unconditioned attic(s). If the equipment serves only one room, it may be located above the ceiling and shall be accessible through an access opening in accordance with the requirements of such openings in this code. Access panels are not required for lay-in ceiling installations, provided the service functions are not obstructed by other above-ceiling construction, such as electrical conduits, piping, audio visual cabling and like equipment components or supports.
All new hospital, outpatient surgery and cardiac catheterization facility construction, for both inpatients and outpatients, shall have completely ducted airsupply, return, outside air and exhaust systems. In hospital buildings with multiple uses, tenants or occupancies, located on a separate floor or floors within the building, or located in a medical office building, only the licensed health care areas where invasive procedures, as defined by The Guidelines, are performed shall be required to be served by separate ducted mechanical air-supply, return and exhaust systems.
In new construction, horizontal offsets of duct system risers penetrating more than one floor shall not be allowed.
Flexible ducts shall be listed and labeled to the UL181 Standard for Factory-Made Air Ducts and Air Connectors and shall be Class 0 or Class 1. Flexible ducts shall meet the following additional performance rating criteria:
The duct shall have a minimum rated air velocity of 4,000 feet per minute, a minimum positive pressure rating of 4 inches water gauge, and a minimum negative pressure rating of 1 inch water gauge.
The outer vapor barrier shall have a perm rating not greater than 0.05 perms when tested in accordance with ASTM E96, Procedure A.
Flexible air connectors shall be limited to 14 feet (4267mm) maximum installed length and shall not pass through any wall, partition, or enclosure of a vertical shaft that is required to have a fire-resistance rating of 1 hour or more. Flexible air ducts shall not be limited in length.
Air ducts and exhaust duct systems shall not be constructed of fiberglass duct board.
Variable air volume systems shall not be permitted for use in surgical departments, obstetrical departments, laboratories, isolation rooms and critical care units and rooms.
Filter housing frame blank-off panels shall be permanently attached to the frame, constructed of rigid materials and have sealing surfaces equal to or greater than the filter media installed in the filter frame. All joints between the blank-off panels, filter housing frames and filter support structure shall be caulked airtight.
During an automatic fire alarm activation or the activation of a duct smoke detector, fan systems and fan equipment serving more than one room shall be stopped to prevent the movement of smoke by mechanical means from the zone in alarm to adjacent smoke zones. Air movement across smoke barriers shall be permitted when the area is not in automatic fire alarm activation.
Fan control shall be designed so as to minimize the interruption of heating, ventilating and air conditioning in compartments remote from the compartment in alarm.
Fan control shall not interfere with the continuous operation of exhaust systems conveying ethylene oxide or other hazardous chemicals and fumes or systems required to operate continuously for the health and safety of occupants. Such systems shall include fume hood exhaust deemed by the governing body of the hospital to present a hazard to occupants if exhaust airflow is stopped. Air-handling systems shall be designed to allow for continuous operation of all such systems and to minimize movement of smoke by mechanical means from the zone in alarm.
See Section 908.7 of this code.
Reference The Guidelines for other requirements.
All plumbing systems shall be designed and installed in accordance with the Florida Building Code, Plumbing.
Where required by another section of this code, a new fire pump, except for a replacement fire pump, that is electric motor-driven shall be connected to the Emergency Power Supply System (EPSS) of the hospital. A fire pump(s) that is not electric motor-driven shall meet the requirements of NFPA 20, Standard for the Installation of Stationary Pumps for Fire Protection, alternative power.
Reference The Guidelines for other requirements.
All materials and equipment shall be factory listed as complying with applicable standards of Underwriter's Laboratories, Inc., or other similarly established standards of a nationally recognized testing laboratory (NRTL) that has been certified by the Occupational Safety and Health Administration (OSHA) for that referenced standard.
Field labeling of equipment and materials shall be permitted only when provided by a nationally recognized testing laboratory that has been certified by the Occupational Safety and Health Administration (OSHA) for that referenced standard.
Nonmetallic sheathed cable or similar systems are not permitted for power and lighting wiring in any facility.
Panel boards located in spaces subject to storage shall have the clear working space in accordance with Chapter 27, Florida Building Code, Building. "ELECTRICAL ACCESS - NOT FOR STORAGE" shall be permanently marked on the floor and wall about the panel. Panel boards shall not be located in an exit access corridor or in an unenclosed space or area that is open to an exit access corridor. Panel boards may be located inside of a room or closet that opens into an exit access corridor only when the room or closet is separated from the exit access corridor by a partition and door that comply with this code.
There shall be documentation for equipotential grounding in all patient care areas, building service ground electrode systems, lightning protection ground terminals and special systems such as fire alarm, nurse call, paging, generator, emergency power, fault analysis and breaker coordination.
All spaces occupied by people, machinery and equipment within buildings and approaches to buildings shall have electric lighting.
Operating rooms and delivery rooms shall have general lighting for the room in addition to local high intensity, specialized lighting provided by special fixtures at the surgical and obstetrical tables. Each special lighting unit for local lighting at the tables shall be connected to an independent circuit and shall be powered from the critical branch. A minimum of one general purpose lighting fixture shall be powered from a normal circuit in an operating room, delivery or similar room.
There shall be a maximum of six duplex receptacles on a circuit in general patient care areas.
The circuitry of all receptacles required by The Guidelines in critical care areas, in all emergency treatment rooms or areas, and other areas including angiographic laboratories, cardiac catheterization laboratories, coronary care units, human physiology laboratories, intensive care units and postoperative recovery rooms, shall be provided as follows:
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