All newly licensed or newly constructed ambulatory surgical centers, all ambulatory surgical center outpatient facilities and ambulatory surgical center mobile and transportable units, unless exempted by Chapter 395.0163, Florida Statutes and all additions, alterations or renovations to an existing licensed ambulatory surgical center shall comply with all applicable requirements of this code and the minimum standards of design, construction and specified minimum essential utilities and facilities of this section and shall have plans reviewed and construction surveyed by the state agency authorized to do so by Chapter 553.80(1)(c), Florida Statutes to assure compliance with all applicable requirements of this code.
A change of ownership of an existing licensed ambulatory surgical center shall not require compliance with this section.
The Florida Building Code, Existing Building, Section 101.2, Scope exempts state licensed ambulatory surgical centers from compliance with that code. Any repair, alteration, change of occupancy, addition and relocation of an existing state licensed ambulatory surgical center shall comply with the applicable requirements of this code and this section.
For project submission and fee requirements, and other administrative, licensure, and programmatic provisions for ambulatory surgical centers, see Agency for Health Care Administration, [AHCA] Chapter 59A-5 Florida Administrative Code (F.A.C.) and Chapter 395, Florida Statutes.
For state licensure purposes, these codes and standards shall be applicable to the project on the effective date of this code at the time of preliminary plan approval by the Agency for Health Care Administration (the Agency) or at the first construction document review if there has been no previous preliminary plan approval for that project.
In addition to the minimum standards required by Section 451 of this code, Chapter 59A-5, Florida Administrative Code or by Chapter 395, Florida Statutes, all new ambulatory surgical centers and all additions, alterations or renovations to existing ambulatory surgical centers shall also be in compliance with the following codes and standards on the effective date of this code as described in Section 451.1.5 of this code.
The fire codes described in Chapter 69A-3.012, Standards of the National Fire Protection Association Adopted, Florida Administrative Code.
Guidelines for Design and Construction of Health Care Facilities (The Guidelines), as reference in Chapter 35 of this code.
In addition to the codes and standards referenced in Section 451.2, the minimum standards of construction and specified minimum essential facilities described in Section 451.3 shall apply to all ambulatory surgical centers as described in Section 451.1. and to all new additions, alterations or renovations to existing ambulatory surgical center on the effective date of the code.
(Reference The Guidelines for other requirements.)
All ambulatory surgical centers shall be equipped with a minimum of one operating room that is in compliance with the requirements of a Class C operating room as described in The Guidelines. Only Class C operating rooms will be listed as operating rooms for purposes of licensure.
If provided, all Class A or Class B operating rooms, and all procedure, examination, or treatment rooms shall meet the requirements for these rooms as described in The Guidelines.
(Reference The Guidelines for other requirements.)
Only the post-anesthesia recovery positions, as described in The Guidelines, will be listed as recovery positions for purposes of licensure.
Where it is not possible to inspect a firerated 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.
(Reference The Guidelines for other requirements.)
No doors shall swing into the corridor except those to small closets or small mechanical or electrical rooms that cannot be usefully occupied with the doors in the closed position.
All exit access corridor doors must be equipped with automatic positive latching hardware.
The use of sliding pocket doors to patient use toilets shall not be permitted.
(Reference The Guidelines for other requirements.)
All new ambulatory surgical centers located in multistory buildings where patient treatment areas are located on other than the exit floor shall have at least one 2,500 pound (933 kg) capacity elevator that shall be in compliance with the requirements of Section 451.3.13.5 and the requirements of Chapter 30 of the code.
This required elevator shall be sized to accommodate an ambulance stretcher 76 inches (1931 mm) long and 24 inches (610 mm) wide in the horizontal position. This elevator shall be identified with a sign indicating it as the ambulance stretcher elevator.
(Reference The Guidelines for other requirements.)
Air-handling equipment shall be located either on the roof of the building it serves or in mechanical equipment rooms unless it serves only one room and is located in that room. In buildings with multiple uses, tenants or occupancies, the licensed health care areas required by this code to maintain filter efficiencies and relative air pressure relationships shall be served by separate ducted mechanical air supply, return and exhaust systems. This equipment may be located in other areas of the building or in the same room as the building air-handling equipment if access during normal business hours is available.
Variable volume systems shall not be permitted in surgical procedures rooms and recovery rooms.
Friable duct linings exposed to air movement shall not be used in ducts, terminal boxes or other systems supplying operating rooms and recovery rooms, unless terminal filters of at least 90-percent efficiency are installed downstream of linings. Flexible duct work shall have a continuous metal inner liner encased by insulating material with an outer vapor jacket conforming to UL 181 unless the flexible duct meets the following criteria.
The duct conforms to UL Class 1 Air Duct, Standard 181 with minimum rated air velocity of 4,000 feet per minute, and is pressure rated for a minimum of 4-inches water gage positive pressure and 1-inch water gage negative pressure.
The inner core of the duct is constructed of Chlorinated Polyethylene (CPE) material encircling a steel helix bonded to the CPE.
The duct has a fire-retardant metalized vapor barrier that is reinforced with crosshatched fiberglass scrim having a permanence of not greater than 0.05 perms when tested in accordance with ASTM E 96 Procedure A.
The duct has passed an impact test similar to the UL 181 standard, conducted by a nationally recognized testing laboratory (NRTL) except it shall use a 25-pound (11 kg) weight dropped from a height of 10 feet (3.048 m). As a result of the test, the inner and outer surfaces of the sample shall not have ruptured, broken, torn, ripped, collapsed or separated in order for the duct to pass the test. In addition, the helix shall rebound to a cross-sectional elliptical area not less than 80 percent of the original test sample diameter. The use of flexible duct shall be limited to flexible air connector applications.
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 air tight.
During an automatic fire alarm activation, 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 or to adjacent areas within the smoke zone if there is only one zone in the facility.
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. 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.
(Reference The Guidelines for other requirements.)
Plumbing shall comply with the Florida Building Code, Plumbing.
Where required in new construction, fire pumps and ancillary equipment shall be separated from other functions by construction having a 2-hour fireresistance rating.
The fire pump normal service disconnect shall be rated to hold locked rotor current indefinitely. If the approved normal service disconnect is located on the exterior, it shall be supervised by connection to the fire pump remote annunciator and shall provide a separate fire alarm system trouble indication.
When the fire pump is placed on the emergency system in addition to the normal supply, the emergency feeder protective device shall be sized in accordance with maximum rating or settings of Chapter 27 of this code.
The fire pump transfer switch may be either manual or automatic. If located on the line side of the controller as a separate unit, the switch must be rated for the pump motor locked rotor current indefinitely and must be located in the pump room.
Combination fire pump controller and transfer switch units listed by the Underwriter's Laboratories, Inc., as prescribed by Chapter 27 of this code are acceptable when the transfer switch has exposable and replaceable contacts, not circuit-breaker-types, rated for the available short-circuit current.
The fire pump shall be installed in a readily accessible location When it is located on the grade level floor, there shall be direct access from the exterior.
(Reference The Guidelines for other requirements.)
All material, including equipment, conductors, controls, and signaling devices, shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities shown in the specifications or indicated on the plans.
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.
There shall be documentation for equipotential grounding in all patient care areas, building service ground electrode systems, and special systems such as fire alarm, nurse call, paging, generator, emergency power and breaker coordination.
All spaces occupied by people, machinery and equipment within buildings, and the approaches thereto, and parking lots, shall have electric lighting.
Patients’ recovery rooms shall have general lighting. Fixed lights not switched at the door shall have switch controls convenient for use at the luminaries. All switches for control of lighting in recovery areas shall be of the quiet operating type.
Operating rooms shall have general lighting for the room in addition to localized specialized lighting provided by a special lighting unit required at the surgical table. The type of special lighting unit shall be as specified by the functional program of the facility. Each special lighting unit for localized lighting at the surgical table shall be permanently installed and permanently connected to an independent circuit that shall be powered from the critical branch. In addition, a minimum of one general purpose lighting fixture shall be powered from a normal circuit in all operating rooms.
The number and circuitry of all duplex receptacles in operating rooms, cardiac catheterization laboratories, and post-operative recovery rooms, shall be provided as follows:
A minimum of four duplex receptacles shall be connected to the critical branch of the essential electrical system.
A minimum of two duplex receptacles shall be connected to a normal power circuit or to a critical branch circuit from a different transfer switch.
There shall be no more than two duplex receptacles per circuit for all receptacles for the areas as listed.
All receptacles shall have engraved cover plates to indicate the panel board and circuit numbers powering the device.
Branch circuit over-current devices shall be readily accessible to nursing staff and other authorized personnel.
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 of this code. “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.
The electrical system shall have coordinated short circuit protection.
Provide color coding for the junction boxes for the branches of the essential electrical system.