Requirements for NPC. For any general acute care hospital located in Seismic Design Category D, as defined by Section 1613A of the 2013 California Building Code:
1.1. By January 1, 2024, the hospital owner shall submit to the Office a complete nonstructural evaluation up to NPC 4 or 4D and NPC 5, for each building.
1.2. By January 1, 2026, the hospital owner shall submit to the Office construction documents for NPC 4 or 4D and NPC 5 compliance that are deemed ready for review by the Office, for each building that will continue to provide acute care services beyond January 1, 2030.
1.3. By January 1, 2028, the hospital owner shall obtain a building permit to begin construction, for NPC 4 or 4D and NPC 5 compliance of each building that the owner intends to use as a general acute care hospital building after January 1, 2030. Hospitals not meeting the January 1, 2028 deadline set by this section shall not be issued a building permit for any noncompliant building except those required for seismic compliance in accordance with the California Administrative Code (Chapter 6), maintenance, and emergency repairs until the building permit required by this section is issued.
Exception: If the hospital has obtained an extension for SPC compliance, the NPC compliance deadlines shall coincide with the approved SPC extension deadlines and the requirements of Sections 1.5.2 shall be deemed to be satisfied.
1.4. After January 1, 2028, buildings with an NPC rating less than 4, all remodels/renovations, or other construction work, shall include anchorage and/or bracing of all equipment and services within the boundary of the scope of work that is not in compliance with NPC 4.
Exception 1: Remodels/renovations, or other construction work, that remove a room or space from service use or occupancy for less than 24 hours.
Exception 2: Where 20 percent or less of the affected existing construction, such as ceilings, walls, and ducts, but independent of finishes, is removed to access equipment and services for anchorage/bracing may be reinstalled as it pre-existed prior to the NPC work, as long as it was in compliance with the code at the time it was installed/constructed.
Exception 3: Buildings that have been removed from general acute care service, or have projects to remove the building from acute care services by 2030.
1.5. Any general acute care hospital building (located in Seismic Design Category D or F) granted an extension up to January 1, 2020 or beyond is deemed to comply with the terms of the extension if all of the following conditions are met:
1.5.1. The hospital meets the anchorage and bracing requirements for NPC 2.
1.5.2. The building is upgraded to NPC 3 in accordance with the compliance timeframes specified in Table 11.1.
Exception: The building is SPC-2, the method of compliance is to remove the building from general acute care service by 2030, and no SPC-4D projects have been submitted to the Office.
Requirements for SPC.
Extension until January 1, 2020. Any SPC-1 general acute care hospital building that has received an extension to the January I, 2008, deadline for both the structural and nonstructural requirements may receive an additional extension of up to seven years to the January I, 2013, deadline for both the structural and nonstructural requirements.
1.1. For an SPC-1 building to be eligible for this extension, all of the following conditions must be met:
The hospital owner requesting an extension for an SPC-1 building in accordance with this section, must submit to the Office no later than March 31, 2012, the following:
An application for extension accompanied by a letter of intent stating whether the hospital intends to rebuild, replace or retrofit the building, or remove all general acute care beds and services from the building.
A facility site plan identifying the SPC-1 hospital building for which the extension is being requested by name and OSHPD assigned building number.
A chart or a bar graph schedule which describes the necessary amount of time and schedule to complete the construction for the subject building in order to achieve the targeted building resolution stipulated in the letter of intent pursuant to Section 1.5.2 Item 2.1.1(a)(i). The chart shall indicate all major milestones required for the implementation of the construction plan.
A narrative description and supporting documentation demonstrating how the hospital intends to meet the requested deadline and why the requested extension is necessary.
When applicable, a narrative description and supporting documentation demonstrating community access to essential hospital services as specified in Section 1.5.2 Item 2.1.5.
When applicable, a narrative description and supporting documentation demonstrating the hospital owner's financial hardship to meet the milestones specified in Section 1.5.2 Items 2.1.6.
Information on the type of use/ occupancy of the SPC-1 building by listing the type of services currently delivered in the building.
The hospital owner submits to the Office, no later than September 30, 2012, an application and required documents ready for review seeking collapse probability assessment for its SPC-1 building in accordance with Section 1.8.2.
The hospital owner submits to the Office, no later than January 1, 2015, construction documents ready for review consistent with the letter of intent and the schedule submitted pursuant to Section 1.5.2 Items 2.1.1(a)(i) and (iii). The construction documents shall be accompanied by a financial capacity report. The financial capacity report shall demonstrate the hospital owner's financial capacity to implement the construction plans submitted pursuant to this subsection.
The hospital owner receives a building permit consistent with the letter of intent and the schedule submitted pursuant to Section 1.5.2 Items 2.1.1(a)(i) and (iii) no later than July 1, 2018.
1.2. A hospital may demonstrate that it has complied with the requirements of their compliance schedule if they received confirmation of compliance from the Office by the end of their extension date.
1.3. Extensions to the January 1, 2013 compliance deadline.
1.3.1. The maximum permitted extension for a hospital building is the greater extension time allowed based on consideration of the structural integrity of the building as determined by the Risk-Based Extension in Section 1.5.2. Item 8.4, the access to essential hospital services as determined in Section 1.5.2 Item 8.5 and the Financial Hardship as determined by Section 1.5.2 Item 8.6. In no event shall the maximum permitted extension exceed seven years or the amount of time reasonably required to complete the construction described in Section 1.5.2 Item 2.1.1(a), whichever is less.
1.3.2. Upon acceptance of the application for extension and all submittal documentation required in Section 1.5.2 Item 8.1(a) an SPC-1 building may be granted an Administrative Extension by the Office.
1.4. Risk-Based Extension. The risk-based extension is based on the seismic risk coefficient.
The seismic risk coefficient posed by a building, P, shall be determined by:
H = the value of the collapse probability in percent, as determined by the requirements of Section 1.8; and,
E = the Exposure Factor, based on the presence of Basic and Supplemental Services, as defined in Part 2, Title 24, Section 1224.3.
The Exposure Factor E shall be taken as:
E = 0.5 where the building houses only storage spaces, central sterile supply spaces, and/or utility plant spaces.
E = 0.7 where the building houses only clinical laboratory, pharmaceutical, dietetic and/or support services spaces, or nonpatient care building which is contiguous to and provides egress or structural support to an acute care hospital building(s).
E = 1.0 where the building houses any other Basic and/or Supplementary Service spaces.
Where a building contains more than one Basic and/or Supplementary Service space, the largest value of E shall apply.
The Risk-Based Extension is determined by the seismic risk coefficient, P:
Where P ≤ 3.0%, the Risk-Based Extension for the building shall not exceed seven years.
Where P > 3.0% but P ≤ 5.0%, the Risk-Based Extension for the building shall not exceed five years.
Where P > 5.0%, the Risk-Based Extension for the building shall not exceed two years.
Regardless of the seismic coefficient, P, the Risk-Based Extension for any building straddling an Active Fault shall not exceed two years.
1.5. Community access to essential hospital services. The potential effect of closure of the hospital building on community access to essential hospital services shall be evaluated. A building at a hospital defined as a Critical Community Provider in accordance with this Section is eligible for a Maximum Permitted Extension of up to seven years. The hospital may be classified as a Critical Community Provider if it meets the requirements of Section 1.5.2 Items 2.1.5(a), 2.1.5(b), 2.1.5(c), 2.1.5(d) or 2.1.5(e):
The hospital meets the requirements of (i) or (ii) below:
Certified as a Sole Community Hospital, Critical Access Hospital, or Rural Referral Center by the Department of Health and Human Service Centers for Medicare & Medicaid Services.
Disproportionate Share Hospital. For purposes of this section a hospital is deemed to be a disproportionate share hospital if it meets the eligibility requirements of the Welfare and Institutions Code, Section 14105.98 for at least two years during the five most current years prior to application for an extension.
The hospital provides care for uninsured/ underinsured populations. To qualify, the hospital must meet or exceed all of the following minimum thresholds:
10 percent Medicaid Discharges.
10 percent Medicaid Emergency Department visits.
10 percent Uninsured Emergency Department visits.
Inpatient Occupancy rate of the hospital general acute licensed beds greater than 50 percent.
The hospital is a critical service provider of any of the following specialized medical care within its service area as defined in Section 1.5.2 Item 2.1.5(f):
Trauma Center as defined by CCR — Title 22, Division 9, Section 100248.
Children's Hospital as defined by the Welfare and Institutions Code, Section 10727.
Burn Unit as defined by CCR — Title 22, Division 5, Section 70421.
Emergency department provides 10 percent or more of the total Emergency Treatment Stations.
A hospital in which its service area has an average number of patient beds/1000 population below 1.5.
The hospital provides more than 20 percent of the licensed acute care beds in the hospitals' service area as defined in Section 1.5.2 Item 2.1.5(f).
A tertiary or specialty hospital dedicated to specific sub-specialty care with volumes in excess of 50 percent of total annual discharges within the county in which the hospital is located.
Hospital Service Area. The total geographic area comprised by the sum of all patient origin regions that significantly contribute to the inpatient population of the subject hospital. For the purposes of determining the hospital service area, conditions (i) and (ii) listed below shall be satisfied:
The number of regions considered shall include all the regions with a relative hospital ratio of inpatient discharges per region greater than 5 percent of the total hospital inpatient discharges. "Relative hospital ratio of inpatient discharges per region" means the number of hospital patients discharged in a region by the subject hospital in relation to the total hospital patients discharged for the same region by all hospitals.
The number of regions considered shall include all the regions with a hospital ratio of inpatient discharges per region that cumulatively account for at least 70 percent of the total hospital patient discharges. "Hospital ratio of inpatient discharges per region" means the number of hospital patients discharged in a region by the subject hospital in relation to the total patients discharged by the subject hospital.
The data utilized to determine community access to essential hospital services shall be based on the hospital's most current fiscal reporting information filed with the Office or on the hospital's fiscal reporting information filed with the Office for any of the most current three years.
1.6. Financial Hardship. Evaluation of financial hardship shall be determined on a hospital-by-hospital basis. A building at a hospital that meets the financial hardship criteria of this section is eligible for a Maximum Permitted Extension of up to seven years. A hospital may be determined to have financial hardship if it meets at least one of the following requirements:
Financial performance. The hospital meets all of the following thresholds:
Negative operating margin for the hospital for at least two years during the five years prior to application for an extension.
For public hospitals, voters rejected the most recent bond issue specifically related to seismic compliance construction work at the facility.
The data utilized to determine financial hardship shall be based on the hospital owner's most current fiscal reporting information filed with the Office or on the hospital owner's fiscal reporting information filled with the Office for any of the most current three years unless noted otherwise in subsection (a) above.
1.7. Extension Adjustments. A hospital may request an extension adjustment necessary to complete the construction for the building granted an extension pursuant to Section 1.5.2 Item 2. In order for this request to be considered, the hospital owner shall notify the Office in writing as soon as practicable, but in no event later than six months after the hospital owner discovered the change of circumstances. The request shall include at a minimum all of the following:
The length/duration of the additional extension time adjustment, but in no event the total extension including the adjustment shall exceed the period specified in Section 1.5.2 Item 2.
The name and OSHPD assigned number for the hospital building requiring the extension adjustment.
A narrative description and data supporting the discovered change of circumstances in completing the construction for the building granted an extension pursuant to Section 1.5.2 Item 2.
An amended bar graph schedule required by Section 1.5.2 Item 2.1.1(a)(iii).
1.8. Extension Revocation/Termination. An extension for any hospital building granted pursuant to Section 1.5.2 Item 2 may be revoked or terminated based on the following:
The Office determines that any information submitted pursuant to this section was falsified; or
The hospital failed to meet a milestone set forth in Sections 1.5.2 Item 2.1.1(a)(iii); or
Where the work of construction is abandoned or suspended for a period of at least six months, unless the hospital demonstrates in a publicly available document that the abandonment or suspension was caused by factors beyond its control.
Additional extension beyond January 1, 2020.
2.1. The Office may grant the hospital owner an additional extension to the January 1, 2020 seismic compliance deadline for each SPC 1 building where all the following conditions are met:
An extension was previously granted pursuant to California Health and Safety Code, Section 130060(g) or Section 130061.5(b).
A prior compliance plan corresponding to a replacement, retrofit or rebuild project was submitted to the Office by January 1, 2018.
The application for an extension is submitted by the owner on a form provided by the Office, and received by the Office no later than April 1, 2019.
The application, one per building, shall identify the seismic compliance method chosen based on a replacement, retrofit or rebuild plan as defined in definitions Section 1.2 of this chapter, for addressing the acute care functions in the SPC-1 building.
Documentation of facts necessary in determining the maximum length of the extension that may be granted in accordance with subsection 2.1.1 shall be submitted with the application.
2.1.1. Maximum length of Extension. The Office shall not grant an extension that exceeds the amount of time needed by the owner to come into compliance. The length of the extension to be granted shall be based upon a showing by the owner of the facts necessitating the additional time. It shall include a review of the plan and all the documentation submitted in the application for the extension, and shall permit only that additional time necessary to allow the owner to deal with compliance plan issues that cannot be fully met without the extension.
2.1.2. Extension for Replacement or Retrofit Plan where Construction has not Started. For an extension request based on a replacement plan or retrofit plan, final seismic compliance shall be achieved, a certificate of occupancy or construction final shall be obtained by July 1, 2022 and the following conditions shall apply:
Application submitted shall contain an extension schedule that identifies:
The maximum extension time requested, but no later than July 1, 2022.
Date when building permit will be obtained.
Date the hospital will begin construction.
A construction schedule shall be submitted within 15 calendar days of obtaining a building permit. The construction schedule shall identify a minimum of two major milestones acceptable to the office that will be used as a basis for determining whether the hospital is making adequate progress. Major milestones identified in the construction schedule shall be chosen such that they are easily verifiable by the Office.
Obtain a building permit.
Compliance with the requirements in (1 through 4) above shall be achieved no later than April 1, 2020.
2.1.3. Extension for Rebuild Plan where Construction has not Started. For an extension requested based on a rebuild plan, final seismic compliance shall be achieved, a certificate of occupancy shall be obtained by January 1, 2025 and the following shall apply:
Application submitted, shall contain an extension schedule that identifies:
The maximum time request for the extension, but no later than January 1, 2025.
Date of submission of the rebuild project deemed ready for review to the Office, but no later than July 1, 2020
Date when building permit will be obtained.
Date the hospital will begin construction.
Submission of the rebuild project deemed ready for review to the Office shall occur no later than July 1, 2020.
A construction schedule submitted within 15 calendar days of obtaining a building permit. The construction schedule shall identify a minimum of two major milestones acceptable to the office that will be used as a basis for determining whether the hospital is making adequate progress. Major milestones identified in the construction schedule shall be chosen such that they are easily verifiable by the Office.
Obtain a building permit.
Compliance with the requirements in 3) through 5) above shall be achieved no later than January 1, 2022.
2.1.4. Extension where Construction has Started. For a hospital building that has previously submitted to the Office a retrofit, replace or rebuild project under construction, the application for an extension request shall contain all the following:
The method of compliance with the requested extension which shall be no later than July 1, 2022 for retrofit or replace plan and January 1, 2025 for rebuild plan. The application shall include the facts necessitating the additional time.
The project number under which the construction has commenced and is continuing.
A revised construction schedule to reflect the extension being requested and at least two major milestones shall be identified. Major milestones shall be chosen such that they are easily verifiable by the Office.
2.2 Quarterly Status Reports. A hospital granted an extension pursuant to this section shall provide a quarterly status report in a form required by the Office, consistent with their extension/construction schedule. The first report is due on July 1, 2019, subsequent status reports shall be due every October 1, January 1, April 1, and July 1, until seismic compliance is achieved. Each quarterly report shall contain the cumulative progress made towards meeting the dates in the extension and the construction schedules, current to 15 calendar days before the report is due. The report may be submitted to the Office no more than 15 calendar days before the due date.
2.3 Fines for Failure to Comply. Failure to comply with the dates for plan submission, construction schedule submission, obtain a building permit, to begin construction identified and accepted by the Office in the extension schedule or the major milestone dates identified and accepted by the Office in the construction schedule shall result in the assessment of a fine of five thousand dollars ($5,000) per calendar day until the requirements or milestones, respectively, are met. The Office shall not issue a construction final or certificate of occupancy for the building until all assessed penalties accrued pursuant to this section have been paid in full or, if an appeal is pending, have been posted subject to resolution of the appeal.
2.4 Adjustments to Schedules. The Office may grant an adjustment as necessary to deal with contractor, labor, material delays, with acts of God, or with governmental entitlements, experienced by the hospital. The hospital shall submit the reason for the delay along with substantiating documents, a revised construction schedule and identify at least two new major milestones consistent with the adjustment. Requests for adjustments shall be made with the Office as soon as the reasons for the delay are known but no less than 30 calendar days before any upcoming affected extension schedule or construction milestone date.
Failure to comply with the revised construction schedule or meet any of the major milestones shall result in penalties as specified in subsection 2.3. The adjustment shall not exceed the corresponding final seismic compliance date of July 1, 2022 for a replacement plan or retrofit plan and January 1, 2025 for a rebuild plan.