Section 1224 [OSHPD 1] Hospitals
The provisions of this section shall apply to general acute-care hospitals and general acute-care hospitals providing only acute medical rehabilitation center services. The provisions of Section 1225 shall apply to distinct part skilled nursing and intermediate-care services on a general acute-care hospital license, provided either in a separate unit or a freestanding building.
New buildings and additions, alterations or repairs to existing buildings subject to licensure shall comply with applicable provisions of the California Electrical Code, California Mechanical Code, California Plumbing Code, California Energy Code, California Fire Code (Parts 3, 4, 5, 6 and 9 of Title 24) and this section.
Exceptions:
- Facilities licensed and in operation prior to the effective date of this section shall not be required to institute corrective alterations or construction to comply with any new requirements imposed thereby or subsequently, except where specifically required or where the enforcing agency determines that a definite hazard to health and safety exists. Facilities for which preliminary drawings have been submitted to the enforcing agency prior to the effective date of this change shall not be required to comply with such new requirements, provided working drawings are submitted within one year of the effective date of such new requirements.
- A change in function shall require compliance with all the functional requirements for new construction in this code, including requirements in Sections 1224, 1225, 1226, 1227 and 1228.
- The provisions of this section do not prohibit the use of alternate space utilization, new concepts of design, treatment techniques, equipment and alternate finish materials provided the intent of this section is accommodated and written approval for such alternative is granted by the enforcing agency. Written substantiating evidence in support of the alternate and a written request for consideration shall be submitted to the enforcing agency.
- Nothing in this section shall prohibit the provisions of required services from a centralized service facility serving two or more licensed facilities when approved in writing by the licensing agency. Buildings and required spaces for services provided in a separate centralized services facility shall comply with all applicable provisions of these regulations and applicable local codes and ordinances for the services so provided.
- Acute psychiatric hospitals and general acute-care hospitals providing only acute medical rehabilitation center services may provide for surgical and anesthesia services to be provided by an outside licensed facility when approved by the licensing agency.
- When the Corrections Standards Authority, the Department of Corrections or the Department of Youth Authority determines that a particular requirement for hospitals located in a correctional facility may compromise the safety, security or protection of staff, inmates or property, the enforcement agency shall consider an alternate design.
Specific terms and definitions are provided to facilitate consistency in the interpretation and application of these requirements. Some of these terms may have a broader definition in other contexts, but the definitions provided here reflect the use of the terms for OSHPD requirements.
AIR CONDITIONING. The process or system by which simultaneously the temperature, humidity, air motion and quality are maintained within required limits.
AIRBORNE INFECTION ISOLATION ROOM. A single-occupancy patient room where environmental factors are controlled in an effort to minimize the transmission of those infectious agents usually spread from person to person by droplet nuclei associated with coughing and inhalation.
AMBULATORY CARE. A defined health care encounter(s) of less than 24 hours in duration that requires direct professional health care support within a specific facility.
AMBULATORY SURGICAL FACILITY. Any surgical facility organized for the purpose of providing procedural, invasive surgical care to patients with the expectation that they will be recovered sufficiently to be discharged in less than a 24-hour period.
ANGIOGRAPHY. The radiographic visualization of blood vessels following introduction of contrast material for purposes of diagnosis.
BASIC SERVICES. Those essential services required for licensure as a hospital, including medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, dietary services and support services. See "SUPPLEMENTAL SERVICES."
BIOTERRORISM. The use, or threat of use, of biological agents to intimidate a political entity or population group.
CENTRAL AIR-HANDLING SYSTEMS. Any units requiring ductwork on the supply or inlet side and serving more than one room.
CHANGE IN FUNCTION. A change in function is a change in activity, service or licensed service provided, within the project limits, that does not necessarily change the use, specific use, and/or occupancy. Conversion of a space that results in a change in activity such that the space will be required to satisfy the functional space requirements under a different code sub-section than that of the prior use is considered a change in function.
CLEAR DIMENSION. An unobstructed room dimension exclusive of built-in casework and equipment and available for functional use.
COURT. An open exterior space bounded on three or more sides by the walls of a structure.
ENVIRONMENT OF CARE. Those features in a built health care entity that are created, structured, and maintained to support quality health care.
EXAM ROOM. A room with a bed, stretcher, or examination table and capability for periodic monitoring (e.g., measurement of blood pressure or pulse oximetry) in which procedures that do not require a specialized suite can be performed (e.g., pelvic examination, blood transfusion).
FLOOR AREA, CLEAR. The actual occupied area exclusive of fixed or wall-mounted cabinets, fixed beds and furnishings, built-in shelves, toilet rooms, closets, lockers, wardrobes, alcoves, anterooms or vestibules.
GENERAL ACUTE-CARE HOSPITAL. A hospital, licensed by the California Department of Public Health, having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff which provides 24-hour inpatient care, including the basic services.
HANDWASHING STATION. An area that provides a hand-washing fixture, cleansing agents and means for drying hands. Refer to the California Plumbing Code, Section 210.0 for the definition of handwashing fixture.
HOSPITAL. A general acute-care hospital, including those providing only acute medical rehabilitation center services and acute psychiatric hospitals.
HOUSEKEEPING. Services anywhere within a health care facility that include general cleaning and tidying and the provision and positioning of identified materials, e.g., soaps, towels, etc. (While routine disinfection protocols can be included in such a definition, the definition is not intended to include complex, nonroutine disinfection procedures nor the nonroutine disposition of hazardous materials such as potentially toxic drugs or other chemicals and radioactive wastes.)
LDR. Labor, Delivery, Recovery (an unlicensed patient bed)
LDRP. Labor, Delivery, Recovery, Postpartum (a licensed patient bed)
LICENSING AGENCY. The Department of Public Health, Licensing and Certification.
LOCATION TERMINOLOGY (terms for relationship to an area or room)
ADJACENT. Located next to but not necessarily connected to the identified area or room.
DIRECTLY ACCESSIBLE. Connected to the identified area or room through a doorway, pass-through, or other opening without going through an intervening room or public space.
IMMEDIATELY ACCESSIBLE. Available either in or adjacent to the identified area or room.
IN. Located within the identified area or room.
READILY ACCESSIBLE. Available on the same floor as the identified area or room.
MONOLITHIC. A surface free of fissures, cracks, perforations, and crevices.
MONOLITHIC CEILING. A ceiling constructed with a surface free of fissures, cracks, and crevices. Any penetrations such as lights, diffusers, and access panels shall be sealed or gasketed. Lay-in ceilings are not considered "monolithic."
NURSING UNIT. A designated patient care area of the hospital which is planned, organized, operated and maintained to function as a unit. It includes patient rooms with adequate support facilities, services and personnel providing nursing care and necessary management of patients.
OPERATING ROOM. A room specifically designed for the performance of surgical procedures. (In common understanding, this means most types of surgical procedures, especially those involving the administration of anesthesia, multiple personnel, recovery room access, and a fully controlled environment.)
HYBRID OPERATING ROOM. A room that meets the definition of an operating room and is also equipped to enable diagnostic imaging before, during, and after surgical procedures. Imaging equipment is permanently installed in the room and may include MRI, fixed single-plane and bi-plane tomographic imaging systems, and computed tomographic equipment.
Note: Use of portable imaging technology does not make an operating room a hybrid operating room.
OUTPATIENT SERVICE. An organizational unit of the hospital, which provides nonemergency healthcare services to patients.
BAY (patient). A space for human occupancy with one hard wall at the headwall and three soft walls (e.g., cubicle curtains or portable privacy screen).
CUBICLE. A space intended for human occupancy that has at least one opening and no door and is enclosed on three sides with full-height or partial-height partitions.
PATIENT CARE STATION. A designated space for a specific patient care function. This term does not imply any structural requirement (e.g., a Post-anesthesia Care Unit (PACU) can have 10 patient care stations of which three are rooms, three are cubicles, and four are bays).
PATIENT ROOM. Licensed patient bed rooms.
PERIOPERATIVE. Patient care and other related supportive activities before, during or after the operative event.
PROTECTIVE ENVIRONMENT. A bedded unit or patient room where severely immunosuppressed patients are cared for.
RESTRICTED AREA. A designated space with limited access eligibility. Such space has one or more of the following attributes: specific signage, physical barriers, security controls and protocols that delineate requirements for monitoring, maintenance, attire, and use. The term is often applied to specialized procedure suites, such as operating rooms and suites, interventional imaging, cardiac catheterization labs, angiography suites, etc.
ROOM. A space enclosed by hard walls and having a door. Where the word "room" or "office" is used, a separate, enclosed space for the one named function is intended. Otherwise, the described area may be a specific space in another room or common area.
SCRUB SINK. A sink used to wash and scrub the hands and arms during the aseptic preparation for surgery, and equipped with a supply spout and controls as required for a handwashing fixture. Refer to the California Plumbing Code Sections 210.0 and 221.0.
SERVICE SINK. A sink located in a housekeeping room and designed for the purpose of cleaning mops and the disposal of waste water.
SUB-ACUTE CARE. A segment within a continuum of levels of care determined by patient acuity, clinical stability, and resource needs.
SUPPLEMENTAL SERVICE. An inpatient or outpatient service which is not required to be provided by law or regulation for licensure. A supplemental service, when provided, must accommodate the provisions of this section.
Note: See "BASIC SERVICES."
SURGICAL SERVICE SPACE. A space that includes the operating room(s) and service areas.
See Section 3416A.
Spaces for dietary, laundry, morgue, ambulance entrance, receiving areas, power plants, mechanical equipment, incinerator, garbage can cleaning, automobile parking and storage areas for garbage, trash and medical gases shall be located and constructed to minimize noise, steam, odors, hazards and unsightliness in patient-care areas and bedrooms.
Radiology, laboratory, pharmacy, physical therapy and service spaces serving only outpatients and similar outpatient service departments shall not be located in nursing units, surgical units, peri-natal units, nursery areas, central sterilization rooms, food-service' areas, power plants, mechanical equipment rooms, maintenance shops, general storage, laundry, employees' dressing or housekeeping facilities.
Exception: Physical and occupational therapy spaces of a rehabilitation service may serve both outpatients and inpatients.
Identifiable spaces shall be provided for each function indicated in all Basic and applicable Supplemental Service Space sections with requirements for support areas. The following rooms and spaces are common to most types of health care facilities and the requirements associated with each, as listed below, shall be used unless modified under a specific Service Space section.
Unless specified elsewhere, if an exam room is provided, it shall have a minimum clear floor area of 80 square feet (7.4 m2), the least dimension of which shall be 8 feet (2438mm). The room shall contain a handwashing fixture and accommodations for written or electronic documentation shall be provided.
Unless specified elsewhere, if a treatment room is provided, it shall have a minimum clear floor area of 120 square feet (11.15 m2), the least dimension of which shall be 10 feet (3048 mm). A minimum of 3 feet (914 mm) is required between the sides and foot of the bed/gurney/table and any wall or other fixed obstruction. The room shall contain an examination light, a work counter for medical equipment, a handwashing fixture, cabinets, medication storage and counter space for writing or electronic documentation. Multi-bed treatment rooms shall have separate patient cubicles with a minimum clear floor area of 80 square feet (7.4 m2) per cubicle. Each cubicle shall contain an examination light, counter and storage facilities, In multi-bed treatment rooms, a hand-washing fixture shall be provided in the room for each three or fewer cubicles.