449.4 Physical Plant Requirements for Disaster Preparedness of New Hospital Construction

For planning purposes, each new facility shall provide a minimum of 30 net square feet (2.79 m²) per patient served in the occupied patient area(s). The number of patients to be served is to be determined by the facility administrator.

As determined by the facility, space for administrative and support activities shall be provided for use by facility staff to allow for care of patients in the occupied patient area(s).

As determined by the facility, space shall be provided for staff and family members of patients and staff.

Except as permitted by Section 1612 of this code, the lowest floor of all new facilities shall be elevated to the base flood elevation as defined in Section 1612 of this code, plus 2 feet, or to the height of hurricane Category 3 (Saffir-Simpson scale) surge inundation elevation, as described by the Sea, Lake, and Overland Surge (SLOSH) from Hurricanes model developed by the Federal Emergency Management Agency (FEMA), United States Army Corps of Engineers (USACE), and the National Weather Service (NWS), whichever is higher.

For all existing facilities, the lowest floor elevations of all additions, and all patient support areas including food service, and all patient support utilities, including mechanical, and electrical (except fuel storage as noted in Section 449.4.2.9.3 of this code) for the additions shall be at or above the elevation of the existing building, if the existing building was designed and constructed to comply with either the site standards of Section 449.4 of this code or local flood-resistant requirements, in effect at the time of construction, whichever requires the higher elevation, unless otherwise permitted by Section 1612 of this code. If the existing building was constructed prior to the adoption of either the site standards of Section 449.4 of this code or local flood-resistant requirements, then the addition and all patient support areas and utilities for the addition as described in this section shall either be designed and constructed to meet the requirements of Section 449.4.2.2.1 of this code or be designed and constructed to meet the dry flood proofing requirements of Section 1612 of this code.

Substantial improvement, as defined by Section 1612 of this code, to all existing facilities located within flood areas as defined in Section 1612 of this code or within a Category 3 surge inundation zone as described in Section 449.4.2.2.1 of this code, shall be designed and constructed in compliance with Section 1612 of this code.

Where an off-site public access route is available to the new facility at or above the base flood elevation, a minimum of one on-site emergency access route shall be provided that is located at the same elevation as the public access route.

New landscaping elements shall be located so if damaged they will not block the on-site emergency access route to the facility. Outdoor signs and their foundations shall be designed to meet the wind load criteria of the Florida Building Code, Building.

New light standards and their foundations used for lighting the on-site emergency access route shall be designed to meet the wind load criteria of ASCE 7 with wind speeds determined from Figure 26.5-1B with appropriate exposure category dependent on site location.

Loose-laid ballasted roofs shall not be permitted.

All new roof appendages such as ducts, tanks, ventilators, receivers, dx condensing units and decorative mansard roofs and their attachment systems shall be structurally engineered to meet the wind load requirements of the applicable building code.

All exterior window units, skylights, exterior louvers and exterior door units including vision panels and their anchoring systems shall be impact resistant or protected with an impact-resistant covering meeting the requirements of the Testing Application Standards (TAS) 201, 202, and 203 of this code in accordance with the requirements of Sections 1626.2 through 1626.4 of this code or the debris impact requirements of ASTM E1996 as described in Section 1609.1.2.2. For the purposes of this requirement, facilities located in areas where the ultimate design wind speeds are 130 mph or less as described in Figure 1609.3(2) of this code, shall meet the requirements for Wind Zone 1. The impact-resistant coverings may be either permanently attached or may be removable if stored on site of the facility. Facilities located in the high velocity hurricane zone (HVHZ) shall comply with Sections 1626.2 through 1626.4.

The location or application of exterior impact protective systems shall not prevent required exit egress from the building.

When not being utilized to protect the windows, the permanently attached impact-resistant coverings shall not reduce the percentage of the clear window opening below that required by this code for the patient room.

Critical systems and utilities identified in this section shall be protected from debris impact by a housing or enclosure complying with the impact protection standards in Sections 1626.2 through 16.26.4 when located at or below 30 feet above the finished grade of the building. Roof mounted equipment shall have fastening systems designed to meet the wind load requirements of the Florida Building Code, Building.

All new air-moving equipment, dx condensing units, through-wall units and other HVAC equipment located outside of, partially outside of, or on the roof of the facility at or below 30 feet above the finished grade of the building and providing service to the new facility shall be permitted only when either of the following are met:

They are located inside a penthouse designed to meet the wind load requirements of the Florida Building Code, Building; or

They are protected in accordance with Section 449.4.2.5.4.

As determined by the facility, occupied patient areas and patient support areas shall be supplied with temperature and humidity control during and immediately following a disaster.

Ventilation air change rates in occupied patient areas shall be maintained as specified in this section during and immediately following a disaster by connection to the essential electrical system. The fan systems necessary to provide this service shall receive their power from the emergency power supply system and shall be protected from horizontal impact in accordance with Section 449.4.2.6.1.

There shall be an independent on-site supply (i.e., water well) or on-site storage capability (i.e., empty water storage containers or bladders) of potable water at a minimum quantity of 3 gallons (14 L) per in-patient and one gallon (3.7 L) per facility staff and other personnel in the new facility or wing or floor addition to an existing facility per day during and immediately following a disaster. For planning purposes, the number of in-patients, staff and other personnel shall be determined in writing by the facility and submitted to AHCA. Hot water in boilers or tanks shall not be counted to meet this requirement.

The facility shall determine what amount of water will be sufficient to provide for patient services, and shall maintain an on-site supply or on-site storage of the determined amount.

When utilized to meet the minimum requirements of this rule, selected system appurtenances such as water pressure maintenance house pumps, and emergency water supply well pumps shall take power from the emergency power supply system(s).

In addition to the requirements of NFPA 99 Health Care Facilities Code and NFPA 70 National Electrical Code, the on-site Level 1 emergency power supply system shall provide electrical power to the occupied patient area(s) and patient support area(s) for the following additional equipment:

Ice-making equipment to produce ice, or freezer storage equipment for the storage of ice.

If required by the emergency food plan, refrigerator unit(s) food service equipment, range hood exhaust fans and selected lighting within the kitchen and dry storage areas.

Selected heating or air conditioning systems as determined by the facility and ventilation systems as required by this code.

Electric lighting required to provide care and service to the patient occupied areas and the necessary patient support areas as defined by this section.

The emergency power system shall be fueled by a fuel supply stored on-site sized to fuel the generator for 100-percent load for 64 hours or for 72 hours of actual demand load of the occupied patient area(s) and patient support area(s) and patient support utilities during and immediately following a disaster, whichever is greater.

The fuel supply and all fuel lines of the emergency power system generator shall either be located below ground or protected in accordance with Section 449.4.2.5.4.

All panel boards, transfer switches, disconnect switches, enclosed circuit breakers or emergency system raceway systems required to support the occupied patient area(s), patient support area(s) or support utilities shall be protected in accordance with Section 449.4.2.5.4, and shall not rely on systems or devices outside of this protected area(s) for their reliability or continuation of service. The equipment system shall be kept entirely independent of all other wiring and equipment and shall not enter the same raceways, boxes, or cabinets with other wiring.

The emergency generator(s) shall be air or self-contained liquid cooled and it and other essential electrical equipment shall be protected in accordance with Section 449.4.2.5.4.

A new facility shall be equipped with either a permanent on-site optional standby generator to operate at least the nonessential loads of the electrical system or the entire normal branch of the electrical system, or there shall be a permanently installed predesigned electrical service entry for the electrical system that will allow a quick connection to a temporary electrical generator to operate at least the nonessential loads of the electrical system or the entire normal branch of the electrical system. This quick connection shall be installed inside of a permanent metal enclosure rated for this purpose and may be located on the exterior of the building.