Section 3418A Removal of Hospital Buildings From General Acute Care Services

The requirements of this section shall apply when general acute care services are completely removed from SPC buildings or when buildings are removed from OSHPD jurisdiction. All buildings that remain under the OSHPD jurisdiction, after one or more SPC buildings are removed, shall satisfy the requirements of the California Building Standards Code. Approval of construction documents and a building permit are required for removal of SPC Buildings from general acute care services or removal of buildings from OSHPD jurisdiction.

A SPC 1 hospital building without an approved delay in compliance requirements in accordance with the California Administrative Code (CAC) Chapter 6 Section 1.5.2 or past the extension date granted in accordance with the CAC Chapter 6 Section 1.5.2 shall not be issued a building permit until a project to remove the subject SPC 1 building from general acute care services has been approved, permitted, and closed in compliance by the Office.

Exception: Building permits for seismic compliance, maintenance and repair shall be permitted to be issued.

The following words and terms are applicable to this section only:

BUILDING. The area included within surrounding exterior walls or any combination of exterior walls and fire walls (as described in Sections 202 and 706) exclusive of vent shafts and courts. Areas of the building not provided with surrounding walls shall be included in the building area if such areas are included within the horizontal projection of the roof or floor above. A building may consist of one or more adjacent SPC buildings.

GENERAL ACUTE CARE SERVICE. Means basic and supplemental services, as defined in Section 1224.3, provided in a general acute care building, as defined in Section 202 and the California Administrative Code, Chapter 6, Section 1.2.

STRUCTURAL SEPARATION.Means a building separation in accordance with this code.

In order to establish that one or more SPC buildings are eligible for removal from general acute care service, the hospital owner shall submit construction documents showing that after the SPC Buildings are removed from general acute care service:

1. All basic acute care services or supplemental services on the hospital’s license are provided in SPC buildings satisfying the requirements for SPC-2, SPC-3, SPC-4, SPC-4D, or SPC-5.

   Exception: If the hospital includes SPC-1 buildings that are not being removed from general acute care service, and these SPC-1 buildings have an approved extension to the SPC-2 deadline, basic acute care services or supplemental services on the hospital’s license are permitted to remain in these SPC buildings for the duration of their extension or until these SPC-1 buildings are removed from general acute care service, whichever comes first.

2. All basic acute care services or supplemental services on the hospital’s license are provided in SPC buildings satisfying the requirements for NPC-3, NPC-4 or NPC-5.

   Exception: Services shall be permitted to be located in SPC buildings satisfying the requirements of NPC-2 if the SPC buildings has approved extension to NPC-3 deadline.

3. The hospital complies with all egress requirements, including occupant load, number of required exits and travel distance to exits, and provides evidence that no egress from any acute care hospital building passes through the SPC buildings removed from general acute care service, SPC-1 buildings, or through buildings not under OSHPD jurisdiction.

   Exceptions:

   1. If the SPC building has an approved extension to the SPC-2 deadline, existing egress through the SPC-1 building shall be permitted for the duration of the extension or until the SPC-1 building is removed from general acute care service, whichever comes first.
   2. When permitted by Section 3417A.1.1.1.6.
   3. No SPC building removed from general acute care service is used as a smoke compartment for any acute care hospital building. Buildings not under OSHPD jurisdiction shall not be used as a smoke compartment for any acute care hospital building.

   4. Structural separation, fire barriers and fire walls shall satisfy the requirements of the California Building Standards Code.

      Exception: An SPC seismic separation in accordance with the California Administrative Code Chapter 6 Section 3.4 shall be deemed to satisfy the building structural/seismic separation requirement in this section for SPC buildings that will remain under OSHPD jurisdiction.

   5. If the SPC building removed from general acute care service shares a common fire alarm system with the acute care hospital, the main fire alarm control panel shall be located in an acute care hospital building. The SPC building removed from general acute care service shall be in a separate zone monitored by the main fire alarm control panel. Flexible connections shall be provided for conduits/conductors crossing structural or SPC seismic separation joints. If the intent is to place the SPC building under local jurisdiction, the building shall satisfy Section 3418A.5.1

      Exception: Flexible connections for fire alarm conduits/conductors crossing seismic separation joints between an SPC building removed from general acute care service and adjacent SPC-1 or SPC-2 buildings may be omitted, provided the fire alarm in the adjacent SPC-1 and SPC-2 buildings have no connection to any SPC-3, SPC-4, SPC-4D, and SPC-5 buildings providing general acute care service.

   6. If the SPC building removed from general acute care service shares the fire sprinkler system with the acute care hospital, an isolation valve with a tamper switch shall be provided to isolate the portion of the system serving the SPC building removed from acute care service. Flexible connections shall be provided in piping that crosses structural or SPC seismic separation joints. The fire sprinkler system shall not originate in the SPC building removed from general acute care service. If the intent is to place the building under local jurisdiction, the building shall satisfy Section 3418A.5.1.

      Exception: Flexible connections for seismic separation joints and fail safe shut-off valves, and disconnects for utilities between an SPC building removed from general acute care service and adjacent SPC-1 or SPC-2 buildings may be omitted, provided utilities in the adjacent SPC-1 and SPC-2 buildings have no connection to any SPC-3, SPC-4, SPC-4D, and SPC-5 buildings providing general acute care service.

   7. Patient access as required by Section 1224.4.7.5 does not pass through an SPC building removed from general acute care service or through buildings that are not under the jurisdiction of OSHPD.
   8. The primary accessible entrance to the hospital is not through an SPC building removed from general acute care service or through buildings that are not under the jurisdiction of OSHPD.
   9. No utilities servicing acute care hospital buildings originate in or pass through, over or under, an SPC building removed from general acute care service, except as permitted by Section 3416A.1.1.1.5, or a building not under OSHPD jurisdiction.

   10. If utilities originating in an acute care hospital building feed an SPC building removed from general acute care hospital service, fail safe shut-off valves and/or disconnects shall be provided that permit isolation of the SPC building removed from general acute care service from the hospital utilities. Flexible connections shall be provided for all utilities crossing structural or SPC seismic separation joints.

       Exception: Flexible connections for seismic separation joints and fail safe shut-off valves, and disconnects for utilities between an SPC building removed from general acute care service and adjacent SPC-1 or SPC-2 buildings may be omitted, provided utilities in the adjacent SPC-1 and SPC-2 buildings have no connection to any SPC-3, SPC-4, SPC-4D, and SPC-5 buildings providing general acute care service.

In order for a freestanding building to remain under OSHPD jurisdiction that is removed from general acute care service, it shall contain one or more qualifying services. Qualifying services include:

1. Services considered “Outpatient Clinical Services” as defined in H&SC §129730 (a):

   1. Administrative space
   2. Central sterile supply
   3. Storage
   4. Morgue and autopsy facilities
   5. Employee dressing rooms and lockers
   6. Janitorial and housekeeping facilities
   7. Laundry

2. Outpatient portions of the following services (with no more than 25 percent in-patient use), including but not limited to:

   1. Surgical
   2. Chronic dialysis
   3. Psychiatry
   4. Rehabilitation, occupational therapy or physical therapy
   5. Maternity
   6. Dentistry
   7. Chemical dependency
3. Services that duplicate Basic Services, as defined in H&SC§1250, or services that are provided as part of a Basic Service, but are not required for facility licensure (with no more than 25 percent in-patient use).

All hospital support services listed in Section 3418A.4.1 Item a that are located in an SPC building at the time general acute care services are removed may remain, provided the California Department of Public Health certifies to the Office that it has received and approved a plan that demonstrates how the health facility will continue to provide all basic services in the event of any emergency when the SPC building may no longer remain functional. This certification shall be submitted by hospital to the Office prior to approval of the application to remove the SPC building from general acute care service.

Existing approved nonacute care occupancies, or services, existing in the SPC building at the time it is removed from general acute care service shall be permitted to remain, and removal of the SPC building from general acute care service is not considered a change in occupancy. The enforcement agency shall be permitted to require evidence that the existing occupancies and services were in compliance at the time they were located in the SPC building. Any hospital support services located in the building removed from general acute care service, including administrative services, central sterile supply, storage, morgue and autopsy, employee dressing rooms and lockers, janitorial and housekeeping service, and laundry, shall be in excess of the minimum requirements for licensure and operation. Prior approval by the California Department of Public Health shall be obtained by hospital to maintain these services in the SPC building removed from acute care service.

A change of service or function for all, or a portion, of the SPC building removed from general acute care service requires compliance with the current requirements for that service, including accessibility requirements in accordance with Chapter 11B.

When general acute care services are removed from an SPC building which is intended to be used for skilled nursing or acute psychiatric services, and the new services will be licensed under the existing license of the general acute care hospital these new services shall comply with Section 3416A.1.1.1.5 for a nonconforming hospital building.

When general acute care services are removed from an SPC building that is intended to be used for outpatient clinical services under the existing acute care hospital license, the building is required to comply with the current OSHPD 3 code requirements for the new service.

When general acute care services are removed from an SPC building, and new services provided in the SPC building are issued an initial license, as determined by the California Department of Public Health, as a skilled nursing facility or acute psychiatric hospital, the SPC building shall comply with the new building code requirements or equivalent provisions of the California Building Standards code at the time of application.

When an SPC building is removed from general acute care service with or without change of license, the new occupancy group and division of the building, and/or new service or function, shall be established. A new certificate of occupancy shall be required for the building removed from general acute care service.

Except as provided by Section 3418A.5.3, at the hospital’s discretion, a building removed from general acute care service shall be permitted to be placed under the jurisdiction of the local enforcement agency. To be eligible for a change in jurisdiction, the building removed from general acute care service shall satisfy the requirements of Section 3418A.5.1.

For a building removed from general acute care service to be eligible for a change in jurisdiction to the local enforcing agency, all the following criteria shall be satisfied:

1. The building removed from general acute care service shall be freestanding, as defined in the California Administrative Code, Section 7-111.
2. Any hospital support services located in the building removed from general acute care service, including administrative services, central sterile supply, storage, morgue and autopsy, employee dressing rooms and lockers, janitorial and housekeeping service, and laundry, shall be in excess of the minimum requirements for licensure and operation. Prior approval by the California Department of Public Health shall be obtained by hospital to locate these services in the building removed from general acute care service.
3. Services/systems and utilities (e.g., power, emergency power, communication/data/nurse-call systems, space-heating systems, fire alarm system, fire-sprinkler system, medical gas and plumbing systems) shall be separate and independent from those serving any buildings under OSHPD jurisdiction.
4. If the building being transferred to the jurisdiction of the local enforcing agency is adjacent to a building under OSHPD jurisdiction and fire resistive construction separations are required, they shall be located in the building under OSHPD jurisdiction.

The owner of the building shall be responsible for bringing the building into compliance with all requirements of the new authority having jurisdiction. If a building requires modification to become eligible for removal from OSHPD jurisdiction, the construction project shall be closed with compliance by OSHPD prior to the change in jurisdiction. All occupancy separation, setback, and allowable area requirements shall be enforced.