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2.3-2 Resident, Participant, and Outpatient Areas
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The requirements for resident care/living areas (units), community areas, and associated support areas included in this section are common to most residential health, care, and support facilities. For requirements specific to a facility type, see the facility chapters in Parts 3 through 5.
A2.3-2.2 Resident care/living area (unit) definition. A resident care/living area (unit) is a group of resident rooms or dwelling quarters in a residential living facility.
See facility chapters in Parts 3 and 4 for requirements for resident care/living areas (units).
See facility chapters in Parts 3 and 4 for requirements for airborne infection isolation rooms and ventilator-dependent resident rooms, and other special care resident room types and facility chapters in Part 5 for requirements for quiet rooms in non-residential support facilities.
Where a single resident room is provided to accommodate care requirements for residents experiencing issues such as personal conflicts, agitation, episodic mental disturbances, or similar conditions that require a quiet or low-stimulation, positive distraction room, the following requirements shall be met:
- Capacity. Each quiet room shall contain only one bed.
- Space requirements
- Based on the care population, the quiet room shall be sized to accommodate the equipment, special furnishings, or positive distractions provided.
- The level of cognitive ability of the care population shall be identified during the functional programming process. See Section 2.2-4 (Design Criteria for Dementia, Mental Health, and Cognitive and Developmental Disability Facilities) for additional requirements.
- Toilet room. A toilet room shall be provided for each quiet room.
- The toilet room shall contain the following:
- Toilet
- Hand-washing station
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Mirror. For requirements, see Section 2.4-2.2.8.7 (Mirror).
- The toilet room shall not be shared with another resident room.
- The toilet room shall contain the following:
- Acoustic requirements. See Section 2.5-8.3 (Design Criteria for Acoustic Finishes), Section 2.5-8.4 (Design Criteria for Room Noise Levels), and Section 2.5-8.5 (Design Criteria for Performance of Interior Wall and Floor/Ceiling Constructions) for requirements.
A2.3-2.3 Daylighting in community areas. See Section 1.2-4.5.1 (Light) and Section 2.5-7.2 (Daylighting Systems in Resident Living, Participant, and Outpatient Areas) for requirements and information.
For new construction and renovation, community areas shall be designed and furnished to encourage resident, participant, and outpatient use.
A2.3-2.3.1 Nothing in the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities is intended to restrict a facility from providing additional square footage per resident, participant, or outpatient beyond what is required herein for dining rooms, activity areas, and other spaces included in this section.
- See the facility chapters in Parts 3 through 5 for additional requirements.
- Shared lobbies shall be permitted in multi-occupancy buildings.
A minimum of one marked, illuminated drop-off or entrance shall be reachable from grade level.
A2.3-2.3.2.2 Vehicular drop-off and pedestrian entrance. Covered/canopied entrances should be provided as required to accommodate the care population and respond to the local climate and community requirements.
Where a central lobby is provided, storage for resident-operated mobility devices shall be provided close to the entry.
Where a mailbox area is provided, it shall be located close to the entry for deliveries and centralized for resident access.
Areas for posting required notices, documents, and other written materials shall be provided in public locations visible to and accessible to residents, staff, and visitors.
A toilet room(s) shall be located close to the lobby.
The space needed for dining, recreation, and activities shall be determined by the following considerations:
- The extent to which users need adaptive equipment and mobility aids and assistance from support and service staff
- The extent to which support programs will be centralized or decentralized
- The number of residents or participants to be seated for dining at one time
(1) General
(a) The design and location of dining facilities shall encourage resident, participant, and visitor use.
(b) Planned use of dining areas for other activities shall be permitted.
*(2) Central dining facility. Where a central dining facility is provided, it shall be sized to accommodate the following:
(a) Space for dining in accordance with the needs of the care population, including residents and participants who use resident-operated mobility devices
(b) Space for residents and participants, including those using wheelchairs and resident-operated mobility devices, to access and leave their tables without disturbing other residents and participants
(c) Clear and unobstructed circulation paths for servers and food carts
(d) Space for caregivers to assist residents and participants who require assistance with eating
(3) Decentralized dining areas. Location of separate or satellite dining areas for small groups of residents or participants shall be permitted:
(a) In or adjacent to resident units
(b) As part of dayrooms for different adult day care populations
(c) Near a wellness center activity (e.g., a juice bar near a fitness center)
(d) In outdoor activity spaces. See Section 2.1-3.6.2 (Outdoor Activity Spaces).
A2.3-2.3.3.2 (2) The dining room should be sized at a minimum of 28 square feet (2.60 square meters) for each resident or participant at one seating. Adult day care programs may require additional participant space based on the care population being served.
See facility chapters in Parts 3 through 5 for requirements.
- Hand-washing stations shall be provided in, next to, or directly accessible to dining areas.
- Toilet facilities that accommodate residents or participants using resident-operated mobility devices shall be readily accessible to all dining, recreation, lounge, and activity locations.
- A "country kitchen," a "great room," or other activity room that supports continued resident and participant involvement in activities of daily living shall be permitted to serve as the required resident and participant kitchen facilities.
- Purpose. Resident and participant kitchen facilities shall be designed to support any combination of the following functions:
- Provision of nourishment between meals
- Cooking activities for residents and participants
- Food preparation by family members
- Preparation of meals by staff with or without assistance from residents or completion of meal preparation begun in a central kitchen and serving/distribution of meals
Where these kitchen facilities are provided, the following requirements shall apply:
(1) Work countertop
(2) Refrigerator
(3) Storage cabinets
(4) Sink with faucet with anti-scalding mixing valve
(5) Range, cooktop, oven, and/or any other cooking or heating device where required in the functional program. These appliances shall be equipped with secured shutoffs where residents have access to the kitchen.
*(6) Food-warming and dishwashing equipment where required in the functional program
(7) Access to self-dispensing drinking water and ice
(a) Ice for resident consumption shall be provided by ice-making equipment.
*(b) Ice-making equipment shall be located, designed, and installed to minimize noise.
(c) Ice-making equipment shall be permitted to serve more than one food area in resident and participant kitchen facilities.
(8) A hand-washing station. This shall be located in or immediately accessible to the resident and participant kitchen facilities.
A2.3-2.3.4.2 Resident and participant kitchen. Also consider provision of these items:
- Double-bowl sink with faucet and sprayer
- Food storage
- Resident and participant countertop. This should allow access for residents and participants using resident-operated mobility devices and facilitate staff and resident interaction.
- Secure locked storage for sharp knives
- Microwave
- Coffee-maker
A2.3-2.3.4.2 (6) Where dishwashing equipment is not included, consider providing a cart alcove to support carts for transferring dishware to the dishwashing equipment in the central kitchen.
A2.3-2.3.4.2 (7)(b) To reduce noise from ice-making equipment, consider locating the equipment in a room with a door or separating the compressor and dispenser so the compressor is not in the corridor. In some settings, use of residential ice makers, which are quieter than commercial ice makers, could be appropriate depending on the size and nature of the care population being served.
See the facility chapters in Parts 3 through 5 for requirements.
Where a family room is included in a project, see facility chapters in Parts 3 through 5 for requirements.
A2.3-2.3.7 Quiet room in a community area. An example of a quiet room or "time out" room that includes positive distractions is a Snoezelen room, a controlled multi-sensory environment. Time in such a room is a therapy for residents with dementia, autism, developmental disabilities, or other agitated conditions. Some facilities have also found that agitated or stressed staff have benefited from having a quiet room available.
In quiet rooms where the risk of self-injury is evident, opportunities for self-harm should be eliminated by concealing protruding elements, using surfaces to which it would be difficult to attach items, and having doors swing out so they cannot be barricaded from the inside.
Where a quiet room is provided for residents experiencing personal conflicts, agitation, episodic mental disturbances, or similar conditions that require a quiet, multi-sensory, low-stimulation, positive distraction room, the following requirements shall be met:
- Based on the care population, the quiet room shall be sized to accommodate the equipment, special furnishings, or positive distractions provided.
- If the care population includes residents with dementia or other cognitive issues, see Section 2.2-4 (Design Criteria for Dementia, Mental Health, and Cognitive and Developmental Disability Facilities) for additional information.
- A toilet room shall be adjacent to the quiet room.
- This toilet room shall be permitted to be shared by residents using other activity spaces.
See the following Guidelines sections for requirements:
- Section 1.2-4.5.1 (Light)
- Section 1.2-4.5.2 (Views of and Access to Nature)
- Section 2.1-3.6.2 (Outdoor Activity Spaces)
For additional requirements for residents with dementia, mental health issues, and cognitive and developmental disabilities, see Section 2.2-4.3.5 (Outdoor Activity Spaces).
Related Code Sections
2.3-2 Design Elements, Resident, Participant, and Outpatient Areas
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*2.3-2.3.4.2 Design Elements, Facility Requirements
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