Part 1 General

Part 2 Hospital Facility Types

ANSI/ASHRAE/ASHE Standard 170-2017 Ventilation of Health Care Facilities

Heads up: There are no amended sections in this chapter.
Appendix material, shown in shaded boxes at the bottom of the page, is advisory only.
This chapter shall be applied to mobile/transportable medical units that are used on a temporary basis.
A2.8-1.1.1.1 The use of mobile/transportable medical units is intended to extend the reach of some health care services to otherwise underserved areas or to minimize the disruption of existing health care services when medical equipment must be taken out of service due to renovation projects, construction of additions, or equipment failure.
This chapter shall not be applied to mobile/transportable medical units placed into service as a result of a civil or local emergency or catastrophe.
This chapter shall not be applied to modular/relocatable medical units that are prefabricated and finished off-site and transported to a permanent foundation on-site that cannot be readily moved.
A2.8-1.1.1.3 This type of prefabricated unit is considered a building. For such units, see the volume/chapter of the Guidelines that has design requirements for the services offered in the unit as well as applicable building and fire codes for requirements.
  1. Class 1 mobile/transportable medical units shall meet the requirements of one of the following:
    1. Exam/treatment room in Section 2.1-3.2 (Examination Room or Emergency Department Treatment Room)
    2. Class 1 imaging room as described in Section 2.2-3.4.1.2 (Imaging room classification)
  2. Provision of medical services for both inpatients and outpatients shall be permitted in Class 1 medical units where the units meet all the Guidelines requirements for the services provided as modified in this chapter.
  1. Class 2 mobile/transportable medical units shall meet the requirements of one of the following:
    1. Procedure room in Section 2.2-3.3.2 (Procedure Room)
    2. Class 2 imaging room as described in Section 2.2-3.4.1.2 (Imaging room classification)
  2. Provision of medical services for both inpatients and outpatients shall be permitted in Class 2 medical units where the units meet all the Guidelines requirements for the services provided as modified by the requirements in this chapter.
  1. Class 3 mobile/transportable medical units shall meet the requirements of one of the following:
    1. Operating room in Section 2.2-3.3.3 (Operating Rooms)
    2. Class 3 imaging room (hybrid operating room) as described in Section 2.2-3.4.1.2 (Imaging room classification)
  2. Use of Class 3 medical units is permitted where the units meet all the Guidelines requirements for clinical and support areas for the procedures being performed.
Provision of hemodialysis shall be permitted in a mobile/transportable unit of any class.
Certification shall be provided in one of the following ways:
  1. The manufacturer of the mobile/transportable medical unit shall provide the governing body with drawings of the unit that have been signed and sealed by an architect or professional engineer.
  2. A third-party nationally recognized testing laboratory (NRTL) shall provide the governing body with a field inspection report certifying the unit meets requirements as described in this chapter or other certification processes acceptable to the AHJ.
The host facility and the mobile/transportable medical unit shall have on-site and available for review records of compliance with all relevant codes and standards required by this chapter for the following:
  1. Fire ratings of all structural materials and finishes
  2. All testing and calibration records, including those for:
    1. Air balancing
    2. Air filtration
    3. Sprinklers, where provided
    4. Biomedical equipment
    5. Electrical wiring and equipment
Access for the unit to arrive shall be provided.
A2.8-1.3.1.1 Site access should address the following:
  1. Turning radius of the vehicles appropriate for the size and type of unit
  2. Ease of the unit's maneuverability when being transported by a carrier
The mobile/transportable unit shall be parked on a solid, level surface, and safeguards shall be in place adequate to prevent movement of the unit while in use.
A minimum separation of 25 feet (7.62 meters) shall be provided between any building outside air intake and any HVAC or generator exhaust from the unit.
The location of the unit and routing of utilities shall avoid interference with appropriate access to and exiting from all occupied areas, including exterior means of egress to a public way.
Use of an exit from the building as an access point to the mobile/transportable unit shall not be permitted unless the exit is designed specifically to serve both functions.
The unit shall be located to avoid interference with fire lanes and direct access to the host facility by emergency personnel and vehicles during an emergency.
The unit shall be sited to accommodate delivery services being provided to the host facility.
Where the unit is located near vehicular drives or parking areas, impact barriers shall be provided.
Tractors and/or cabs that have fuel tanks with a capacity of less than or equal to 100 gallons and that do not support the mobile/transportable unit while it is in use shall be detached and located more than 10 feet from the host facility. Tractors and/or cabs with fuel capacities greater than 100 gallons shall meet the requirements of NFPA 30: Flammable and Combustible Liquids Code.
Sites shall provide parking for patients using the mobile/transportable unit.
Access to the unit shall be provided for wheelchairs, gurneys, stretchers, and patients with walkers.
  1. Where an electric power lift is used to meet this requirement, it shall be connected either to the host facility's essential electrical system or to the unit's essential power supply system.
  2. Stairs or ramps that are not part of the unit and that provide an entrance into the unit shall be provided in accordance with the adopted edition of the following:
    1. Building code
    2. NFPA 101: Life Safety Code®
    3. Accessibility code for new facilities
Protection from rain, sleet, wind, and snow during transport of patients from the host facility to the mobile/transportable unit shall be provided.
  1. Where protection to and from the host facility is provided by a fabric-type canopy, the material shall comply with adopted fire codes.
  2. Where provided, fabric (membrane) structures and supporting elements shall be designed to comply with local, state, and federal codes and regulations.
  3. Where provided, a permanent, enclosed passageway from the host facility to the unit shall be in accordance with all building and fire codes and separated from the unit by a fire wall as required for a building.
Access to the mobile/transportable unit from the host facility shall be marked and lighted.
A2.8-1.3.4 In geographic areas where freezing temperatures occur, a means of freeze protection is recommended for each site that requires provision of water and waste services to the unit.
The site or the mobile unit shall be provided with power, waste, water, telephone, and fire alarm connections to meet the requirements of the medical services provided and of state and local codes.
Utility connections, cables, and wires shall be protected by one of the following methods:
  1. Concealment in conduits
  2. Burial underground
  3. Installation overhead
Sites shall have a level parking area or concrete pad.
Construction of the unit pad shall:
  1. Meet local, state, and seismic codes.
  2. Conform to the manufacturer's requirements.
  3. Be designed to support the loads of the unit.
The unit shall be secured in place to prevent unintentional movement.
Because magnetic fields generated by magnetic resonance imaging (MRI) units may extend beyond the MRI scanner room, a perimeter to restrict entry of all persons who have not been successfully screened for magnetic field contraindications shall be established around all areas in and around the MRI equipment with a static magnetic field of 5 gauss (0.5 millitesla) or greater.
A2.8-1.3.6.1 Magnetic field effect on site selection. Environmental factors, such as the presence of ferromagnetic materials (e.g., steel framing or reinforcing members), electromagnetic sources (e.g., RF transmission sources, power lines, transformers, or switchgear), and moving metal (e.g., parking areas or vehicle drop-off lanes) in proximity to the MRI scanner may adversely affect MRI image quality and may limit MRI functionality. It is recommended that the health care organization carefully consider the potential implications of sites selected for mobile, temporary, or interim MRI services.
  1. Where mobile/transportable MRI units are used, siting designs shall allow the permanent facility and mobile/transportable unit, together, to comply with the following:
    1. Section 2.2-3.4.5.1 (Configuration of the MRI suite)
    2. American College of Radiology (ACR) four-zone access control
    3. ACR screening protocols
  2. For protection of patients, visitors, and health care workers, providers shall provide areas for the following:
    1. Interviews
    2. Clinical and physical screening
    3. Ferromagnetic detection screening
    4. Access controls to Zone 3 and Zone 4 areas
  3. Providers that are unable to comply with Section 2.2-3.4.5.1 (Configuration of the MRI suite) (e.g., due to physical separation of the mobile/transportable unit from the building) shall be permitted to submit an MRI risk assessment and risk mitigation plan prepared by a certified medical physicist, certified MR Medical Director, certified MR Safety Expert, or certified MR Safety Officer to the AHJ for a finding of equivalency.
Radiation protection for ionizing radiation sources (e.g., x-ray and gamma ray sources) shall meet the requirements in the following:
Section 2.2-3.4.1.3 (Radiation protection).
National Council on Radiation Protection & Measurements (NCRP) report 147 (Structural Shielding Design for Medical X-Ray Imaging Facilities)
NCRP report 116 (Limitation of Exposure to Ionizing Radiation)
Applicable local and state requirements
A2.8-3.1.1 The use of Class 2 mobile/transportable medical units that do not comply with all the minimum space requirements for procedure rooms or Class 2 imaging rooms located in the hospital should be limited based on the medical complexity of the procedures being performed in the unit.
Where a Class 1 or Class 2 mobile/transportable medical unit cannot meet the Guidelines space requirements for the services provided in the unit, it shall meet the following space requirements inside the unit:
  1. Class 1 units
    1. Minimum room dimensions and clearances shall be sized and arranged to accommodate the required equipment and clearances in accordance with the manufacturer's technical specifications for maintenance, operation of the equipment, operation of the clinician, and patient safety.
    2. In the absence of such specifications from the manufacturer, the governing body of the host facility shall complete a safety risk assessment regarding the acuity of the patients being served and the procedures being provided to assure patient safety; see Section 1.2-4 (Safety Risk Assessment).
  2. Class 2 units
    1. Class 2 units shall meet all Guidelines clearance and room dimension requirements for the services to be provided in the unit.
    2. Where these space requirements cannot be met due to the design and configuration of the mobile/transportable unit, the governing body of the host facility shall complete a safety risk assessment regarding the acuity of the patients being served and the procedures being provided to assure patient safety; see Section 1.2-4 (Safety Risk Assessment). Based on this safety risk assessment, the AHJ shall be permitted to grant an alternate method of compliance to all or a portion of the space requirements in the Guidelines.
Class 3 units shall meet all Guidelines clearance and room dimension requirements for the procedures to be performed in the unit.
All mobile/transportable medical units shall be provided with a hand-washing station in accordance with Section 2.1-2.8.7 (Hand-Washing Station).
Class 1 and Class 2 mobile/transportable units shall provide a holding area either in the unit or readily accessible in the host facility.
For Class 2 units, a recovery area(s) that meets requirements in Section 2.1-3.4 (Pre- and Post-Procedure Patient Care) shall be provided adjacent to or in the mobile unit.
For Class 2 units, support areas that meet the requirements of Section 2.2-3.4.8 (Support Areas for Imaging Services) shall be provided in the mobile/transportable medical unit, in the host facility but readily accessible to the mobile unit, or a combination of the two, except as amended in this section.
For Class 3 unit requirements, see Section 2.8-1.1.2.3 (2) (Class 3 medical units).
A clean workroom or clean supply room that meets the requirements of Section 2.1-2.8.11 (Clean Workroom or Clean Supply Room) shall be provided.
The clean workroom or clean supply room shall be permitted to be located either in the Class 1 or Class 2 unit or in the host facility provided it is readily accessible to the unit.
A soiled workroom that meets the requirements in Section 2.1-2.8.12.2 (Soiled workroom) shall be provided.
The soiled workroom shall be permitted to be located either in the Class 1 or Class 2 unit or in the host facility provided it is readily accessible to the unit.
This room shall be permitted to serve both the mobile/transportable unit and an adjacent unit in the host facility.
Storage areas for equipment, clean gowns, and supplies shall be permitted to be located either in the Class 1 or Class 2 unit or in the host facility provided they are adjacent to the host facility's access point to the mobile/transportable unit.
Storage for oxygen or other gases required for the services provided shall be included in space planning.
An environmental services closet shall be provided.
The environmental services closet shall be permitted to be located either in the Class 1 or Class 2 unit or readily accessible in the host facility.
A patient changing area(s) designed for privacy of patients shall be provided.
Changing areas shall be permitted to be located either in the Class 1 or Class 2 unit or in the host facility provided it is readily accessible to the unit.
A patient toilet room shall be permitted to be located either in the Class 1 or Class 2 unit or in the host facility provided it is readily accessible to the unit.
Space shall be provided in the Class 1 or Class 2 unit or in the host facility for storing patient belongings in accordance with Section 2.2-3.3.10.3 (Support Areas for Patients, Families, and Visitors-Patient changing area).
See Section 2.1-6 (Public and Administrative Areas) for requirements as amended in this section.
Where a mobile/transportable unit is placed at a host facility, the following shall be provided in the host facility:
  1. Public waiting area or room
  2. Provisions for drinking water
  3. Provisions for telephone access
  4. Public toilet room(s) readily accessible to the mobile/transportable medical unit
For Class 1 and Class 2 mobile/transportable medical units, a waiting area for patients to be received and wait for services shall be provided either in the unit or in the host facility.
The mobile/transportable medical unit shall meet the requirements in Section 2.1-7.2 (Architectural Details, Surfaces, and Furnishings) for the type of service provided.
Stairs for mobile and transportable units shall comply with NFPA 101: Life Safety Code® for new facilities.
Handrails shall be installed and constructed in accordance with NFPA 101, with the following exception: Provided the distance from grade to unit floor height is not greater than 4 feet 5 inches (1.35 meters), one intermediate handrail with a clear distance between rails of 19 inches (48.26 centimeters) maximum shall be permitted. (This exception is not applicable to existing units with a floor height of 5 feet 3 inches, or 1.60 meters, maximum.)
HVAC systems shall comply with the requirements in Section 2.1-8.2 (HVAC Systems) as modified in this section:
HVAC equipment, ductwork, and related equipment shall be installed in accordance with NFPA 90A: Standard for the Installation of Air-Conditioning and Ventilating Systems.
Mobile/transportable medical units that are limited to provision of noninvasive diagnostic and treatment services without use of anesthetics shall meet the following mechanical requirements:
  1. Mechanical system design
    1. A minimum indoor winter design capacity temperature of 75°F (24°C) shall be set for all patient areas.
    2. Controls shall be provided for adjusting the temperature as appropriate for patient activities and comfort.
  2. Ventilation and space-conditioning requirements. All occupied areas shall be ventilated by mechanical means.
  3. Where procedures or patients require positive or negative ventilation for infection prevention, the medical unit shall meet the ventilation requirements in Part 3 (ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities).
  4. HVAC ductwork. Air-handling duct systems shall meet the requirements of NFPA 90A: Standard for the Installation of Air-Conditioning and Ventilating Systems.
In addition to the requirements of Class 1 units, Class 2 units shall meet the requirements of ASHRAE 170 for the services provided.
All outdoor air intakes and exhaust discharges shall meet the requirements of ASHRAE 170.
Air intake for the mobile/transportable unit shall be located a minimum of 25 feet (7.62 meters) from all plumbing vents, exhaust fans, sources of combustion, idling vehicles, and any other sources of noxious fumes or odors. This distance shall be increased if prevailing wind patterns dictate this is appropriate.
  1. Class 2 and Class 3 units shall meet the requirements of NFPA 99: Health Care Facilities Code and NFPA 70: National Electrical Code® for the building system category provided in the unit.
  2. Class 2 and Class 3 units shall have an essential power supply system (EPSS) in accordance with NFPA 110: Standard for Emergency and Standby Power Systems or be connected to the host facility's EPSS. For requirements, see Section 2.8-8.3.3 (Power-Generating and -Storing Equipment).
  3. For Class 2 and Class 3 units, electrical material and equipment, including conductors, controls, signaling devices, and information technology systems shall be designed and installed in compliance with NFPA 99: Health Care Facilities Code and NFPA 70: National Electrical Code® for the building system category provided in the unit.
  1. For all units, electrical installations, including fire alarm, nurse call, emergency power supply system (EPSS), information technology, and communication systems, shall be tested for compliance with applicable codes and standards.
  2. A written record of performance tests on electrical systems and equipment shall show compliance with applicable codes and standards.
  3. When a unit is relocated, retesting of the systems shall be completed and a written record of the retesting shall be provided showing current compliance with applicable codes and standards.
For Class 2 and Class 3 units that are not connected to the host facility's essential electrical system (see Section 2.1-8.3.3.1), a Level I EPSS as defined by NFPA 110: Standard for Emergency and Standby Power Systems shall be provided and shall be in accordance with the requirements in NFPA 110 and in Section 2.1-8.3.1.1 (Applicable standards).
  1. The host facility shall provide documentation showing that emergency generators that are an integral part of the mobile/transportable unit have been tested and inspected as required by NFPA 110. Documentation of such testing shall be maintained with the mobile/transportable unit at all times and shall be made available for review to the authority having jurisdiction.
  2. Fuel storage shall be provided on-site for enough fuel to run an on-board emergency generator continuously for at least 90 minutes.
  3. Emergency exit lighting shall be provided by battery backup or lighting fixtures served by the life safety branch of the EPSS.
A portable or fixed examination light shall be provided for spaces where procedures are performed.
Fixed and mobile/transportable x-ray equipment installations shall conform to requirements of NFPA 70.
For Class 2 and Class 3 units, all electrical equipment and devices, receptacles, and wiring shall comply with NFPA 99 and NFPA 70 for the building service category provided in the unit.
Grounded-type hospital-grade receptacles shall be installed in accordance with Section 2.1-8.3.6.2 (Receptacles in patient care areas).
Plumbing and other piping systems shall be installed in accordance with applicable plumbing codes, unless specified herein.
Water and sanitary lines to and from the unit shall have a means of freeze protection as required by the geographic location of the host facility.
For plumbing requirements for dialysis procedures, see sections 2.1-8.4.2.2 (Hemodialysis/hemoperfusion water distribution) and 2.2-3.10.8.18 (Hemodialysis water treatment equipment area).
Backflow prevention shall be installed at the point of water connection on the unit.
All waste lines shall be designed and constructed to discharge into the host facility sanitary sewage system or directly into the utility sewage system.
Venting through the roof shall not be required for hand-washing stations in mobile/transportable units. Waste lines shall be permitted to be vented through the sidewalls or other locations that meet the plumbing code.
Where medical gas and suction systems are provided, they shall meet the requirements in:
Table 2.1-3 (Station Outlets for Oxygen, Vacuum, Medical Air, and Instrument Air Systems in Hospitals)
NFPA 99: Health Care Facilities Code for the building system category provided in the unit
A means for connecting the unit to the hospital emergency communication system shall be provided.
Nurse call devices shall be provided in accordance with Table 2.1-2 (Locations for Nurse Call Devices in Hospitals).
A telephone shall be located inside the unit to communicate directly with the host facility's public branch exchange or a continually staffed location inside the host facility.
Fire alarm notification shall be provided from the unit to the host facility and from the host facility to the unit while the unit is on-site.
Where a unit connects to a building, the connecting link and/or passageway shall be equipped with fire alarm systems and with smoke detection as required by NFPA 101.
  1. The fire alarm system shall comply with minimum requirements for the fire alarm system of the building to which the unit is connected in accordance with NFPA 101.
  2. Where a fire alarm system is provided, at least one manual pull station shall be provided in the unit or in the connecting passageway where the unit attaches to the building in accordance with NFPA 72: National Fire Alarm and Signaling Code.
Fire alarm notification for all units shall be provided by one of the following methods:
  1. An auto-dialer directly connected to the fire department or third-party respondent and connected to the unit's smoke detectors or manual pull station
  2. Any unit fire alarm device activation connected to the host facility's building fire alarm system
A manual fire extinguisher shall be provided in accordance with NFPA 10: Standard for Portable Fire Extinguishers.
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