Heads up: There are no amended sections in this chapter.
Specific terms and definitions are provided to facilitate consistency in the interpretation and application of the Guidelines. Some of these terms may have a broader definition in other contexts, but the definitions provided here reflect the use of the terms in the Guidelines.
Activity area: An area of a residential care facility that is used by residents and activity directors/coordinators to engage in activities such as arts and crafts, individual or group games (e.g., cards, electronic games, board games), education, watching video/television. Note: This is differentiated from a recreation area.
Adjacent: See Location terminology.
Administrative areas: Designated spaces such as offices and meeting rooms that accommodate admission and discharge processes, medical records storage, medical and nursing administration, business management and financial services, human resources, purchasing, community services, education, and public relations.
Airborne infection isolation (AII) room: A room designated for persons having or suspected of having an infection that is spread through coughing or other ways of suspending droplets of pathogens into the air (e.g., tuberculosis, smallpox).
Ambulate: To walk or move about from place to place with or without assistance.
Area: A particular extent of space or surface serving a defined function.
Authority having jurisdiction (AHJ): An individual or organization designated by a state or government agency to enforce building codes and other regulations related to construction projects.
Bariatric resident: See Person of size.
Centralized services: As used in this document, a resident unit, facility, or setting that provides central services.
Clearance: The shortest unencumbered distance between the outermost dimensions of a specified object (e.g., a resident bed or exam table) and specified, fixed reference points (e.g., walls, cabinets, sinks, and doors).
Clear dimension: An unobstructed room dimension exclusive of built-in casework and equipment and available for functional use.
Clear floor area: The floor area of a defined space that is available for functional use excluding toilet rooms, closets, lockers, wardrobes, alcoves, vestibules, anterooms, and auxiliary work areas. Note: Door swings and floor space below sinks, counters, cabinets, modular units, or other wall-hung equipment that is mounted to provide usable floor space counts toward "clear floor area." Space taken up by minor fixed encroachments that do not interfere with room functions can be included in calculating clear floor area.
Clinical sink: A flushing-rim sink or "hopper" used for disposal of blood or body fluids (e.g., bedpan washing). Note: This is not the same as a hand-washing sink or an instrument-cleaning sink (single- or double-sink type).
Community residence (CR): A residential facility that provides supervised and supportive living environments. Note: In a supervised CR, staff are immediately available on-site 24/7 and supplies for daily living, like food and toiletries, are provided. Supervised CRs are designed to provide a home-like atmosphere where individuals with developmental disabilities can acquire the skills needed to live as independently as possible.
Country kitchen: An activity component usually connected to a great room or other activity room that is intended for use by residents, participants, or outpatients as well as staff. Note: A country kitchen is used for activities and for warming food and serving food as part of an integrated food service program.
Culture change: Common name given to resident-centered care processes for transforming health, care, and supportive services based on person-directed values and practices in which the voices of residents, their families, and those working with them are considered and respected and person always comes before task.
Curbless shower: An area of a room that serves as the shower. Note: Other terms may include open shower, European shower, or European wet room.
Differential pressure: A measurable difference in air pressure that creates a directional airflow between adjacent spaces.
Directly accessible: See Location terminology.
Documentation area: A work area associated with or near a resident care area where information specific to residents is recorded, stored, and reviewed to facilitate ready access by authorized individuals.
Emergency call system: Devices that are activated to indicate the need for staff assistance. Note: Such devices produce an audible or visual indication (or both) or may be connected or transmit to an area alert monitor or personal hand-held device.
Environment of care: Those physical environment features in a residential health, care, or support facility that are created, structured, and maintained to support and enhance the delivery of care and services.
Environmental services (housekeeping): Services anywhere in a residential health, care, or support facility that provide general cleaning and supply identified cleaning materials (e.g., soaps, towels). Note: Although routine disinfection protocols can be included in such a definition, the definition is not intended to include complex, non-routine disinfection procedures nor the non-routine disposition of hazardous materials such as potentially toxic drugs or other chemicals.
Equipment, portable or mobile: Floor-based equipment that moves on the floor surface, such as floor-based sling lifts and sit-to-stand lifts. Note: This equipment may be moved horizontally either manually or with the assistance of motorized wheels. When the term "portable" is used in connection with ceiling lifts, it may also refer to a lift motor and hoist that can be removed from a track system in one room and attached to the track system in another room.
Examination room: A room with a bed or examination table and capability for periodic monitoring and checkups.
Facility: A discrete physical entity composed of various functional units as described in the Guidelines.
Fixed equipment: Equipment with track systems attached at some point in the room. Note: Fixed equipment includes ceiling-mounted or overhead lifts, wall-mounted lifts, and other lifting devices with fixed tracking. An alternative would be a demountable track that may be fully or partially disassembled and removed from the space.
Functional program: A record of the key environment of care considerations and facility functional and operational parameters that drive the space program for a project. Note: The governing body or its delegate develops the functional program, which is intended to inform the designers of record, authority having jurisdiction, and users of the facility. The size and complexity of the project will determine the length and complexity of the functional program.
Governing body: The person or persons who have overall legal responsibility for the operation of a residential health, care, or support facility. Note: Often, the "owner" or "provider" is representative of the governing body.
Hand sanitation dispenser: A dispenser that contains a liquid solution that has been approved by the FDA for hand hygiene.
Hand-washing station: An area that provides a sink with a faucet that can be operated without using hands, cleansing agents, and means for drying hands.
Hands-free faucets: Faucets that are controlled by knee- or foot-operated pedals or by motion sensors such as electric eye controls. Note: This term does not refer to faucets operated using wrist blades or single-lever faucets.
Hazard: Anything that has the potential to cause harm.
Health, care, or support facility: Any facility type listed in the table of contents of this book.
Immediately accessible: See Location terminology.
Independent living: Category of residential living that often includes supportive services for residents.
Intermediate care facility for individuals with intellectual disabilities: A residential institution (or distinct part of an institution) for individuals with intellectual disabilities or related conditions that (1) is primarily for the diagnosis, treatment, or rehabilitation of the intellectually disabled or persons with related conditions and (2) provides, in a protected residential setting, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitation services to help each individual function to his or her greatest ability.
Location terminology (terms for relationship to an area or room)
In Located within the identified area or room
Directly accessible Connected to the identified area or room through a doorway, passthrough, or other opening without going through an intervening room or public space
Adjacent Located next to but not necessarily connected to the identified area or room
Immediately accessible Available either in or adjacent to the identified area or room
Readily accessible Available on the same floor as the identified area or room
In the same building Available in the same building as the identified area or room, but not necessarily on the same floor
Marine plywood: Wood construction that resists delamination and fungal attack to perform longer in humid and wet conditions.
Medication errors: Any preventable event that may cause or lead to inappropriate medication use or resident, participant, or outpatient harm while a medication is in the control of a health care professional, resident, or consumer, whether that person is prescribing; communicating an order for; dispensing; distributing; administering; educating about; monitoring use of; or using a medication. (Definition adapted from the National Coordinating Council for Medication Error Reporting and Prevention definition; see www.nccmerp.org.)
Minimum clearance: See Clearance and Clear dimension.
Mobility: The functional ability of a resident, participant, or outpatient to move readily from place to place, with or without the use of mobility-related assistive devices.
Mobilize or mobilization: The application of resources necessary to cause or enable a resident, participant, or outpatient or limb of a resident, participant, or outpatient to move or continue to move to help the resident, participant, or outpatient maintain or increase physical activity and movement.
Movement: Staff-assisted transfers of a dependent resident (e.g., from a bed to a chair or toilet or from a room to another location). Note: "Movement" can apply to repositioning a dependent resident in a bed or chair and can be the result of ambulation or mobilization. See also Ambulation, Mobilization.
Nature: An organic environment in which the majority of ecosystem processes are present (e.g. birth, death, reproduction, relationships between species) or any single element of the natural environment (e.g., plants, animals, soil, water, air). Note: This includes the spectrum of habitats from wilderness areas to farms and gardens as well as domestic and companion animals and cultivated potted plants. Nature can also refer collectively to the geological, evolutionary, biophysical, and biochemical processes that have occurred throughout time to create the Earth as it is today.
Net usable program area: The sum of all interior areas in a project available to house the project's program. Areas housing building equipment, vertical circulation, and structural systems shall be excluded.
Nurse call: A hardwired or wireless system for calling care staff to a resident room or other location when a resident, participant, or outpatient is in need of assistance.
Nurse station: A multipurpose staff work area used by all caretakers in a resident unit in centralized care models.
Office: See Room.
Participant: A person receiving care and services in an adult day care, adult day health care, or PACE facility or a wellness center that provides day services only and no overnight stays.
Patient: A person receiving medical care or rehabilitation therapy in an outpatient facility.
Patient care area: An area used primarily for the provision of clinical care to patients. Note: Such care includes outpatient rehabilitation therapy services.
Person of size: A person whose height, weight, body width, weight distribution, and/or size require increased space for care and expanded-capacity devices, equipment, furniture, technology, and supplies. Note: This term is often interchangeable with obese, morbidly obese, and bariatric.
Personal care home: A residence that provides residents with shelter, meals, supervision, and assistance with personal care tasks. Note: The services provided vary and are based on the individual needs of each resident. These facilities typically house older people or people with physical, behavioral health, or cognitive disabilities who are unable to care for themselves but do not need nursing home or medical care.
Places of respite: Spaces within a residential health, care, or support facility or on a campus provided to connect residents, participants, outpatients, visitors, and staff to the health benefits of the natural environment. (Green Guide for Health Care, Sustainable Site Design: Places of Respite Technical Brief, www.gghc.org/tools.technical.php)
Post-acute care: Category of residents who are discharged from acute care hospitals to inpatient rehabilitation facilities, nursing homes, or home health care providers.
Provisions for drinking water: Availability of readily accessible potable water for resident, staff, and visitor needs. Note: Water may be provided in a variety of ways, including fountains, pitchers, and bottled water.
Public or community areas: Designated spaces freely accessible to the public. Note: These spaces include parking areas, secured entrances and areas, entrance lobbies, reception and waiting areas, public toilets, snack bars, cafes, vending areas, gift shops and other retail locations, resource libraries and meeting rooms, chapels, and gardens.
Readily accessible: See Location terminology.
Recreation area: An area in a residential care facility that is used by residents and recreation therapists/coaches for physical exercise and movement. Note: This is differentiated from an activity area.
Resident: A person living and receiving health, care, and/or support services in a nursing home, hospice facility, assisted living facility, independent living setting, or inpatient rehabilitation facility.
Resident-centered care: A philosophical approach to residential health, care, and support environments that honors and respects the voice of those being served and those working most closely with them. Note: This care model process is intended to individualize care and deinstitutionalize the residential health, care, and/or support environment.
Residential care and support facilities: Category of facilities such as assisted living facilities and independent living settings in which services such as assistance with activities of daily living (ADL) and/or instrumental activities of daily living (IADL) are provided to residents.
Residential health facilities: Category of facilities in which long-term health services are provided (e.g., nursing homes and hospice facilities).
Residential support facilities: Category of facilities in which health, care, and/or support services that do not require overnight accommodation are provided.
Resident-operated mobility devices: Equipment (e.g., wheelchairs, walkers, ambulation-assistance equipment, battery-operated mobile chairs) used by residents, participants, and outpatients in residential health, care, support, and related settings to enable them to mobilize.
Resident safety risk assessment (RSRA): A multidisciplinary organizational process that focuses on reducing risk from infections, mobility and transfer activities, resident falls, dementia and mental health issues, medication errors, security issues, and disasters throughout planning, design, and construction (including renovation) for residential health, care, and support facilities and settings.
Risk: The likelihood that somebody or something will be harmed by a hazard, multiplied by the severity of the potential harm.
Room: A space enclosed by hard walls and having a door. Note: Where the word "room" or "office" is used in the Guidelines, 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.
Service areas: Designated spaces that house auxiliary functions that do not routinely involve contact with residents, participants, or the public (e.g., supply, processing, storage, and maintenance services such as dietary, laundry processing and storage, environmental services (housekeeping), maintenance operations, and clean and soiled utility rooms).
Speech privacy: Techniques to render speech unintelligible to casual listeners. (Definition from ANSI T1.523-2001: Glossary, a standard maintained by the U.S. Department of Commerce, National Telecommunications and Information Administration, Information Security Program.) Note: This definition matches earlier ones in ANSI S3.5 (1969) and ASTM E1130 (1997 & 2001) and is consistent with ASTM E2638 (2011). See ASTM E1130 and ASTM E2638 for four defined, measurable levels of speech privacy. Speech privacy is a condition required by HIPAA (the Health Insurance Portability and Accountability Act) and is the subject of the "noise-at-night question" on the HCAHPS patient satisfaction survey.
Station: See Hand-washing station, Nurse station.
Subacute care: Category of care requiring less intensity of care/resources than acute care. Note: Subacute care falls within a continuum of care determined by resident acuity, clinical stability, and resource needs.
Support areas (resident units, diagnostic and treatment areas, etc.): Designated spaces or areas in which staff members perform auxiliary functions that support the main purpose of the unit or other location. Note: Where the word "room" or "office" is used, a separate, enclosed space for the one named function is intended. Otherwise, the described area is permitted to be a specific space in another room or common area.
Support areas (resident, family, and/or visitor): Designated spaces for the use of residents, participants, patients, or visitors (e.g., changing areas, dining rooms, toilet rooms, activity rooms) or families and visitors (e.g., waiting areas and lounges, children's play areas, toilet rooms). Note: Where the word "room" or "office" is used, a separate, enclosed space for the one named function is intended. Otherwise, the described area is permitted to be a specific space in another room or common area.
Support areas (staff): Designated spaces for the personal use of staff (e.g., changing areas, toilet rooms, showers, lounges, dining areas). Note: Where the word "room" or "office" is used, a separate, enclosed space for the one named function is intended. Otherwise, the described area is permitted to be a specific space in another room or common area.
Sustainability: A means of configuring human activity so that society, its members, and its economies are able to meet their needs and express their greatest potential in the present, while preserving biodiversity and natural ecosystems in the long term; improving the quality of human life while living within the carrying capacity of supporting ecosystems.
Sustainable design: The art of designing physical objects, the built environment, and services to comply with principles of economic, social, and ecological sustainability.
Therapeutic and restorative gardens: A space, usually outdoors but sometimes indoors, that promotes physical and emotional health and well-being through passive and/or active engagement with nature. Note: At best, these spaces are designed based on research (evidence-based design) for a specific population, site, and intended outcome (e.g., stress reduction, positive distraction, exercise, facilitating social connection, rehabilitation, play). Sometimes referred to as a "healing garden."
Treatment room: A room where therapy or other care services are provided.
Type III environmental product declaration (EPD): A Type III environmental product declaration provides quantified environmental data using predetermined parameters and, where relevant, additional environmental information. Note: An EPD can be either brand-specific or industry-wide.
Unit: An area or space usually dedicated to a single defined organizational function.
Universal design: The concept of designing all products and the built environment to be usable and non-stigmatizing to the greatest extent possible by everyone, regardless of age, ability, or status in life.
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