Adopts Without Amendments:

FGI Hospital, 2018

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 apply to facilities that provide acute rehabilitation hospital care and identify and market themselves to the general public as rehabilitation hospitals, rehabilitation inpatient health care centers, or rehabilitation centers of excellence.
The rehabilitation hospital shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines.
Requirements described in Chapter 2.1, Common Elements for Hospitals, and Chapter 2.2, Specific Requirements for General Hospitals, shall apply to rehabilitation hospitals as cross-referenced in this chapter.
A2.6-2.1 See appendix section A2.1-2.1.1 (Accommodations to encourage patient mobility) for mention of this aspect of patient care unit design.
Patient care unit(s) in rehabilitation hospitals shall meet the minimum design requirements described in Section 2.6-2.2 (Rehabilitation Patient Care Unit) as applicable.
Where compliance with this section is impractical for renovation of patient care units in an existing-rehabilitation hospital, see Section 1.1-3 (Renovation) for further guidance.
Where accommodations for care of patients of size are provided, they shall meet the requirements in Section 2.1-2.3 (Accommodations for Care of Patients of Size).
A2.6-2.2 In general, rehabilitation hospitals have larger space requirements, longer lengths of stay, and environments that are less institutional and more residential than general hospitals.
A2.6-2.2.2 Efforts should be made to provide patients with some control of the room environment.
  1. See Section 2.2-2.2.2.1 (Medical/Surgical Patient Care Unit: Patient Room-Capacity) for requirements.
  2. Where the necessity of a two-bed arrangement has been demonstrated by the hospital and approved by the AHJ, at least two single-patient rooms with private toilet rooms shall be provided in each patient care unit.
  1. Area. Patient rooms shall have a minimum clear floor area of 140 square feet (13.01 square meters) in single-patient rooms and 125 square feet (11.61 square meters) per bed in multiple-patient rooms.
  2. Clearances
    1. The dimensions and arrangement of rooms shall provide a minimum clearance of 4 feet (1.22 meters) between the sides and foot of the bed and any wall or any other fixed obstruction in both single- and multiple-patient rooms.
    2. A turning space for wheelchairs shall be provided.
A2.6-2.2.2.2 Space requirements. Patient rooms in a rehabilitation hospital should be able to accommodate the equipment used as well as furniture for one or two family members without blocking staff access to patients. Movable seating to support visitation and teaming around the patient should be provided to support the rehab services provided in the facility.
See Section 2.1-7.2.2.5 (Windows in patient rooms) for requirements.
See Section 2.1-2.1.2 (Patient Privacy) for requirements.
See 2.1-2.2.5 (Hand-Washing Station in the Patient Room) for requirements.
See Section 2.1-2.2.6 (Patient Toilet Room) for requirements in addition to those in this section.
  1. Where the bathing facility/shower is located in the patient toilet room, space shall be provided for an attendant.
  2. Each toilet room shall be sized to provide access for a patient in a wheelchair.
  3. Where portable patient lifts are provided, the door opening into each patient toilet room shall be wide enough to allow health care providers to transfer patients to the toilet using a portable lift.
  4. Thresholds shall be designed to facilitate use and prevent tipping of wheelchairs and other portable wheeled equipment by patients and staff.
  1. Patient bathing facilities shall meet the requirements in Section 2.2-2.2.2.7 (Patient bathing facilities) as amended in this section.
  2. Central bathing facilities
    1. General. Each tub or shower in an individual room or privacy enclosure shall include space for a wheelchair and an attendant.
    2. Number. Bathtubs or showers shall be provided at a ratio of one bathing facility for every eight beds not otherwise served by bathing facilities in patient toilet rooms.
    3. Showers in central bathing facilities shall be at least 16 square feet (1.49 square meters), curb-free, and designed for use by patients in wheelchairs.
    4. Door openings to the toilet room in or directly accessible to a central bathing facility shall be provided in accordance with Section 2.1-7.2.2.3 (2) (Door openings).
Each patient shall be provided with an individual wardrobe or closet.
  1. This storage shall have a minimum net depth of 2 feet (55.88 centimeters), a minimum net width of 2 feet 6 inches (76.2 centimeters), and a minimum volume of 25 cubic feet (.71 cubic meter).
  2. A shelf shall be provided in the closet or wardrobe.
  3. Omission of the shelf shall be permitted where at least two accessible drawers or other storage compartments are provided.
A2.6-2.2.2.8 Rehab patients' length of stay is longer than that of typical acute care patients.
Airborne infection isolation (AII) room. AII rooms that comply with Section 2.1-2.4.2 (AII Room) shall be provided where required by an infection control risk assessment.
  1. The support areas noted shall be provided in or readily accessible to each patient care unit and meet the requirements in Section 2.1-2.8 (Support Areas for Patient Care Units and Other Patient Care Areas) as amended in this section.
  2. Size. The size of each support area shall depend on the numbers and types of beds served.
  3. Location. Each support area shall be permitted to be arranged and located to serve more than one patient care unit, but at least one such support area shall be provided on each patient care floor.
Administrative center or nurse station
Documentation area
  1. An office shall be provided for the nursing staff.
  2. Office or other work space shall be provided for staff who provide psychological and social services.
Each patient care unit shall have equipment to provide ice for treatments and for nourishment in accordance with Section 2.1-2.8.10 (Ice-Making Equipment).
  1. Clean linen storage
  2. Equipment storage room. A storage room shall be provided for equipment such as IV stands, inhalators, air mattresses, and walkers.
  3. Storage space for stretchers and wheelchairs
  4. Equipment storage space with power outlets for charging equipment
  5. Storage for administrative supplies
An examination room shall be provided in accordance with the requirements in Section 2.1-3.2.2 (Single-Patient Examination Room).
  1. Omission of this room shall be permitted where all patient rooms in the unit are single-patient rooms.
  2. The examination room in the evaluation unit shall be permitted to serve this purpose where it is readily accessible to the patient care unit.
Support areas shall be provided in accordance with Section 2.1-2.9 (Support Areas for Staff).
Patient dining, recreation, and day spaces shall be permitted to be separate or adjoining spaces.
A glazed area shall allow daylight from the exterior wall to reach each dining, recreation, and day space.
  1. Inpatient spaces. A minimum of 55 square feet (5.11 square meters) per bed shall be provided.
  2. Outpatient services
    1. Where dining is part of a day care program, a minimum of 55 square feet (5.11 square meters) per person shall be provided.
    2. Where dining is not part of a day care program, a minimum of 35 square feet (3.25 square meters) per person shall be provided for recreation and day spaces.
A hand-washing station shall be provided in each dining room.
Storage spaces shall be provided for recreational equipment and supplies.
A unit shall be provided for teaching activities of daily living.
  1. Facility requirements. The unit shall include the following:
    1. A bedroom
    2. A bathroom. The bathroom shall be in addition to other toilet and bathing requirements.
    3. A kitchen
    4. Space for training stairs
  2. Equipment. Functional equipment similar to that in a residential environment shall be provided so patients can learn to use such equipment at home.
A2.6-3.1 Rehabilitation therapy is primarily for restoration of body functions and may comprise one or several categories of services. In behavioral health facilities, it may also be used for diagnosis and treatment of mental functions as well as to address physical functions to varying degrees.
Therapies and services offered in a rehabilitation therapy program may include the following:
  1. Physical therapy
    • -Ultrasonics
    • -Hydrotherapy
    • -Thermotherapy
    • -Diathermy
  2. Speech and hearing therapy
  3. Occupational therapy
    • -Activities of daily living therapy
    • -Recreation therapy. Recreation therapy assists patients in the development and maintenance of community living skills through the use of leisure-time activity tasks. These activities may occur in a recreation therapy area, in specialized facilities such as a gymnasium, in a patient care unit, in a multipurpose space, or outdoors.
    • -Education therapy
    • -Vocational therapy. Vocational therapy assists patients in the development and maintenance of productive work and interaction skills through the use of work tasks. These activities may occur in an industrial therapy workshop, in another department, or outdoors.
  4. Prosthetics and orthotics
The requirements in this section shall apply in any location where rehabilitation therapy services are provided.
A2.6-3.1.1.1 Rehabilitation therapy services may be provided in a department or a facility that is specifically designed for these services, or they may be provided where convenient for the patient, for example, at the patient's bed side or in corridor space near the patient's room.
Where two or more rehabilitation services are provided, sharing of facilities and equipment between the services shall be permitted.
Space shall be provided for carrying out each type of therapy provided.
A2.6-3.1.2.1 Physical therapy spaces
  1. Group work areas should be sized for one therapy group at a time.
  2. Provision of a private therapy room(s) should be considered.
  1. Space requirements
    1. Space requirements shall be based on the equipment used for therapeutic treatment and shall allow access to the equipment when in use by the patient and the therapist.
    2. Clearances. Each patient care station shall permit an arrangement that provides a minimum clearance of 2 feet 8 inches (81.28 centimeters) on at least three sides of the therapy furniture (e.g., chairs, recliners, tables, beds, or mats).
  2. Patient privacy
    1. Each individual patient care station shall have privacy screens or curtains.
    2. Windows in therapy areas shall have features, curtains, or shades to provide patient privacy.
  3. Hand-washing stations. Hand-washing stations that meet the requirements in Section 2.1-2.8.7 (Hand-Washing Station) shall be provided.
The layout of the exercise area shall include a staff work area arranged so that the staff can view all activities taking place in the exercise area.
A2.6-3.1.2.3 The size of the exercise area should be determined by:
  1. The number of patients who will be treated at the same time
  2. The number of staff members who will be present at the same time
  3. The space required for equipment used for therapeutic treatment
  1. Soiled material storage. Separate storage for soiled linen, towels, and supplies shall be provided.
  2. Equipment and supply storage
    1. Clean linen and towel storage
    2. Storage for equipment and supplies
Where occupational therapy is part of the rehabilitation therapy service, the following shall be provided:
At least one classroom/dining room shall be provided.
  1. Each classroom/dining room shall have 30 square feet (2.79 square meters) per person plus an additional 30 square feet (2.79 square meters) for the instructor and instructional resources.
  2. Each classroom/dining room shall have a minimum of 150 square feet (13.94 square meters).
These shall be suitable for wheelchair access.
An area for teaching activities of daily living shall be provided.
A2.6-3.1.3.4 Patients need to learn both how to adapt to their home environment and how to adapt their home environment so they can live in their physically challenged state. Therefore, the facilities provided for teaching activities of daily living should be equipped as if they were a residence.
Hand-washing stations that comply with Section 2.1-2.8.7.2 (Hand-Washing Station-Design requirements) shall be provided in each room where therapy or teaching is conducted.
Equipment and supply storage shall be provided.
Where prosthetics and orthotics are part of the service, at least the following shall be provided:
  1. Space for evaluation and fitting. This shall have provision for privacy.
  2. Hand-washing station
    1. Where staff are required to work with or mix wet material or handle material or chemicals that are caustic, a hand-washing station shall be provided.
    2. Where staff are not required to work with or mix wet material or handle material or chemicals that are caustic to the skin, provision of a hand sanitation dispenser or a hand-washing station shall be permitted.
  3. Clinical sink. Where prosthetic and orthotic areas need running water for materials preparation, a clinical sink(s) shall be provided.
  4. Eyewash station. Where staff are required to work with or mix wet material or handle material or chemicals that are caustic, an eyewash station shall be provided.
  1. Where speech and hearing services are offered, space for evaluation and treatment shall be provided.
  2. A hand-washing station that complies with Section 2.1-2.8.7.2 (Hand-Washing Station-Design requirements) shall be provided.
  3. The therapy area(s) shall be provided with speech privacy. The design shall minimize external sound from high-traffic, public, and similar noisy areas.
Where portable hydrotherapy facilities are used, the requirements of Section 2.1-8.4.3.9 (Hydrotherapy facilities) shall be met.
Each rehabilitation therapy department shall include the following support areas, which shall be permitted to be shared or provided as separate units for each service.
Where reception and control station(s) are provided, they shall have visual control of waiting areas(s).
Provision shall be made for documenting, filing, and retrieving patient records.
Access to a demonstration/conference room shall be provided.
A room shall be provided for storage and holding as part of a system for distribution of clean and sterile materials.
A room shall be provided for the temporary holding of soiled material.
  1. Reserved
  2. Secured storage shall be provided for potentially harmful supplies and equipment.
  3. Wheelchair, lift, and gurney storage
    1. Space(s) shall be provided for storing wheelchairs, lifts, and gurneys out of traffic while patients are using the services.
    2. These spaces shall be permitted to be separate from the service area but shall be immediately accessible.
A readily accessible environmental services room shall be provided in accordance with Section 2.1-2.8.14 (Environmental Services Room).
Each rehabilitation therapy department shall include the following support areas, which shall be permitted to be shared or provided as separate units for each service:
A staff toilet(s) shall be provided in the department.
Lockable storage shall be readily accessible to each work area for securing staff personal effects.
Each rehabilitation therapy department shall include the following support areas, which shall be permitted to be shared or provided as separate units for each service:
These shall be located out of traffic with provision for wheelchairs.
Patient toilet rooms shall have toilets and hand-washing stations that are accessible to wheelchair patients.
In rehabilitation hospitals where respiratory therapy services are provided, see Section 2.2-3.9 (Respiratory Therapy) for requirements.
Imaging facilities shall be sized to accommodate the services provided.
Where areas for the following services are provided, they shall meet the requirements in Section 2.2-3.4 (Imaging Services).
  1. CT scan
  2. MRI
  3. Nuclear medicine
  4. Diagnostic x-ray
Where the following services are provided, they shall meet the requirements in the referenced sections.
See Section 2.1-4.1 (Laboratory Services) for requirements.
See Section 2.1-4.2 (Pharmacy Services) for requirements.
See Section 2.1-4.3 (Food and Nutrition Services) for requirements.
See Section 2.1-5.2 (Linen Services) for requirements.
See Section 2.1-5.3 (Materials Management) for requirements.
See Section 2.1-5.4 (Waste Management) for requirements.
See Section 2.1-5.5 (Environmental Services) for requirements.
See Section 2.1-5.6 (Engineering and Maintenance Services) for requirements.
See Section 2.1-6 (Public and Administrative Areas) for requirements.
See Section 2.1-7 (Design and Construction Requirements) for requirements.
For electrical system requirements, see Section 2.1-8.3 (Electrical Systems) and additional requirements in this section.
See Section 2.1-8.4 (Plumbing Systems) for plumbing system requirements.
Call systems shall meet the requirements in Section 2.1-8.5.1 (Call Systems).
Locations for terminating telecommunications and information system devices shall be provided.
An area shall be provided for central equipment locations. Special air conditioning and voltage regulation shall be provided when recommended by the manufacturer.
See Section 2.1-8.6.1 (Fire Alarm System) for requirements.
See Section 2.1-8.7 (Special Systems) for requirements.
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