Adopts Without Amendments:

FGI Outpatient, 2018

Part 1 General

Part 2 Outpatient 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 where rehabilitation therapy and services are provided.
A2.12-1.1.1 Rehabilitation therapy and services. Rehabilitation therapy is primarily intended to restore body functions and may comprise one or several categories of services. In behavioral health facilities, it may 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 multipurpose space in another area, 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.
    • -Other occupational therapy activities. Occupational therapy may include such activities as woodworking, leather-tooling, art, needlework, painting, sewing, metalwork, and ceramics.
  4. Prosthetics and orthotics
The outpatient rehabilitation facility shall meet the standards described in this chapter and the standards in Part 1 of these Guidelines as amended in this section.
Requirements in Chapter 2.1, Common Elements for Outpatient Facilities, shall apply to outpatient rehabilitation facilities as cross-referenced in this chapter.
In addition to the requirements in Section 2.1-1.2.3 (Shared/Purchased Services), the following requirements shall apply to the outpatient rehabilitation facility.
An outpatient rehabilitation facility located in a facility housing other services shall have its own identifiable space.
All support areas shall be permitted to be shared.
See Section 2.1-2 (Accommodations for Care of Patients of Size) for requirements.
In rehabilitation centers where two or more rehabilitation therapies and services are provided, sharing of facilities and equipment between the therapies and services shall be permitted.
A2.12-3.1 Facilities for additional services. In addition to the therapies and services included in Section 2.12-3 (Patient Care and Diagnostic Areas), social, psychological, and vocational services may be provided in outpatient rehabilitation centers. Where such services are provided, dedicated spaces to accommodate them, including work space for therapists, should be provided.
Where physical and/or occupational therapy is offered, the requirements in this section shall be met.
Space shall be provided for carrying out each type of rehabilitation therapy and service provided in the facility. A therapy space shall be permitted to be shared with another function.
  1. Where patient disrobing is necessary to receive treatment, an individual therapy room(s) that meets the requirements in this section shall be provided.
  2. Space requirements
    1. Area. An individual therapy room shall have a minimum clear floor area of 80 square feet (7.43 square meters).
    2. Clearances. Room arrangement shall permit a minimum clearance of 2 feet 8 inches (81.28 centimeters) on at least three sides of the therapy furniture and equipment.
  1. Area. Where individual therapy spaces are provided in a therapy or exercise area, each therapy space shall have a minimum clear floor area of 60 square feet (5.57 square meters).
  2. Patient privacy. Individual treatment spaces shall have provisions for patient privacy.
  1. Hand-washing station(s) shall be provided in accordance with Section 2.1-3.8.7 (Hand-Washing Station).
  2. A hand-washing station shall be permitted to serve several therapy spaces.
The layout of the exercise area shall include a staff work area arranged so that staff can view activities taking place in the exercise area.
An open, barrier-free space for rehab therapy shall be provided based on the following:
  1. Number of patients treated at the same time
  2. Number of staff members present at the same time
  3. Clearance requirements for equipment used
At least one hand-washing station shall be provided in the exercise area. See Section 2.1-3.8.7 (Hand-Washing Station) for requirements.
A2.12-3.2.4 Therapeutic pool. Where a therapeutic pool is provided, consider complying with the Arthritis Foundation Aquatics Facility Guidelines. Also refer to the CDC Web page "Design and Operation of Pools and Hot Tubs" for additional information.
Where therapy services include use of a pool, the pool shall be large enough to accommodate the number of patients to be served at one time.
A patient changing area shall be provided where therapy services include use of a pool.
  1. The patient changing area shall consist of single unisex rooms or a locker room to service multiple people of the same sex.
  2. The patient changing area shall be directly accessible to the pool without entering public or exercise areas.
  3. Patient toilet room. A toilet room shall be provided that is directly accessible to the changing area.
  4. Shower
    1. At least one shower shall be provided separate from the toilet room.
    2. The shower shall be in or directly accessible to a room containing the following:
      1. Toilet in a separate enclosure
      2. Hand-washing sink
      3. Storage for soap and towels
  5. Securable lockers shall be provided.
Where provided, space for evaluation and fitting of prosthetics and orthotics shall meet the requirements in this section.
Space for evaluation and fitting of prosthetics and orthotics shall have provision for privacy.
The prosthetics and orthotics area shall have a hand-washing station that meets the requirements in Section 2.1-3.8.7.2 (Hand-Washing Station-Design requirements).
Where running water is needed in prosthetic and orthotic areas for materials preparation, a clinical sink(s) shall be provided.
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.
Where speech and hearing therapies are offered, rooms that meet the requirements in this section shall be provided.
Speech and hearing therapy rooms shall have a clear floor area of 80 square feet (7.43 square meters).
A gasketed door with a sweep shall be provided in speech and hearing room(s).
  1. See Section 2.1-3.8.7 (Hand-Washing Station) to determine if a hand-washing station(s) must be provided in the speech and hearing area.
  2. A speech or hearing area that does not require a hand-washing station shall have a dedicated hand sanitation dispenser.
Accommodations for written and/or electronic documentation shall be provided in all therapy service areas. See appendix section A2.1-3.8.3 (Documentation area) for recommendations.
Where medications are administered in the outpatient rehabilitation center, see Section 2.1-3.8.8 (Medication Safety Zones) for requirements.
  1. Storage for clean linen and towels shall be provided in cabinets, closets, or separate storeroom(s), or space shall be provided for clean linen carts.
  2. Separate storage for soiled linen, towels, and supplies shall be provided.
Designated storage for therapeutic equipment, safety devices, and other clinical supplies shall be provided for the following areas when they are part of the clinical services offered by the facility:
  1. Exercise area(s)
  2. Therapy room(s) and therapy area(s)
  3. Pool area(s)
  4. Prosthetic, orthotic, speech, hearing, or other clinical services
Wheelchair, lift, and gurney storage. Space(s) shall be provided for storing wheelchairs, lifts, and gurneys.
Provisions for drinking water shall be provided.
A2.12-3.10 Support areas for patients. Patient changing areas, toilets, showers, and lockers may be needed depending on the services provided in the outpatient rehabilitation facility.
See Section 2.1-5.2.1 (Waste Collection and Storage Facilities) for requirements.
An environmental services room shall be provided in accordance with Section 2.1-5.3.1 (Environmental Services Room).
Separate storage for pool chemicals and testing equipment shall be provided.
A2.12-5.3.2 Pool chemical storage. See the Environmental Protection Agency publication "Safe Storage and Handling of Swimming Pool Chemicals" for more Information.
Public areas shall be provided in accordance with Section 2.1-6.2 (Public Areas).
A2.12-6.2 Waiting areas or rooms. The following should be considered during design, location determination, and seating capacity calculations for waiting areas or rooms in outpatient rehabilitation facilities:
  1. Patients arriving and waiting for treatment may be using devices for mobility, including crutches, walkers, and wheelchairs. Therefore, to reduce the chances for tripping or injury, seating should not be located near the path of travel.
  2. Because patients may need to wait for transport, such as cabs, buses, or specialty transport services, consider including a window overlooking the entrance so patients can sit inside to wait for transport.
Depending on the administrative services provided in the outpatient rehabilitation facility, administrative areas shall be provided to support the management staff based on evaluation of staffing needs completed as part of the functional programming process.
Staff office space and file storage shall be provided based on the staff required to operate and provide therapy services.
Reception shall be permitted to be combined with office and clerical space.
Space for storage of office equipment and supplies shall be provided based on staff requirements and outpatient needs.
The required minimum corridor width shall be provided in accordance with Section 2.1-7.2.2.1 (Corridor width).
Window(s) in therapy areas shall have features, curtains, or shades to provide patient privacy.
See Section 2.1-8.2 (HVAC Systems) for requirements.
A2.12-8.2 Prosthetics and orthotics areas. Drying glue vapors and flying debris from shaping prosthetics and orthotics should be controlled by appropriately designed local exhaust equipment. See ACGIH® Industrial Ventilation: A Manual of Recommended Practice.
See Section 2.1-8.3 (Electrical Systems) for requirements.
See Section 2.1-8.4 (Plumbing Systems) for requirements.
Where portable hydrotherapy whirlpools are used, the requirements in Section 2.1-8.4.3.9 (Hydrotherapy facilities) shall be met.
See Section 2.1-8.5 (Communications Systems) for requirements.
See Section 2.1-8.6 (Fire Alarm System) for requirements.
See Section 2.1-8.7 (Elevator System) for requirements.
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