DHS 124.34 History History: Emerg. renum. from DHS 124.27 (8), eff. 7-1-96; renum. from DHS 124.27 (8), Register, December, 1996, No. 492, eff. 1-1-97.
DHS 124.35 DHS 124.35Additional requirements for particular patient care areas.
DHS 124.35(1)(1)Special care units.
DHS 124.35(1)(a)(a) In new construction, viewing panels shall be provided in doors and walls of special care units for nursing staff observation of patients. Curtains or other means shall be provided to cover the viewing panels when privacy is desired.
DHS 124.35(1)(b) (b) In new construction a sink equipped for handwashing and a toilet shall be provided in each private patient room on special care units. In multi-bed rooms at least one sink and one toilet for each 6 beds shall be provided. Individual wall-hung toilet facilities with privacy curtains or another means of safeguarding privacy may be substituted for a toilet room.
DHS 124.35(1)(c)1.1. In new construction all special care unit beds shall be arranged to permit visual observation of the patient by the nursing staff from the nursing station.
DHS 124.35(1)(c)2. 2. In existing facilities, if visual observation of special care unit beds is not possible from the nursing station, staffing or television monitoring shall permit continuous visual observation of the patient.
DHS 124.35(1)(d) (d) In new construction the dimensions and clearances in special care unit patient rooms shall be as follows:
DHS 124.35(1)(d)1. 1. Single bed rooms shall have minimum dimensions of 10 feet by 12 feet;
DHS 124.35(1)(d)2. 2. Multi-bed rooms shall have a minimum side clearance between beds of at least 7 feet; and
DHS 124.35(1)(d)3. 3. In all rooms the clearance at each side of each bed shall be not less than 3 feet 6 inches and the clearance at the foot of each bed shall be not less than 5 feet.
DHS 124.35(2) (2)Psychiatric units. The requirements for patient rooms under s. DHS 124.34 apply to patient rooms in psychiatric nursing units and psychiatric hospitals except as follows:
DHS 124.35(2)(a) (a) In new construction and remodeling a staff emergency call system shall be included. Call cords from wall-mounted stations of individual patient rooms may be removed when justified by psychiatric program requirements.
DHS 124.35(2)(b) (b) Doors to patient rooms and patient toilet room doors may not be lockable from the inside.
DHS 124.35(2)(c) (c) Patients' clothing and personal items may be stored in a separate designated area which is locked.
DHS 124.35(2)(d) (d) Moveable hospital beds are not required for ambulatory patients.
DHS 124.35(3) (3)Surgical and recovery facilities.
DHS 124.35(3)(a)(a) Facilities within the surgical suite shall include:
DHS 124.35(3)(a)1. 1. At least one room equipped for surgery and used exclusively for that purpose.
DHS 124.35(3)(a)2. 2. A scrub room or scrub area adjacent to the room used for surgery.
DHS 124.35(3)(a)3. 3. A clean-up or utility room.
DHS 124.35(3)(a)4. 4. Storage space for sterile supplies.
DHS 124.35(3)(a)5. 5. In each operating room, means for calling for assistance in an emergency.
DHS 124.35(3)(a)6. 6. Housekeeping facilities adequate to maintain the operating room or rooms.
DHS 124.35(3)(a)7. 7. A flash sterilizer, unless sterilization facilities are accessible from the surgery area.
DHS 124.35(3)(b) (b) The surgical suite and necessary facilities shall be located and arranged to discourage unrelated traffic through the suite.
DHS 124.35(3)(c) (c) The room or rooms for postanesthesia recovery of surgical patients shall at minimum contain a medications storage area, handwashing facilities and sufficient storage space for needed supplies and equipment.
DHS 124.35(3)(d) (d) Oxygen and suctioning equipment shall be available in the surgical suite and recovery rooms.
DHS 124.35(4) (4)Labor and delivery units.
DHS 124.35(4)(a) (a) The labor and delivery unit shall be located and arranged to discourage unrelated traffic through the unit.
DHS 124.35(4)(b) (b) Facilities within the labor and delivery unit shall include:
DHS 124.35(4)(b)1. 1. At least one room equipped as a delivery room and used exclusively for obstetrical procedures;
DHS 124.35(4)(b)2. 2. A labor room adjacent to or near the delivery room;
DHS 124.35(4)(b)3. 3. A scrub-up room adjacent to the delivery room;
DHS 124.35(4)(b)4. 4. A clean-up or utility room with a flush-rim clinical sink; and
DHS 124.35(4)(b)5. 5. A separate janitor's closet with room for housekeeping supplies for the unit.
DHS 124.35(4)(c) (c) A means of calling for assistance in an emergency shall be located in the labor and delivery unit.
DHS 124.35(4)(d) (d) Oxygen and suctioning equipment shall be available in the labor and delivery unit.
DHS 124.35(4)(e) (e) In new construction, in addition to lighting for general room illumination, adjustable examination and treatment lights shall be provided for each labor bed.
DHS 124.35(4)(f) (f) In new construction, if there is a recovery room, the room shall contain at least 2 beds with a minimum clear area of 80 square feet per bed. There shall be a minimum of 4 feet between beds or stretchers and between a bed and wall except at the head of the bed.
DHS 124.35(5) (5)Nursery units. If the hospital has a maternity service, a separate nursery or nurseries for newborn infants shall be provided which shall have:
DHS 124.35(5)(a) (a) In new construction, a connecting workroom with a work counter, refrigerator, sink equipped for handwashing and storage area;
DHS 124.35(5)(b) (b) In new construction, a nursing station or administrative center located within or adjacent to the nursery;
DHS 124.35(5)(c) (c) Size specifications for the nursery, as follows:
DHS 124.35(5)(c)1. 1. For a full-term nursery, 24 square feet per bassinet;
DHS 124.35(5)(c)2. 2. For an intermediate nursery, 30 square feet per bassinet;
DHS 124.35(5)(c)3. 3. For an isolation nursery, 40 square feet per bassinet; and
DHS 124.35(5)(c)4. 4. For all nurseries, a minimum of 2 feet between bassinets, except that in new construction the minimum distance between bassinets shall be 3 feet;
DHS 124.35(5)(d) (d) The following equipment:
DHS 124.35(5)(d)1. 1. An infant sleeping unit for each infant;
DHS 124.35(5)(d)2. 2. A clock; and
DHS 124.35(5)(d)3. 3. At least one approved isolation-type sleeping unit;
DHS 124.35(5)(e) (e) Space for necessary housekeeping equipment in or near the nursery; and
DHS 124.35(5)(f) (f) An examination area and work space for each nursery.
DHS 124.35(6) (6)Isolation nursery.
DHS 124.35(6)(a) (a) If an isolation nursery is provided in new construction:
DHS 124.35(6)(a)1. 1. The isolation nursery shall be within the general nursery area and may not open directly to another nursery; and
DHS 124.35(6)(a)2. 2. Access to the isolation nursery shall be through an anteroom which shall have at least a sink equipped for handwashing, gowning facilities, an enclosed storage space for clean linen and equipment, a charting area, a closed hamper for disposal of refuse and a work counter.
DHS 124.35(6)(b) (b) A private patient room with handwashing facilities may be used as an isolation nursery.
DHS 124.35(7) (7)Postpartum lounge area. The lounge and dining room when provided for maternity patients shall be separate from other areas.
DHS 124.35 History History: Emerg. renum. from DHS 124.27 (9), eff. 7-1-96; renum. from DHS 124.27 (9), Register, December, 1996, No. 492, eff. 1-1-97.
DHS 124.36 DHS 124.36Other physical environment.
DHS 124.36(1)(1)Raised thresholds. Raised thresholds shall be easily crossed by equipment on wheels.
DHS 124.36(2) (2)Emergency fuel and water. The hospital shall make provision for obtaining emergency fuel and water supplies.
DHS 124.36(3) (3)Emergency lighting system. The emergency lighting system and equipment shall be tested at least monthly.
DHS 124.36(4) (4)Diagnostic and therapeutic facilities, supplies and equipment. Diagnostic and therapeutic facilities, supplies and equipment shall be sufficient to permit medical and nursing staffs to provide an acceptable level of patient care.
DHS 124.36(5) (5)Walls and ceilings. Patient rooms and patient care areas shall have walls and ceilings with smooth, washable surfaces. The walls and ceilings shall be kept in good repair. Loose, cracked or peeling wallpaper and paint on walls and ceilings shall be replaced or repaired. Washable ceilings shall be provided in surgery rooms, delivery rooms, the nursery, intensive care units, recovery rooms, kitchens, dishwashing rooms, janitor closets and utility rooms.
DHS 124.36(6) (6)Floors. All floor materials shall be easy to clean and have wear and moisture resistance appropriate for the location. Floors in areas used for food preparation or food assembly shall be water-resistant and grease-proof and shall be kept clean and in good repair.
DHS 124.36(7) (7)Cords. Electrical cords shall be maintained in good repair.
DHS 124.36(8) (8)Carpeting.
DHS 124.36(8)(a) (a) Carpeting may not be installed in rooms used primarily for food preparation and storage, dish and utensil washing, cleaning of linen and utensils, storage of janitor supplies, laundry processing, hydrotherapy, toileting and bathing, resident isolation or patient examination.
DHS 124.36(8)(b) (b) Carpeting, including the underlying padding, if any, shall have a flamespread rating of 75 or less when tested in accordance with standard 255 of the National Fire Protection Association's National Fire Codes, 1981 edition, or a critical radiant flux of more than 0.45 watts per square centimeter when tested in accordance with standard 253 of the National Fire Protection Association's National Fire Codes, 1978 edition. Certified proof by the manufacturer of this test for the specific product shall be available in the facility. Certification by the installer that the material installed is the product referred to in the test shall be obtained by the facility. Carpeting may not in any case be applied to walls except where the flamespread rating can be shown to be 25 or less.
DHS 124.36(9) (9)Acoustical tile. Acoustical tile shall be noncombustible.
DHS 124.36(10) (10)Wastebaskets. Wastebaskets shall be made of noncombustible materials.
DHS 124.36(11) (11)Fire report. All incidents of fire in a hospital shall be reported to the department within 72 hours.
DHS 124.36 History History: Emerg. renum. from DHS 124.27 (10), eff. 7-1-96; renum. from DHS 124.27 (10), Register, December, 1996, No. 492, eff. 1-1-97.
subch. VI of ch. DHS 124 Subchapter VI — Critical Access Hospitals
DHS 124.37 DHS 124.37Applicability. This subchapter applies to the department and to all hospitals designated by the department as critical access hospitals.
DHS 124.37 History History: Emerg. cr., eff. 9-12-98; cr. Register, January, 1999, No. 517, eff. 2-1-99.
DHS 124.38 DHS 124.38Definitions. In this subchapter:
DHS 124.38(1) (1)“Clinical nurse specialist" means a registered nurse who is currently certified as a clinical nurse specialist by a national certifying body that is recognized by the state board of nursing.
DHS 124.38(2) (2)“Network hospital" means a full-time, general hospital that has an agreement with a critical access hospital to provide ongoing acute care services and other services for patients transferred or referred from the critical access hospital.
DHS 124.38(3) (3)“Nurse practitioner" means a registered nurse who is currently certified as a nurse practitioner by a national certifying body that is recognized by the state board of nursing.
DHS 124.38(4) (4)“Rural health plan" means a plan approved by the federal centers for medicare and medicaid services that describes how the department will implement and administer parts of the federal medicare rural hospital flexibility program — critical access hospitals — under 42 USC 1395i-4.
DHS 124.38(5) (5)“Rural hospital" means a hospital that was initially approved as a hospital prior to January 1, 2003 and is located in a county that has at least a portion of a rural census tract of a Metropolitan Statistical Area (MSA) as determined under the most recent version of the Goldsmith Modification as provided in 42 CFR 412.103(a)(1).
DHS 124.38 Note Note: The most recent version of the Goldsmith Modification as determined by the Office of Rural Health Policy (ORHP) of the Health Resources and Services Administration is available via the ORHP website at http://www.raconline.org/topics/what-is-rural/faqs/#goldsmith or from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, 5600 Fishers Lane, Room 9A-55, Rockville, MD 20857. 42 CFR 412.103 of the federal regulations addresses hospitals located in urban areas that want to apply for reclassification as rural hospitals.
DHS 124.38 History History: Emerg. cr. eff. 9-12-98; cr. Register, January, 1999, No. 517, eff. 2-1-99; emerg. cr. (5), eff. 3-21-03; CR 03-042: am. (4), cr. (5) Register September 2003 No. 573, eff. 10-1-03.
DHS 124.39 DHS 124.39Designation as a critical access hospital.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.