DHS 124.35 Additional requirements for particular patient care areas. 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.
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.
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.
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.
In new construction the dimensions and clearances in special care unit patient rooms shall be as follows:
Single bed rooms shall have minimum dimensions of 10 feet by 12 feet;
Multi-bed rooms shall have a minimum side clearance between beds of at least 7 feet; and
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.
(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:
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.
Doors to patient rooms and patient toilet room doors may not be lockable from the inside.
Patients' clothing and personal items may be stored in a separate designated area which is locked.
Moveable hospital beds are not required for ambulatory patients.
At least one room equipped for surgery and used exclusively for that purpose.
In each operating room, means for calling for assistance in an emergency.
Housekeeping facilities adequate to maintain the operating room or rooms.
A flash sterilizer, unless sterilization facilities are accessible from the surgery area.
The surgical suite and necessary facilities shall be located and arranged to discourage unrelated traffic through the suite.
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.
Oxygen and suctioning equipment shall be available in the surgical suite and recovery rooms.
The labor and delivery unit shall be located and arranged to discourage unrelated traffic through the unit.
Facilities within the labor and delivery unit shall include:
At least one room equipped as a delivery room and used exclusively for obstetrical procedures;
A separate janitor's closet with room for housekeeping supplies for the unit.
A means of calling for assistance in an emergency shall be located in the labor and delivery unit.
Oxygen and suctioning equipment shall be available in the labor and delivery unit.
In new construction, in addition to lighting for general room illumination, adjustable examination and treatment lights shall be provided for each labor bed.
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.
(5) Nursery units.
If the hospital has a maternity service, a separate nursery or nurseries for newborn infants shall be provided which shall have:
In new construction, a connecting workroom with a work counter, refrigerator, sink equipped for handwashing and storage area;
In new construction, a nursing station or administrative center located within or adjacent to the nursery;
For all nurseries, a minimum of 2 feet between bassinets, except that in new construction the minimum distance between bassinets shall be 3 feet;
Space for necessary housekeeping equipment in or near the nursery; and
The isolation nursery shall be within the general nursery area and may not open directly to another nursery; and
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.
A private patient room with handwashing facilities may be used as an isolation nursery.
(7) Postpartum lounge area.
The lounge and dining room when provided for maternity patients shall be separate from other areas.
DHS 124.35 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.
Raised thresholds shall be easily crossed by equipment on wheels.
(2) Emergency fuel and water.
The hospital shall make provision for obtaining emergency fuel and water supplies.
(3) Emergency lighting system.
The emergency lighting system and equipment shall be tested at least monthly.
(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.
(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.
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.
Electrical cords shall be maintained in good repair.
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.
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.
(9) Acoustical tile.
Acoustical tile shall be noncombustible.
Wastebaskets shall be made of noncombustible materials.
(11) Fire report.
All incidents of fire in a hospital shall be reported to the department within 72 hours.
DHS 124.36 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.
DHS 124.37 Applicability.
This subchapter applies to the department and to all hospitals designated by the department as critical access hospitals.
DHS 124.37 History
Emerg. cr., eff. 9-12-98; cr. Register, January, 1999, No. 517
, eff. 2-1-99.
DHS 124.38 Definitions.
In this subchapter:
“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.
“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.
“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.
“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
“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
DHS 124.38 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
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 Designation as a critical access hospital. DHS 124.39(1)(1)
Except as provided under sub. (2) (a)
, to be eligible for designation as a critical access hospital, a hospital shall be all of the following: