216 R.I. Code R. 216-RICR-40-10-4.8 - Physical Plant

4.8.1 New Construction, Addition or Modification

A. All new construction, alterations, extensions or modifications of an existing facility shall be subject to the laws, rules, regulations and codes:

1. Guidelines for Design and Construction of Hospital and Health Care Facilities, incorporated above at § 4.2(A)(10) of this Part.

2. Rhode Island State Fire Safety Code, R.I. Gen. Laws Chapter 23-28.1.

3. Rhode Island State Building Code, R.I. Gen. Laws Chapter 23-27.3.

4. Department of Environmental Management's Air Pollution Control Regulation No. 12: Incinerators (250-RICR- 120-05-12).

5. NFPA 1: Fire Code, incorporated above at § 4.2(A)(13) of this Part.

6. Lighting for Hospitals and Healthcare Facilities, incorporated above at § 4.2(A)(11) of this Part.

7. "Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities," incorporated above at § 4.2(A)(7) of this Part.

8. All other appropriate state and local laws, codes, regulations, and ordinances.

B. Where there is a difference between codes, the code having the more stringent standard shall apply.

C. All plans for new construction or the renovation, alteration, extension, modification or conversion of an existing facility that may affect compliance with Guidelines for Design and Construction of Hospital and Health Care Facilities, incorporated above at § 4.2(A)(10) of this Part, shall be reviewed by a licensed architect, acceptable to the Director. Said architect shall certify that the plans conform to the construction requirements of Guidelines for Design and Construction of Hospital and Health Care Facilities, incorporated above at § 4.2(A)(10) of this Part, prior to construction. The facility shall maintain a copy of the plans reviewed and the architect's signed certification, for review by the Department of Health upon request.

1. In the event of non-conformance for which the facility seeks a variance, the general procedures outlined in §4.9.2 shall be followed. Variance requests shall include a written description of the entire project, details of the non-conformance for which the variance is sought and alternate provisions made, as well as detailing the basis upon which the request is made. The Department may request additional information while evaluating variance requests.

2. If variances are granted, a licensed architect shall certify that the plans conform to all construction requirements of Guidelines for Design and Construction of Hospital and Health Care Facilities, incorporated above at § 4.2(A)(10) of this Part, except those for which variances were granted, prior to construction. The facility shall maintain a copy of the plans reviewed, the variance(s) granted and the architect's signed certification, for review by the Department upon request.

D. Upon completion of construction, the facility shall provide written notification to the Department, describing the project, and a copy of the architect's certification. The facility shall obtain authorization from the Department prior to occupying/re-occupying the area. At the discretion of the Department, an on-site visit may be required.

E. In addition to the above requirements, the following requirements of §§4.8.2 through 4.8.6 of this Part shall apply.

4.8.2 Fire Safety

Each hospital shall establish a monitoring program for the internal enforcement of all applicable fire and safety laws and regulations and such a program shall include written procedures for the implementation of said rules and regulations, and logs shall be maintained.

4.8.3 Incinerators

A. Incinerators within hospitals shall be segregated from other parts of the building by non-combustible construction, with walls, floors and ceilings having a fire resistance rating of not less than two hours. Openings to such rooms shall be protected by Class B fire doors, and equipped with positive self-closing devices in accordance with R.I. Gen. Laws Chapter 23-28.1.

B. Incinerators shall be gas, electric, or oil fired and capable of destroying pathological and other types of waste.

1. An incinerator installed to handle pathological waste materials shall have the capability of completely burning the waste material and shall meet the air emission requirements of the Department of Environmental Management's Air Pollution Control Regulation No. 12: Incinerators (250-RICR- 120-05-12 ).

2. Refuse incinerators shall be capable of burning rubbish containing 50 percent wet materials, and shall meet the air emission requirements of the Department of Environmental Management's Air Pollution Control Regulation No. 12: Incinerators (250-RICR- 120-05-12 ).

3. A multi-purpose incinerator shall meet the requirements of both §§4.8.3(B)(1) and (2) of this Part above.

C. Hospital incinerators shall be designed and installed in accordance with the air emission requirements of the Department of Environmental Management's Air Pollution Control Regulation No. 12: Incinerators (250-RICR- 120-05-12).

4.8.4 Lighting && Electrical Services

A. Policies and procedures shall be established to govern the use and operation of all electrical equipment.

B. The standards of Lighting for Hospitals and Healthcare Facilities, incorporated above at § 4.2(A)(11) of this Part, shall serve as a guide to determine the lighting levels within each area of the hospital.

C. All electrical appliances used by hospitals shall be listed or labeled by an approved testing agency or be approved by local electrical inspection authorities.

D. Each hospital shall continuously evaluate (i.e., not less than every two (2) years) the essential electrical system's demand and compare that to the capacity of their emergency generation system. This evaluation shall be conducted by a qualified electrical consultant acceptable to the Director. A report on the results of the evaluation(s) shall be provided to the Director upon request.

E. Each hospital shall have a plan for responding to electrical system problems and failures in a timely manner. The plan shall include procedures for diagnosing and alleviating electrical problems or failures that may develop. Emergency generators and automatic transfer switches shall be tested in accordance with the most current applicable NFPA code. In addition to its own internal resources, each hospital shall also have agreements with contracted service providers for emergency services.

4.8.5 Plumbing

A. All plumbing material and plumbing systems or parts thereof installed shall meet the minimum requirements of State Building Code regulations "RISBC- 3 R hode IslandPlumbing Code."

B. All plumbing shall be installed in such a manner as to prevent back siphonage or cross connections between potable and non-potable water supplies.

C. Fixtures from which grease is discharged shall be served by a line in which a grease trap is installed. The grease trap shall be cleaned sufficiently often to sustain efficient operation.

4.8.6 Waste Water Disposal

Any new facility shall be connected to a public sanitary sewer.

4.8.7 Waste Disposal

A. Medical Waste

Medical waste as defined in the Department of Environmental Management's Medical Waste Regulations (250-RICR- 140-15-1) shall be managed in accordance with the provisions of the aforementioned regulations.

B. Other Waste

Wastes which are not classified as medical waste, hazardous wastes or which are not otherwise regulated by law or rule may be disposed in dumpsters or load packers provided the following precautions are maintained:

1. Dumpsters shall be tightly covered, leak proof, inaccessible to rodents and animals, and placed on concrete slabs preferably graded to a drain. Water supply shall be available within easy accessibility for washing down of the area. In addition, the pick-up schedule shall be maintained with more frequent pick-ups when required. The dumping site of waste materials must be in sanitary landfills approved by the Department of Environmental Management.

2. Load packers must conform to the same restrictions required for dumpsters and, in addition, load packers shall be:

a. high enough off the ground to facilitate the cleaning of the underneath areas of the stationary equipment; and

b. the loading section shall be constructed and maintained to prevent rubbish from blowing from said area site.

4.8.8 Water Supply

A. Water shall be obtained from a community water system as defined in "Rules and Regulations Pertaining to Public Drinking Water."

B. The water shall be distributed to conveniently located taps and fixtures throughout the buildings and shall be adequate in volume and pressure for all hospital purposes, including firefighting.

4.8.9 Existing Structures

In all instances, where exceptions are not granted by the licensing agency, the same standards as specified for new construction shall apply.

Notes

216 R.I. Code R. 216-RICR-40-10-4.8