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007.05.10-75. Physical Facilities, Outpatient Care Facilities.

AR ADC 007.05.10-75Arkansas Administrative CodeEffective: February 5, 2021

West's Arkansas Administrative Code
Title 007. Department of Health
Division 05. Health Facility Services
Rule 10. Rules for Critical Access Hospitals in Arkansas (Refs & Annos)
Effective: February 5, 2021
Ark. Admin. Code 007.05.10-75
007.05.10-75. Physical Facilities, Outpatient Care Facilities.
A. General Considerations. See Section 43.A, Physical Facilities.
1. This section applies to the outpatient care unit licensed under the facility as a department and under the rule of the Governing Body. An outpatient care unit can be a part of the facility or a separate freestanding facility. An outpatient unit within the main facility building shall be located so outpatients do not traverse inpatient areas.
2. The general standards set forth in the following sections shall apply to each of the items below:
a. Outpatient psychiatric centers;
b. Primary care outpatient centers; and
c. Diagnosis and/or treatment centers.
3. Each element provided in the outpatient care facility shall be described in the written functional program and meet the requirements outlined herein as a minimum.
B. General Construction Considerations. See Section 43.A, Physical Facilities.
C. Site Location, Inspection, Approval and Subsoil Investigation. See Section 43.D-M, Physical Facilities.
D. Construction Documents. See Section 43.K, Physical Facilities.
E. Codes and Standards. New/existing Outpatient Care Facilities which do not meet the criteria of the NFPA, Life Safety Code Volume 101 for healthcare and/or ambulatory healthcare occupancies may be classified as a Business Occupancy as defined in LSC 101, Chapter 26 (new)/27 (existing) with exceptions noted within these regulations.
F. General Requirements for Outpatient Care Facilities. As needed the following elements shall be provided to satisfy the functional program.
1. Functional Program. See Section 43, Physical Facilities.
2. Parking. Each facility should provide adequate parking for staff and patients.
3. Patient Privacy. Each facility design shall ensure patient audible and visual privacy and dignity during interview, examination, treatment and recovery.
4. Administration and Public Areas. The following shall apply to each outpatient care facility described herein with additions and/or modification as noted for each specific type.
a. Entrance. Located at grade level and able to accommodate wheelchairs.
b. Public services shall include:
1) Conveniently accessible wheelchair storage;
2) A reception and information counter or desk;
3) Waiting space(s). Where an organized pediatric service is part of the outpatient care facility, provisions shall be made for separating pediatric and adult patients;
4) Public toilets;
5) Drinking fountain; and
6) Public telephones.
c. Interview space(s). Private interviews related to social services, credit, etc. shall be provided.
d. General or individual offices for business transactions, records, administrative and professional staffs shall be provided.
e. Clerical space or rooms for typing, clerical work, and filing, separated from public areas for confidentiality, shall be provided.
f. Multipurpose room(s) equipped for visual aids shall be provided for conferences, meetings and health education purposes.
g. Special storage for staff personal effects with locking drawers or cabinets (may be individual desks or cabinets) shall be provided. Such storage shall be near individual work stations and staff controlled.
h. General storage facilities for supplies and equipment shall be provided as needed for continuing operation.
i. In new construction and renovation where hemodialysis or hemoperfusion are routinely performed, there shall be a separate water supply and a drainage facility that do not interfere with handwashing.
5. General purpose examination rooms. For medical, and similar examinations, rooms shall have a minimum floor area of 80 square feet, excluding vestibules, toilets, and closets. Room arrangement shall permit at least two feet eight inches clearance at each side and at the foot of the examination table. A handwashing fixture and a counter or shelf space for writing shall be provided.
6. Special- purpose examination rooms. Rooms for special clinics such as eye, ear, nose, and throat examinations, if provided, shall be designed and outfitted to accommodate procedures and equipment used. A handwashing stations and a counter or shelf space for writing shall be provided.
7. Treatment Room(s). Rooms for diagnosis and/or treatment if provided, shall have a minimum floor area of 120 square feet, excluding vestibule, toilet, and closets. The minimum room dimension shall be 10 feet. A handwashing fixture and counter or shelf for writing shall be provided.
8. Observation room(s). Observation rooms for the isolation of suspect or disturbed patients shall have a minimum floor area of 80 square feet and shall be convenient to a nurse or control station. This is to permit close observation of patients and to minimize possibilities of patients' hiding, escape, injury, or suicide. An examination room may be modified to accommodate this function. A toilet room with lavatory should be immediately accessible.
9. Control Station. A work counter, communication system, space for supplies, and provisions for charting shall be provided.
10. Medication Distribution Station. This may be a part of the control station and shall include a work counter, sink, refrigerator, and locked storage for biologicals and medications.
11. Clean Holding. A separate room or closet for storing clean and sterile supplies shall be provided. This storage shall be in addition to that of cabinets and shelves.
12. Soiled Holding. Provisions shall be made for separate collection, storage, and disposal of soiled materials.
13. Sterilizing Facilities. A system for sterilizing equipment and supplies shall be provided, if required by the narrative program.
14. Wheelchair Storage Space. Such storage shall be out of the direct line of traffic.
15. The need for and number of required airborne infection isolation rooms shall be determined by an infection control risk assessment. When required, the airborne infection isolation room(s) shall comply with the general requirements of Section 44.C.
16. Imaging Suite. See Section 52, Physical Facilities, Imaging Suite.
17. Laboratory. See Section 55, Physical Facilities, Laboratory Services.
18. Rehabilitation Services. See Section 76, Physical Facilities, Rehabilitation Facilities.
19. Environmental Services, Safety Services, Physical Environment. See Section 43, Physical Facilities.
20. Staff Facilities. See Section 66, Physical Facilities, Engineering Service and Equipment Areas
21. Waste Processing Services. See Section 67, Physical Facilities, Waste Processing Services.
22. Social Spaces/Group Therapy. See Rules for Hospitals and Related Institutions in Arkansas, Section, Physical Facilities for Psychiatric Hospitals -- F.3 Service Areas
23. Details shall comply with the following standards:
a. Minimum patient corridor width shall be five feet. Staff only corridors may be 44 inches wide.
b. Each building shall have two exits that are remote from each other. Other details relating to exits and fire safety shall comply with NFPA 101 and the standards outlined herein.
c. Items such as drinking fountains, telephone booths, vending machines, etc., shall not restrict corridor traffic or reduce corridor width below the minimum. Out of traffic storage space for portable equipment shall be provided.
d. The minimum nominal door width for patient use shall be three feet. If the outpatient facility services hospital inpatients, the minimum nominal width of doors to rooms used by hospital inpatients transported in beds shall be three feet eight inches.
e. Doors, sidelights, borrowed lights, and windows glazed to within 18 inches of the floor shall be constructed with safety glass, wired glass, or similar materials. Glazing materials used for shower doors and bath enclosures shall be safety glass or plastic.
f. Threshold and expansion joints covers shall be flush with the floor surface.
g. Handwashing stations shall be located and arranged to permit proper use and operation.
h. Provisions for hand drying shall be included at all handwashing facilities.
i. Radiation protection for X-ray and gamma ray installations shall be in accordance with the rules and regulations of the Arkansas Department of Health.
j. The minimum ceiling height shall be seven feet eight inches.
24. Finishes shall comply with the following:
a. Cubicle curtains and draperies shall be noncombustible or flame-retardant and shall pass both the large- and small-scale tests required by NFPA 701.
b. The flame spread and smoke development ratings of finishes shall comply with NFPA 101, Chapter 38.
c. Floor materials shall be readily cleanable and appropriately wear- resistant. In all areas subject to wet cleaning, floor materials shall not be physically affected by liquid germicidal and cleaning solutions. Floors subject to traffic while wet, including showers and bath areas, shall have a nonslip surface.
d. Wall finishes shall be washable, and in the proximity of plumbing fixtures, shall be smooth and water resistant.
e. Wall bases in areas frequently subject to wet cleaning methods shall be monolithic and coved with the floor, tightly sealed to the wall, and constructed without voids.
f. Floor and wall areas penetrated by pipes, ducts, and conduits shall be tightly sealed to minimize entry of rodents and insects. Joints of structural elements shall be similarly sealed.
25. Provision for Disasters. See Section 42, Physical Environment.
26. Mechanical, Plumbing and Electrical.
a. Small Outpatient Clinics that provide space and equipment serving four or fewer direct patient care workers at one time shall comply with the following minimum requirements:
1) Emergency lighting shall be connected to rechargeable back-up batteries as a means of emergency illumination.
2) A protected premises fire alarm system as defined in Chapter 3, NFPA 72 is required.
b. Large Outpatient Facilities that provide space and equipment for more than four direct patient care workers at one time shall comply with the following minimum requirements:
1) Emergency lighting and power shall be provided in accordance with NFPA 99, NFPA 101, and NFPA 110.
2) Any fire alarm system shall be as required by NFPA 101 and installed per NFPA 72.
3) The installation, testing, and certification of nonflammable medical gas and air systems shall comply with the requirements of NFPA 99.
4) Clinical vacuum system installed shall be in accordance with NFPA 99.
5) All electrical material and equipment shall be installed, tested and certificated in accordance with NFPA 70 and NFPA 99.
6) The mechanical system shall comply with Section 70, Physical Facilities, Mechanical Requirements, with the following exceptions:
a) Redundant space heating and water heating capability are not required, unless required by the written functional program;
b) Ducted return air systems are not required, unless required by the written narrative.
c) Stand-by fuel for space and water heating is not required.
7) A nurses emergency call system shall be provided for all patient use at each patient toilet, bath, sitz bath and shower room. This system shall be accessible to a patient lying on the floor. Inclusion of a pull cord shall satisfy this standard.
8) Fire extinguisher(s) shall be provided and be easily accessible per NFPA requirements.

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Amended Jan. 1, 2016; Feb. 5, 2021.
<Statutory authority: Promulgated under the Authority of Ark. Code Ann. ยง 20-7-123, 20-9-201 et seq.>
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.10-75, AR ADC 007.05.10-75
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