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007.05.10-76. Physical Facilities, Rehabilitation Facilities.

AR ADC 007.05.10-76Arkansas 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 007.05.10-76
007.05.10-76. Physical Facilities, Rehabilitation Facilities.
Currentness
A. General Considerations. Rehabilitation facilities may be organized under hospitals (organized departments of rehabilitation), outpatient clinics, rehabilitation centers, and other facilities designed to serve either single- or multiple-disability categories including but not limited to: cerebrovascular, head trauma, spinal cord injury, amputees, complicated fractures, arthritis, neurological degeneration, genetic, and cardiac. In general, rehabilitation hospitals shall have larger space requirements than general hospitals, have longer lengths of stay and have less institutional and more residential environments.
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. See Section 43.A and O, Physical Facilities.
F. Functional Units and Service Areas.
1. Required units. Each rehabilitation facility shall contain a medical evaluation unit and shall provide the following service areas, if the services are not otherwise conveniently accessible to the facility and appropriate to program functions:
a. Psychological services;
b. Social services;
c. Vocational services;
d. Patient dining, recreation and day spaces;
e. Dietary;
f. Personal care facilities;
g. Space for teaching activities of daily living;
h. Administration Department;
i. Medical Records;
j. Engineering service and equipment areas;
k. Laundry Services;
l. Housekeeping Rooms;
m. Employees' facilities;
n. Nursing unit; 76-2
o. Physical therapy;
p. Occupational therapy; and
q. Speech and hearing.
2. Optional Units. The following special services areas, if required by the functional program, shall be provided as outlined in these sections. The sizes of the various departments will depend upon the services to be provided:
a. Sterilizing facilities;
b. Prosthetics and orthotics;
c. Dental;
d. Radiology;
e. Pharmacy;
f. Laboratory;
g. Home health;
h. Outpatient services; and
i. Therapeutic pool.
G. Evaluation Unit.
1. Office(s) for Personnel.
2. Examination Rooms. The rooms shall have a minimum floor area of 140 square feet excluding such spaces as the vestibule, toilet, closet, and work counter (whether fixed or movable). The minimum room dimension shall be ten feet. The room shall contain a lavatory or sink equipped for handwashing, a work counter and storage facilities, and a desk, counter, or shelf space for writing.
3. Evaluation Rooms. The room areas shall be arranged to permit appropriate evaluation of patient needs and progress and to determine specific programs of rehabilitation. Rooms shall include a desk and work area for the evaluators, writing and work space for patients, and storage for supplies. Where the facility is small and workload light, evaluation may be done in the examination room.
4. Laboratory Facilities. Facilities shall be provided within the rehabilitation department or through contract arrangement with a nearby hospital or laboratory service for hematology, clinical chemistry, urinalysis, cytology, pathology, and bacteriology. If these facilities are provided through contract, the following minimum laboratory services shall be provided in the rehabilitation facility:
a. Laboratory work counter(s) with a sink, and gas and electric service;
b. Handwashing stations;
c. Storage cabinet(s) or closet(s); and
d. Specimen collection facilities. Urine collection rooms shall be equipped with a water closet and lavatory. Blood collection facilities shall have space for a chair and work counter.
5. Imaging Facilities. Imaging facilities, if required by the functional program, shall be in accordance with Section 52, Physical Facilities, Imaging Suite.
H. Psychological Service. Office(s) and work space for testing, evaluation, and counseling shall be provided.
I. Social Service. Office space(s) for private interviewing and counseling shall be provided.
J. Vocational Services. Office(s) and work space for vocational training, counseling, and placement shall be provided.
K. Dining, Recreation, and Day Spaces.
The following standards shall be met for patient dining, recreation, and day spaces (areas may be in separate or adjoining spaces):
1. Inpatient and residents shall have a total of 55 square feet per bed.
2. Outpatients, if dining is part of the day care program, a total of 55 square feet per person shall be provided. If dining is not part of the program, at least 35 square feet per person shall be provided for recreation and day spaces.
3. Storage spaces shall be provided for recreation equipment and supplies.
L. Dietary Department. See Section 59, Physical Facilities, Dietary Facilities.
M. Personal Care Unit for Inpatients. A separate room with appropriate fixtures and utilities shall be provided for patient grooming. The activities for daily living unit may serve this purpose.
N. Activities for Daily Living Unit. An area for teaching daily living activities shall be provided. It shall include a bedroom, bath, kitchen, and space for training stairs. Equipment shall be functional. The bathroom shall be in addition to other toilet and bathing requirements. The daily living area shall be similar to a residential environment for the purpose of facilitating the patient's skill for daily living.
O. Administration Department and Medical Records. See Sections 60, Physical Facilities, Administration and Public Areas.
P. Engineering Service and Equipment Areas. See Section 66, Physical Facilities, Engineering Service and Equipment Areas.
Q. Laundry Services. See Section 64, Physical Facilities, Linen Service.
R. Housekeeping Rooms. See Section 65, Physical Facilities, Cleaning and Sanitizing Carts and Environmental Services.
S. Employee Facilities. See Section 66, Physical Facilities, Engineering Service and Equipment Areas.
T. Nursing.
1. The nursing units for rehabilitation facilities shall follow the standards as described in Section 44, Physical Facilities, Patient Accommodations (Adult Medical, Surgical, Communicable or Pulmonary Disease), with the following exceptions:
a. Patient Rooms. Minimum areas exclusive of toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules shall be 140 square feet in single-bed rooms and 125 square feet per bed in semi-private rooms.
b. Each patient shall have access to a toilet room without having to enter the general corridor area. One toilet room shall serve no more than four beds and no more than two patient rooms. The toilet room shall contain a water closet, a handwashing fixture and a tub and/or shower. The handwashing fixture may be omitted from a toilet room that serves single-bed and two bed rooms if each such patient's room contains a handwashing fixture. Each toilet room shall be of sufficient size to ensure that wheelchair users and staff shall have access.
c. Each patient shall have access to a wardrobe, closet, or locker with minimum clearance of one foot ten inches by one foot eight inches. A clothes rod and adjustable shelf shall be provided.
2. Nursing Unit Service Areas shall follow the standards described in Section 44, Physical Facilities, Patient Accommodations (Adult Medical, Surgical, Communicable or Pulmonary Disease), with the following exceptions:
a. Patient Bathing Facilities. At least one island-type bathtub and/or gurney shower shall be provided in each nursing unit. Each tub and/or shower shall be in an individual room or privacy enclosure that provides space for the private use of bathing fixtures, for drying and dressing, and for a wheelchair and an assistant. Showers in central bathing facilities shall be at least four feet square, curb-free and designed for use by a wheelchair patient;
b. At least one room on each floor containing a nursing unit shall be provided for toilet training. It shall be accessible from the nursing corridor. A minimum clearance of three feet shall be provided at the front and at each side of the water closet. The room shall also contain a lavatory; and
c. Handrails shall be provided on both sides of corridors used by patients. A clear distance of one and one-half inches shall be provided between the handrail and the wall, and the top of the rail shall be 34 inches minimum and 36 inches maximum above the floor. Exceptions for height shall be for special care areas such as those serving children.
U. Sterilizing Facilities. See Section 65, Physical Facilities, Cleaning and Sanitizing Carts and Environmental Services.
V. Rehabilitation Therapy. See Section 56, Physical Facilities, Rehabilitation Therapy Department.
W. Pharmacy Unit. See Section 58, Physical Facilities, Pharmacy.
X. Details and Finishes. See Section 68, Physical Facilities, Details and Finishes.
Y. Design and Construction, Including Fire-Resistant Standards. See Section 69, Physical Facilities, Construction, Including Fire Resistive Requirements.
Z. Waste Processing Services. See Section 67, Physical Facilities, Waste Processing Services.
AA. Elevators. See Section 72, Physical Facilities, Electrical Standards.
BB. Mechanical, Plumbing and Electrical Standards. See Sections 71, 72 and 75.F.22.

Credits

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 February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.10-76, AR ADC 007.05.10-76
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