TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER c: LONG-TERM CARE FACILITIES
PART 390 MEDICALLY COMPLEX FOR THE DEVELOPMENTALLY DISABLED FACILITIES CODE
SECTION 390.2660 NURSING UNIT


 

Section 390.2660  Nursing Unit

 

a)         The number of resident beds, cribs or  bassinets in a nursing unit shall not exceed 75.

 

b)         General Requirements for Bedrooms

 

1)         Resident bedrooms shall have an entrance  directly off a corridor with an entrance  door which swings into the room.

 

2)         The facility shall provide a closet or wardrobe of at least  four square feet for each resident.

 

3)         Resident bedroom floors shall be at or above  grade level.

 

4)         Each room used as a resident bedroom shall  have at least one outside window, with a  total window area equal to one-tenth the floor area of the room.

 

5)         There shall be separate bedrooms for males  and females over six years of age unless  the interdisciplinary team determines that separation is not necessary due to the  functional level of individual residents.

 

6)         A handwashing lavatory shall be provided in  each bedroom.

 

7)         Resident bedrooms shall have adequate and  satisfactory artificial light and be  equipped in accordance with Section 390.2740(d)(2).

 

8)         Receptacles shall be provided in accordance with Section 390.2740(e).

 

9)         Nurses' call system shall be provided in  accordance with Section 390.2740(g).

 

10)       Visual privacy shall be provided for each  resident in multibed rooms in accordance with Section 390.2220(a)(4).  Location of screen or curtain shall not restrict resident access  to bathing facilities, toilet or lavatory.

 

11)       Residents shall have access to a  bathing/toilet room without entering the  general corridor area.

 

12)       No resident bedroom shall be located more  than 120 feet from the  nurses' station, clean utility room, and  soiled utility room.

 

13)       Vision panels shall be provided in corridor  walls or room doors of each bedroom.

 

c)         Resident Bedrooms

 

1)         Each single bedroom used for a resident  shall have at least 100 square  feet of usable net floor area, not including any space taken up for closets, wardrobes,  bathrooms, and clearly definable entryway areas.

 

2)         Each multiple bedroom for residents shall  have the following floor areas, exclusive of  closets, wardrobes, bathrooms, and clearly  defined entryways:

 

A)        Not less than 80 square feet per bed. Size:  38"-40" x 75"- 84".  No more than 4 beds per room.

 

B)        Not less than 70 square feet per small bed.  Size:  37" to less than 38" x 61" to less than 75".  No more than 4 beds per room.

 

C)        Not less than 65 square feet per large crib.  Size:  30" to less than 37" x 56" to less than 61".

 

D)        Not less than 55 square feet per medium crib.  Size:  27" to less than 30" x 43" to less than 56".

 

E)        Not less than 50 square feet per small crib. Size:  19" to less than 27 x 35" to less than 43".

 

F)         Not less than 30 square feet per bassinet. Size:  Smaller than 19" x 35". All sleeping accommodations shall be adequate in size to allow for the resident's comfort.

 

3)         Multiple resident bedrooms shall not have  more than four beds of any size located not more than three deep  from the outside wall.

 

4)         Any combination of beds, cribs and bassinets (of any size) may be placed in the same bedroom when appropriate to the functional levels of the residents.  However, no bedroom shall contain more beds, cribs, and bassinets (of any size) than can be contained in 390 square feet of floorspace, except that no more than four beds of any size can be contained in one room and such rooms shall not contain any cribs or bassinets of any size.  In addition, the number of residents in a bedroom shall not exceed eight.

 

5)         The facility shall provide a minimum clearance of three feet at the foot and side of all sleeping accommodations.  Clearance is not required when accommodation is not occupied, however, an exit path must always be maintained in accordance with the requirements of the National Fire Protection Association's Standard No. 101:  Life Safety Code.

 

6)         The minimum dimension of bedrooms shall be  ten feet between walls or a wall and  any built-in furniture or storage space.

 

d)         Special Care Room

 

1)         The facility shall provide one special care room for each nursing unit, complying with bedroom  requirements in subsections (b) and (c) of this Section.

 

2)         The facility shall provide one workroom with observation windows adjacent to special care room.  Space within this room or in separate rooms  shall be designed to include all or part of  the following functions:

 

A)        Hygenic care including bathing, complying with this Section.

 

B)        Separated soiled area with hampers for soiled linen, diapers and disposables. This area shall be provided with a double compartment sink with integral drainboard and clinical rim flush sink.

 

C)        Separated clean area with storage cabinets, work counter, refrigerator, formula storage-dispensing and clean linen storage.

 

D)        Gowning for staff.

 

3)         When more than one resident is housed in  this room, it may only be used to isolate  residents with the same communicable disease.

 

4)         This room shall be located to allow direct  appropriate visual supervision from the  nurses' station.

 

5)         This room may be included in the authorized  maximum bed capacity for the facility.

 

6)         It is permissible for the room to be  occupied by residents not in need of special  care, provided the resident is clearly  informed and understands that he or she will be  immediately transferred out of the room any  time of day or night, whenever the room is  needed to care for a resident requiring  special care.

 

e)         Nurses' Station  (B)

 

1)         The facility shall provide a minimum of one nursing station  for each nursing unit.  The station shall  have direct access to a corridor, shall be  located near the area it will serve, and  shall be designed to provide visual control  of the area.  It shall be separated  satisfactorily from the nurses' utility  rooms.

 

2)         One or more nursing units may be combined  with a central nursing station if sufficient  space is provided for all nursing  functions.

 

3)         A toilet room shall be provided near each  station for nursing staff.  A lounge with  lockers for safekeeping of coats and  personal effects shall be provided either  within this space or in a convenient central location.

 

f)         Bathing and Toilet Rooms

 

1)         The bathing/toilet room adjacent to resident  room shall serve no more than two resident rooms nor more than 16 beds, cribs or bassinets.

 

2)         Fixtures shall be provided as follows:

 

A)        Lavatories:  One per eight.

 

B)        Clinical rim flush sink and water closet for residents capable of using them:  One per eight.

 

C)        Bathing or shower fixtures:  One per ten.

 

3)         The lavatory may be omitted from the  bathing/toilet room when installed in the  resident room.

 

4)         The facility shall provide a minimum of one bathtub for  assisted bathing per nursing unit.  There shall be a clear area at least three feet wide on one long side.

 

5)         The facility shall provide a minimum of one shower stall  for assisted showering per nursing unit.  The shower stall shall be at least four feet square with no curb.

 

6)         Other acceptable fixtures for bathing the  residents may be provided with Department approval.

 

7)         All plumbing fixtures shall be designed and  installed to satisfactorily serve the residents using them.

 

8)         There shall be separate toilet and bathing  areas on each floor for males and females over six years of age unless the interdisciplinary team determines that  separation is not necessary due to the functional level of individual residents.

 

9)         The facility shall provide one wheelchair toilet room for residents residing in the nursing unit.  This room shall be accessible from the corridor and shall contain a water closet and  lavatory.

 

10)       Wheelchair resident toilet rooms are not  required when all resident toilet rooms can  accommodate wheelchair residents.

 

11)       Grouped bathing and toilet facilities shall  be partitioned or curtained for privacy.

 

g)         Utility Rooms

 

1)         The clean utility room shall have direct access  to a corridor or access may be through the  nurses' station entrance.  This room shall contain work counters, single or double  compartment sink with integral drainboard,  storage cabinets, and an autoclave.  (Autoclave may be waived in lieu of other  methods if sterilization is approved by  Department.)

 

2)         A clean linen storage room or closet within  the clean utility room shall be provided.  If a closed cart system is used, storage may  be in an alcove.

 

3)         The soiled utility room shall have direct access  to a corridor. This room shall contain work  counters, double compartment sink with integral drainboard, storage cabinets with  shelves, a clinical rim flush sink, and sanitizer (See Section 390.2230).

 

4)         The charging room for a linen chute shall be  large enough to unload the collecting cart  with the corridor door closed.

 

h)         A medicine station shall be provided for  convenient and prompt 24 hour distribution of medicine to residents.

 

1)         The medicine preparation room shall be under the  nursing staff's visual control and contain a  work counter, refrigerator, and locked  storage for biologicals and drugs.  A sink for handwashing and preparation of medication shall be provided in the medication preparation room.

 

2)         If medicine dispensing carts are used, a  specific space shall be provided which may  be located in the nurses' station or in an alcove or other space under the direct  control of the nursing staff.  A sink for handwashing and preparation of medication shall be  provided in the nurses' station.

 

i)          A nourishment station shall be provided with a handwashing sink and equipment including  refrigerator, and storage cabinets for  serving nourishment between scheduled  meals.

 

1)         Commercially prepared formulas can be stored  and dispensed from this room or from the  special care workroom.

 

2)         Ice for residents' use shall be provided  only by icemaker dispenser unit.

 

3)         There shall be a separate room or area for  bottle and nipple washing and cleaning,  equipped as necessary to carry out proper technique.

 

j)          A room for examination and treatment of  residents shall be provided and shall have a  minimum floor area of 100 square feet, excluding space for vestibule,  closets and work counters (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; storage  facilities; and as desk, counter, or shelf  space for writing.  When this room is not  being used for examination or treatment, it  may be used for other functions (such as an office).

 

k)         Equipment storage rooms shall be provided  for storage of equipment such as I.V.  stands, inhalators, air mattresses, walkers, and wheelchairs.

 

l)          Parking space for wheelchairs shall be  provided and located out of path of normal traffic.

 

(Source:  Amended at 18 Ill. Reg. 1453, effective January 14, 1994)