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CODE OF MARYLAND REGULATIONS
TITLE 10. DEPARTMENT OF HEALTH AND MENTAL HYGIENE
SUBTITLE 07. HOSPITALS
CHAPTER 02. COMPREHENSIVE CARE FACILITIES AND EXTENDED CARE FACILITIES
Date:
08/31/2009
Document:
.28 Resident Bedroom and Toilet Facilities.
A. Unless otherwise noted, requirements are applicable to existing facilities as well as new facilities.
B. Bedroom Accommodations. The following requirements shall be met:
(1) Each patient's room shall have direct access to an exit as specified by the Life Safety Code.
(2) A room which opens into the kitchen may not be used as a patient bedroom.
(3) A room may not be used as a patient bedroom which necessitates passing through a kitchen to reach any other area.
(4) Patients may not occupy rooms extending below the ground level.
(5) More than six persons may not occupy a multiple occupancy bedroom.
(6) Care shall be exercised to prevent beds from being located near radiators, registers, or sources of draft.
(7) In new construction, cubicle curtains and tracks shall be provided in multiple occupancy bedrooms between beds to insure privacy of patients when necessary.
Agency Note: In existing facilities, curtains or screens shall be acceptable.
(8) Adequate closet space shall be provided in, or convenient to, each bedroom to allow each patient to keep necessary items of clothing. Where closets are locked, a master key or duplicate key shall be available in the administrator's office. Adequate storage space shall be provided for patients' personal possessions, including the storage of seasonal clothing.
(9) Each facility shall maintain, at all times, the capability to physically isolate any patient who may contract a communicable disease from the remaining patient population. This shall include access to bathing and toilet facilities not used by the rest of the patient population.
(10) All occupants of any bedroom shall be of the same sex, except in the case of a two-bed room occupied only by husband and wife.
C. Floor and Window Space. The following requirements shall be met:
(1) A distance of at least 3 feet shall be maintained between each bed. Each bed is to be placed so that all sides of the bed are at least 18 inches from walls or heating units.
(2) The following allowance of floor space shall be considered a minimum:
(a) Single-bed room--100 square feet.
(b) Multiple-bed rooms--80 square feet (per bed).
Agency Note: Recommended for multi-bed rooms, 100 square feet per bed; single-bed rooms, 125 square feet per bed.
(3) For any bedroom in a new facility, the following floor areas may not be included in the calculation of floor space:
(a) The floor area of toilet rooms and bathing facilities;
(b) The floor area of closets;
(c) The floor area occupied by wardrobes, bureaus, or lockers;
(d) The floor area occupied by, or directly under, any HVAC equipment, including any steam, water, or electrical supply or return lines which may run parallel to the floor, or interrupt the floor surface;
(e) The floor area occupied by any support columns, pipe chases, or other structure, whether free-standing or as an integral part of a wall; and
(f) The floor area described by the arc of any door, excluding closet doors, which opens into the room.
(4) For any bedroom in a new facility, the minimum horizontal dimension is to be 10 feet to facilitate the placement of beds as required in ยง C(1) of this regulation and to maintain a minimum clearance of 3 feet at the foot of the bed.
(5) In existing facilities, the usable floor area for rooms having sloping walls shall be calculated for bed occupancy only for that area having a ceiling height of 8 feet and 50 percent of the area having ceiling height of between 4 feet and 7 feet 6 inches provided that at least 50 percent of the total area has a ceiling height of 8 feet. The minimum horizontal dimension of any room shall be 9 feet.
(6) The window area may not be less than 10 square feet per bed, half of which is able to be opened. A window opening shall be at least 28 inches X 28 inches (to permit entry of firemen, removal of smoke, and emergency evacuation). In case of air-conditioning, the presence of portable air-conditioning units may not block window space. The installation of portable air-conditioning units shall be approved by fire authorities.
D. Furnishings. The following shall be provided;
(1) Each patient shall be provided with his own bed which shall be at least 36 inches wide, be substantially constructed and in good repair. Rollaway type beds, cots or folding beds may not be used.
(2) Each bed shall be provided with satisfactory type springs in good repair, and a clean comfortable mattress, standard in size for the bed.
(3) Each bed shall be provided with a clean, comfortable pillow. Extra pillows shall be available.
(4) Each patient shall be provided with the following furnishings which shall be convenient to the patient:
(a) Bedside stand with a drawer.
(b) Towel rack. A towel rack in an existing private bathroom satisfies this requirement.
(c) A comfortable chair.
(d) At least two dresser drawers in a chest of drawers.
(e) Enclosed space for hanging clothing.
(f) Wall mirror in each room (unless contraindicated by physician's order).
(g) Bedside lamp or other directional light source for patient reading or bedside care, or both.
(5) Windows shall be provided with shades or draperies adequate to control glare and maintain privacy.
(6) Each living room for patients' use shall be provided with a sufficient number of reading lamps, tables, and comfortable chairs or sofas.
(7) In new construction each patient's room shall be provided with a lavatory with both hot and cold running water unless private toilet or bathroom facilities are connected to the bedroom.
(8) There shall be at least one bathtub or shower, or bathing device (approved by the Department), in a separate room or compartment for each 12 beds. The compartment shall be large enough to accommodate wheelchair and attendant.
(9) There shall be at least one toilet room on each floor large enough to accommodate wheelchair and attendant, to permit toilet assistance or training.
Agency Note: If the toilet facilities described above are provided in private patient toilet rooms, a separate toilet room on every floor will not be required. An inter-connecting bathroom may not be considered a private bath.
(10) For each eight beds there shall be at least one toilet enclosed in a separate room or stall.
(11) There shall be one lavatory for every four beds.
(12) For handwashing purposes there shall be a towel dispenser and a supply of paper towels and soap dispenser adjacent to all lavatories.
(13) Bedpans, Urinals, and Basins--New and Existing Facilities.
(a) Each floor of the facility shall be equipped with equipment, approved by the Department, to clean and sanitize bedpans, urinals, and basins.
(b) Common-use pans and urinals shall be cleaned and sanitized after each patient use (sanitization by heat, chemicals, gas, or other means approved by the Department).
(c) Disposable pans and urinals shall be cleaned and sanitized when needed or at least weekly; they shall be discarded when damaged or no longer in cleanable condition. Disposable pans, even though sanitized, may not be transferred from one patient to another.
(d) Pans and urinals used in isolation cases shall be sterilized by approved methods.
E. Body Holding Room--New and Existing Facilities. In a new facility, if a body holding room is provided, it shall be located to facilitate quiet and unobtrusive ingress and egress of bodies, convenient to the elevator and with an isolated exit. If a body holding room is not provided, a holding area shall be designated which approximates the above conditions.
Agency Note: Existing facilities shall provide a method for holding which minimizes the psychological effect on other patients in the home.
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