Ariz. Admin. Code § 9-10-324

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-10-324 - Physical Plant Standards

A. An administrator shall ensure that the premises and equipment are sufficient to accommodate:

1. The services stated in the behavioral health inpatient facility's scope of services, and

2. An individual accepted as a patient by the behavioral health inpatient facility.

B. An administrator shall ensure that:

1. A behavioral health inpatient facility has a:

a. Waiting area with seating for patients and visitors;

b. Room that provides privacy for a patient to receive treatment or visitors; and

c. Common area and a dining area that:

i. Are not converted, partitioned, or otherwise used as a sleeping area; and

ii. Contain furniture and materials to accommodate the recreational and socialization needs of the patients and other individuals in the behavioral health inpatient facility;

2. A bathroom is available for use by visitors during the behavioral health inpatient facility's hours of operation and:

a. Provides privacy; and

b. Contains:

i. A working sink with running water,

ii. A working toilet that flushes and has a seat,

iii. Toilet tissue,

iv. Soap for hand washing,

v. Paper towels or a mechanical air hand dryer,

vi. Lighting, and

vii. A window that opens or another means of ventilation;

3. For every six patients, there is at least one working toilet that flushes and has a seat and one sink with running water;

4. For every eight patients, there is at least one working bathtub or shower with a slip-resistant surface;

5. A patient bathroom complies with the following:

a. Provides privacy when in use;

b. Contains:

i. A shatterproof mirror, unless the patient's treatment plan requires otherwise;

ii. A window that opens or another means of ventilation; and

iii. Nonporous surfaces for shower enclosures and slip-resistant surfaces in tubs and showers;

c. Has plumbing, piping, ductwork, or other potentially hazardous elements concealed above a ceiling;

d. If the bathroom or shower area has a door, the door swings outward to allow for staff emergency access;

e. If grab bars for the toilet and tub or shower or other assistive devices are identified in the patient's treatment plan, has grab bars or other assistive devices to provide for patient safety;

f. If a grab bar is provided, has the space between the grab bar and the wall filled to prevent a cord being tied around the grab bar;

g. Does not contain a towel bar, a shower curtain rod, or a lever handle that is not a specifically designed anti-ligature lever handle;

h. Has tamper-resistant lighting fixtures, sprinkler heads, and electrical outlets; and

i. For a bathroom with a sprinkler head where a patient is not supervised while the patient is in the bathroom, has a sprinkler head that is recessed or designed to minimize patient access;

6. If a patient bathroom door locks from the inside, an employee has a key and access to the bathroom;

7. Each patient is provided a bedroom for sleeping;

8. A patient bedroom complies with the following:

a. Is not used as a common area;

b. Is not used as a passageway to another bedroom or bathroom unless the bathroom is for the exclusive use of a patient occupying the bedroom;

c. Contains a door that opens into a hallway, common area, or outdoors and, except as provided in subsection (E), another means of egress;

d. Is constructed and furnished to provide unimpeded access to the door;

e. Has window or door covers that provide patient privacy;

f. Has floor to ceiling walls:

g. Is a:

i. Private bedroom that contains at least 60 square feet of floor space, not including the closet; or

ii. Shared bedroom that:

(1) Is shared by no more than four patients;

(2) Contains, except as provided in subsection (B)(9), at least 60 square feet of floor space, not including a closet, for each patient occupying the bedroom; and

(3) Provides sufficient space between beds to ensure that a patient has unobstructed access to the bedroom door;

h. Contains for each patient occupying the bedroom:

i. A bed that is: at least 36 inches wide and at least 72 inches long, and consists of at least a frame and mattress and linens that is not a threat to health and safety; and

ii. Individual storage space for personnel effects and clothing such as shelves, a dresser, or chest of drawers;

i. Has clean linen for each bed including mattress pad, sheets large enough to tuck under the mattress, pillows, pillow cases, bedspread, waterproof mattress covers as needed, and blankets to ensure warmth and comfort for each patient;

j. Has sufficient lighting for a patient occupying the bedroom to read; and

k. If applicable, has a drawer pull that is recessed to eliminate the possibility of use as a tie-off point;

9. If a behavioral health inpatient facility licensed before November 1, 2003 was approved for 50 square feet of floor space for each patient in a bedroom, ensure that the bedroom contains at least 50 square feet for each patient not including the closet;

10. In a patient bathroom or a patient bedroom:

a. The ceiling is secured from access or at least 9 feet in height; and

b. A ventilation grille is:

i. Secured and has perforations that are too small to use as a tie-off point, or

ii. Of sufficient height to prevent patient access;

11. For a door located in an area of the behavioral health inpatient facility that is accessible to patients:

a. A door closing device, if used on a patient bedroom door, is mounted on the public side of the door;

b. A door's hinges are designed to minimize points for hanging;

c. Except for a door lever handle that contains specifically designed anti-ligature hardware, a door lever handle points downward when in the latched or unlatched position; and

d. Hardware has tamper-resistant fasteners; and

12. A window located in an area of the behavioral health inpatient facility that is accessible to patients is fabricated with laminated safety glass or protected by polycarbonate, laminate, or safety screens.

C. An administrator of a licensed behavioral health inpatient facility may submit a request, in a Department-provided format, for additional time to comply with a physical plant requirement in subsection (B)(5)(c) through (B)(5)(i), (B)(10), (B)(11), or (B)(12) that includes:

1. The rule citation for the specific plant requirement,

2. The current physical plant condition that does not comply with the physical plant requirement,

3. How the current physical plant condition will be changed to comply with the physical plant requirement,

4. Estimated completion date of the identified physical plant change, and

5. Specific actions taken to ensure the health and safety of a patient until the physical plant requirement is met.

D. When the Department receives a request for additional time to comply with a physical plant requirement in subsection (B)(5)(c) through (B)(5)(i), (B)(10), (B)(11), or (B)(12) submitted according to subsection (C), the Department may approve the request for up to 24 months after the effective date of these rules based on:

1. The behavioral health inpatient facility's scope of services,

2. The expected patient acuity based on the behavioral health inpatient facility's scope of services,

3. The specific physical plant requirement in the request, and

4. The threat to patients' health and safety.

E. A bedroom in a behavioral health inpatient facility is not required to have a second means of egress if:

1. An administrator ensures that policies and procedures are established, documented, and implemented that provide for the safe evacuation of a patient in the bedroom based on the patient's physical and mental limitations and the location of the bedroom; or

2. The building where the bedroom is located has a fire alarm system and a sprinkler system required in R9-10-322(A)(1).

F. If a swimming pool is located on the premises, an administrator shall ensure that:

1. The swimming pool is enclosed by a wall or fence that:

a. Is at least five feet in height as measured on the exterior of the wall or fence;

b. Has no vertical openings greater that four inches across;

c. Has no horizontal openings, except as described in subsection (F)(1)(e);

d. Is not chain-link;

e. Does not have a space between the ground and the bottom fence rail that exceeds four inches in height; and

f. Has a self-closing, self-latching gate that:

i. Opens away from the swimming pool,

ii. Has a latch located at least 54 inches from the ground, and iii. Is locked when the swimming pool is not in use; and

2. A life preserver or shepherd's crook is available and accessible in the pool area.

G. An administrator shall ensure that a spa that is not enclosed by a wall or fence as described in subsection (F)(1) is covered and locked when not in use.

Ariz. Admin. Code § R9-10-324

Section R9-10-324, formerly numbered as R9-10-235, renumbered as an emergency effective February 22, 1979, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 79-1). Adopted effective June 14, 1979 (Supp. 79-3). Former Section R9-10-324 repealed, new Section R9-10-324 adopted effective February 4, 1981 (Supp. 81-1). Section repealed by final rulemaking at 8 A.A.R. 2785, effective October 1, 2002 (Supp. 02-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by final rulemaking at 25 A.A.R. 1583, effective 10/1/2019.