W. Va. Code R. § 69-9-6

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 69-9-6 - PHYSICAL FACILITY

6.1. Facility Construction and Renovation.

6.1.a. Before construction or extensive renovation of a neonatal abstinence syndrome center begins, the program sponsor shall submit for approval a complete set of plans for the project to the state oversight agency.

6.1.b. The plans shall include the drawings and specification for the architectural, structural, and mechanical design for the construction or renovation.

6.1.c. The state oversight agency shall advise the program sponsor in writing delivered by regular mail whether approval has been granted within 30 days from the date of receipt of the plans.

6.1.d. In the event the plans for the project are not approved, the state oversight agency shall set forth in writing the reasons for the disapproval and provide the program sponsor the opportunity to correct any deficiencies.

6.1.e. Construction or extensive renovation of a facility may not begin until the Secretary has issued final approval of the plans in writing delivered by regular mail.

6.1.f. All centers must meet all other requirements of applicable federal or state regulatory oversight agencies.

6.2. Facility Security Requirements.

6.2.a. Only persons who are employed by the neonatal abstinence syndrome center, volunteers, patients, parents, legal representatives, or other persons designated as approved contractors or visitors are permitted entrance to the neonatal abstinence syndrome center.

6.2.b. All employees and volunteers must wear an identity badge with a picture and first name listed while on the premises;

6.2.c. All doors providing entrance and exit to the center and secure areas of the center must use mechanical and/or electronic locking mechanisms to best ensure the safety of the patients and staff;

6.2.d. Visitation hours must be established by the center for all visitors other than parents and/or the legal representative;

6.2.e. All visitors must present valid government-issued photo identification to be permitted entrance into the facility;

6.2.f. Facilities must have policies and procedures addressing what visitors may or may not bring into the center;

6.2.g. Visitors are not permitted in any area of the facility not specifically identified for visitors; and

6.2.h. Visitors are not permitted to be in any area of the facility without an escort.

6.3. Service Environment.

6.3.a. The center shall ensure all patients have the necessities to meet their basic daily needs.

6.3.b. The center shall provide each patient with a nursery room including at a minimum, a baby bed and a rocking chair to accommodate his or her individual needs.

6.3.c. The center shall provide adequate storage space to accommodate clothing and personal items.

6.3.d. The facility shall have a sprinkler system in accordance with state fire marshal requirements.

6.3.e. The facility shall have a fire alarm system installed in accordance with state fire marshal requirements.

6.3.f. The center shall ensure the basic needs of the patient are consistently met.

6.3.g. The center shall ensure the overall environment is clean, pleasant in appearance, and conducive to the development and treatment of the patient.

6.3.h. All temporary walls or items being used as physical barriers shall be firmly anchored so they pose no threat to the safety of the patient, personnel, or visitors.

6.3.i. The center shall ensure no strings, cords and hanging items are of no threat to the patients.

6.4. Laundry and Linens.

6.4.a. The center shall have written policies for handling, storing, processing, and transporting linens and other laundered goods in a manner to prevent the spread of infection.

6.4.b. The soiled linen room shall be one hour fire rated, have negative air that discharges directly to the outside, and have a hand wash sink in the room.

6.4.c. The center shall provide clean waterproof mattresses or mattress covers that are non-absorbent.

6.4.d. Sufficient supplies shall be available to center personnel to assure the cleanliness and comfort of each patient.

6.4.e. The center shall provide each patient with individual towels, wash cloths, and bedding.

6.5. Nursing Equipment and Sterile Supplies.

6.5.a. The center shall have the sufficient quantity and type of nursing equipment to meet the individual care needs for each patient.

6.5.b. All electrical patient care equipment shall be maintained, inspected and tested in accordance with the manufacture recommendations, and the applicable sections of the "National Fire Protection Association NFPA 99 Standard for Health Care Facilities."

6.5.c. The generator and all life safety and critical branch electrical circuits shall comply with the standards as identified in the "National Fire Protection Association NFPA 99 Standard for Health Care Facilities."

6.5.d. All equipment shall be maintained in accordance with the provisions of this rule.

6.5.e. Clean nursing equipment and sterile supplies shall be stored in a clean work room or store room that does not permit patient or visitor access.

6.5.f Sterile supplies shall not be stored under sink drains, in soiled utility rooms or in areas where contamination may occur.

6.5.g. Sterile supplies shall not be stored nor used beyond their dated shelf life.

6.5.h. Damaged supplies and utensils shall not be used, and shall be disposed of properly.

6.6. Housekeeping and Maintenance.

6.6.a. The facility shall be constructed, maintained and equipped to protect the health and safety of patients, personnel, and the public.

6.6.b. The center shall establish and implement a maintenance program that assures that:

6.6.b.1. All equipment is operable and in a safe working condition;

6.6.b.2. The interior and exterior of the building is safe; and

6.6.b.3. The grounds are maintained in a presentable condition free from rubbish and other health hazards of a similar nature.

6.6.c. The center shall establish and implement a housekeeping program and services that assures a clean, sanitary environment.

6.6.d. The center shall be kept free of insects, rodents and vermin by an effective pest control program.

6.6.e. Pesticides shall be applied only by an applicator certified by the West Virginia Department of Agriculture.

6.6.f. The center shall have sufficient supplies for housekeeping and maintenance properly stored and conveniently located to permit frequent cleaning of floors, walls, woodwork, windows, and screens, and to facilitate building and grounds maintenance. These supplies shall be stored in such a way as to prevent contact with patients or visitors.

6.7. Storage of Supplies.

6.7.a. All cleaning and maintenance supplies must be kept in their original package or container with their labels intact.

6.7.b. All cleaning and maintenance supplies must be kept sealed and locked in an area separate from patient care areas.

6.7.c. All cleaning and maintenance supplies must be used according to the manufacturer's instructions.

6.8. Construction, Additions, Renovations, and Other Standards.

6.8.a. The center shall be located within fifteen minutes of a hospital.

6.8.b. The center shall comply with the most current edition of the National Fire Protection Association (NFPA) standards for limited health care facilities.

6.8.c. The center shall comply with the most current edition of the state building code.

6.8.d. The center shall comply with all applicable provisions of the Americans with Disabilities Act (ADA).

6.8.e. The center shall submit a complete set of architectural, structural, and mechanical drawings, drawn to scale not less than one-eighth inch equals one foot, and shall be approved by the Director before construction begins.

6.8.e.1. This requirement applies to new construction, additions, renovations, or alterations to an existing center.

6.8.e.2. This requirement applies to alterations, renovations, and equipment modifications or additions which may necessitate changes to the center's floor plan, impact on safety, or require the services of a design professional

6.8.e.3. The Director shall approval all plans prior to beginning construction.

6.8.e.4. The submitted drawing and specifications shall be prepared, signed, and sealed by a person registered to practice architecture in the state of West Virginia.

6.8.e.5. The project shall be inspected during the construction phase by a registered professional architect or his or her representative.

6.8.e.6. The requirement for a registered architect may be waived by the Director depending on the scope of the project.

6.8.e.7. The center shall submit complete architectural drawings and specifications for any alterations, renovations, and equipment modifications or additions which may necessitate changes to the center's floor plan, impact on safety, or require the services of a design professional, and shall be approved by the Director prior to beginning any construction.

6.8.e.8. Minor renovations that do not alter floor plans, impact on safety or require the services of a design professional may not require approval of the Director.

6.8.e.9. A performance statement shall be obtained by the owner from the builder and design professional of a proposed center stating the builder has followed the plans which are on file with and approved by the Director.

6.8.f. All new facilities, additions, and alterations shall be inspected by the Director and shall have the Director's approval in writing prior to admitting patients.

6.8.g. The center shall request in writing a pre-opening inspection no less than thirty (30) days prior to the proposed opening date.

6.8.h. Unless substantial construction is started within one year of the date of approval of final drawings, the owner or architect shall secure written notification from the Director that the plan approval for construction is still valid and in compliance with this rule.

6.9. Site Characteristics.

6.9.a. Sites for all centers and sites for additions to existing centers shall be inspected by the Director prior to site development and the completion of final drawings and specifications.

6.9.b. The site shall be located in an environment that is free from flooding and excessive noise.

6.9.c. The site shall not be exposed to excessive smoke, foul odors or dust.

6.9.d. The site shall have good drainage, approved sewage disposal, an approved potable water supply, electricity, telephone and other necessary utilities available on or near the site.

6.9.e. The site shall be accessible to physicians, emergency services and other necessary services.

6.9.f Accessibility and transportation to the site and the center shall be facilitated by paved, hard surfaced, all weather roads which are kept passable at all times.

6.9.g. The road shall connect directly to a paved hard surface highway.

6.9.h. Grades to all sites shall permit access for emergency vehicles and firefighting equipment in all weather conditions.

6.9.i. Parking areas shall be sufficient according to the latest edition of the Guidelines for Design and Construction of Health Care Facilities according to the Facilities Guidelines Institute and published by the American Society for Healthcare Engineering at http://fgiguidelines.org/

6.9.J. Local building codes and zoning restrictions shall be followed.

6.9.k. The owner, or his or her designee, shall maintain documentation certifying compliance signed by local fire, building and zoning officials, and this documentation shall be available for review.

6.9.l. Bed capacity may only be increased after the Director has determined the center's physical facilities will support the increase and there is compliance with other requirements, including certificate of need requirements.

6.10. hifection Control.

6.10.a. The neonatal abstinence syndrome center shall establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of disease and infection.

6.10.b. The center shall establish and implement an infection control program to:

6.10.b.1. Investigate, control, and prevent infection in the center;

6.10.b.2. Determine what procedures, such as isolation, shall be applied to a patient, and only to the extent required to protect the patient and others; and

6.10.b.3. Maintain a record of incidents, investigations, and corrective actions related to infections. This record shall provide analysis of causal factors and identification of preventative actions to be implemented.

6.10.c. The center shall prohibit employees, volunteer and contracted personnel with a communicable disease or infected skin lesions from direct contact with patients and their food, if direct contact will transmit the disease.

6.10.d. The center shall require staff to wash or sanitize their hands after each direct contact and after engaging in any activity for which hand washing or sanitizing is indicated by accepted standards of professional practice.

6.10.e. Personnel shall handle, store, process and transport linens in order to prevent the spread of infection.

6.10.f hifections, including culture results, shall be reported to applicable county health departments according to local, county or state laws, rules, and regulations.

6.11. Solid Waste and Bio-Hazard Waste Disposal.

6.11.a The center shall have procedures and contracts for disposing of bio-hazardous waste.

6.11.b Chain of custody receipts and forms shall be maintained by the center for one year.

6.11.c. The center shall have procedures for disposing of non-hazardous medical waste and similar waste that is not considered hazardous in a safe sanitary manner.

6.11.d. Solid waste, including garbage and refuse, shall be removed from the building daily or more often as necessary.

6.11.e. All garbage and refiise shall be stored in durable, covered, leak-proof and vermin-proof containers or dumpsters.

6.11.f. The containers and dumpsters shall be kept clean of all residue accumulation.

6.11.g. All garbage and refiise shall be disposed of in accordance with the applicable provisions of state and local law and rules governing the management of garbage and refuse.

6.12. Water Supply.

6.12.a. The facility shall have a water supply that is safe and of sufficient capacity to meet the patients' needs and the requirements of the sprinkler system.

6.12.b. The facility shall have as its source of water, a public water system that complies with West Virginia Division of Health Rules, Public Water Systems, 64CSR3, or water well that complies with West Virginia Division of Health Rules, Water Well Regulations, 64CSR19 and Water Well Design Standards, 64CSR46.

6.12.c. The facility shall have hot and cold running water in sufficient supply to meet the needs of the patients.

6.12.d. Hot water distribution systems serving patient care areas shall be recirculating to provide continuous hot water at each hot water outlet.

6.12.e. The temperatures shall be appropriate for comfortable use but shall not exceed 110 degrees Fahrenheit.

6.12.f. The center shall have written agreements with water suppliers to deliver water when there is a loss of the normal supply.

6.13. Sewage Disposal.

6.13.a. Sewage disposal shall be in accordance with West Virginia Division of Health Rules, Sewage System Rules, 64CSR9, and West Virginia Division of Health Rules, Sewage Treatment and Collection System Design Standards, 64CSR47.

6.13.b. The sewage system shall be adequate to meet the center's needs.

6.13.c. Sewage systems shall be kept in good working order and shall be properly operated and maintained.

6.14. Fire Safety, Disaster and Emergency Preparedness.

6.14.a. The administrator shall provide evidence of the center's compliance with applicable rules of the State Fire Commission.

6.14.b. Any variation to compliance with the fire code shall be coordinated with the state oversight agency and approved in writing by the State Fire Marshal.

6.14.c. The center shall have a written internal and external disaster and emergency preparedness plan approved by the Director that sets forth procedures to be followed in the event of an internal or external disaster or emergency that could severely affect the operation of the center.

6.14.d. The disaster and emergency preparedness plan shall have procedures to be followed in the event of the following: fire, missing patient, high winds, tornadoes, bomb threats, utility failure, flood and severe winter weather.

6.14.e. The disaster and emergency preparedness plan shall include at least an alternate shelter agreement, an emergency transportation policy, and an emergency food supply list that will provide nutrition for all patients residing in the center for a minimum 72 hours.

6.14.f. The disaster and emergency preparedness plan shall be developed and maintained with the assistance of qualified fire safety and other emergency response teams.

6.14.g. There shall be copies of the disaster and emergency preparedness plan at all staff stations or emergency control stations.

6.14.h. The disaster and emergency preparedness plan shall be located in an area that allows visual contact at all times. The center staff shall know the location of the plan at all times.

6.14.i The local fire department shall be provided with a floor and disaster plan and be given opportunities to become familiar with the center.

6.14.j. The center shall have a written plan and procedures for transferring casualties and uninjured patients.

6.14.k. These procedures shall include the transfer of pertinent patient records including identification information, diagnoses, allergies, advance directives, medications and treatments, and other records needed to ensure continuity of care.

6.14.l. The center shall have written instructions regarding the location and use of alarm systems, signals and firefighting equipment.

6.14.m. The center shall have information regarding methods of fire containment.

6.14.n. The center shall have written instructions regarding accessibility for evacuation routes.

6.14.o. The disaster and emergency preparedness plan shall be reviewed and updated by the administrator or his or her designee on an annual basis and signed and dated by the administrator or his or her designee to verify the plan was reviewed.

6.14.p. Emergency call information shall be conspicuously posted near each telephone in the center, exclusive of telephones in patient rooms. This information shall include at least the telephone numbers of the fire department, the police, and ambulance service and other appropriate emergency services; and key personnel telephone numbers, including at least the following:

6.14.p.1. The administrator;

6.14.p.2. The Director of Nursing or the registered professional nurse on duty;

6.14.p.3. The maintenance director or safety director;

6.14.p.4. The physician on-site or on-call; and

6.14.p.5. Other appropriate personnel.

6.14.q. The center shall have at least one non-coin operated telephone or one extension on each distinct unit, section or wing of the center and additional telephones and extensions if needed to summon help in case of an emergency.

6.14.r. The facility shall include an area of sufficient space to hold the congregate population with a heat source that is supplied with emergency electrical power from the emergency power source.

6.14.s. The center shall operate an internal disaster preparedness program that includes orientation and ongoing training and drills in procedures and specific assignments.

6.14.t. The internal disaster plan shall be rehearsed at least annually.

6.14.u. Fire drills shall be held at least quarterly for each shift.

6.14.v. The center shall keep on file for at least two years, a dated written report and an evaluation of each disaster rehearsal and fire drill conducted on the premises.

W. Va. Code R. § 69-9-6